摘要
目的:通过评价咽鼓管球囊扩张及鼓膜置管治疗儿童复发性分泌性中耳炎(OME)的近期及远期疗效,为儿童OME的治疗提供新思路。方法:回顾性分析29例行咽鼓管球囊扩张及鼓膜置管的OME患儿资料,记录其病史,既往鼓膜置管和(或)腺样体切除史,术前听力及咽鼓管功能,术后1、6、9、12、18、24、36个月纯音测听阈值及咽鼓管功能主客观评价,评估术后咽鼓管功能恢复情况以及OME的预后。结果:29例患儿术后1、6、9、12、18、24、36个月纯音测听平均听阈分别为17.5、22.5、18.5、22.5、18.5、22.5、22.5 dBnHL,所有患儿术后随访期间纯音测听阈值均达正常水平。术前咽鼓管评分(ETS)为(2.404±2.618)分,术后1个月为(4.064±3.003)分,术后6个月为(5.230±2.790)分,术后9个月为(5.787±2.170)分,术后12个月为(6.490±2.292)分,术后与术前相比差异有统计学意义(P<0.01)。结论:咽鼓管球囊扩张术治疗儿童OME安全可靠,其疗效在术后9个月稳定体现,对于合并咽鼓管功能不良的OME患儿建议同期行咽鼓管球囊扩张及鼓膜切开置管术,并于术后12个月拔除鼓膜通气管,避免中耳积液复发,降低再次置管风险。
Objective:To evaluate the short-term and long-term efficacy of balloon dilatation Eustachian tuboplasty(BET)and insertion of tympanostomy tubes in the treatment of recurrent otitis media with effusion(OME)in children,and to provide new ideas for the treatment of OME.Method:We made a retrospective analysis of 29 OME patients who had accepted BET and insertion of tympanostomy tubes in Beijing Children’s Hospital.Their case history,the past history of insertion of tympanostomy tubes or adenoidectomy,and the audiometry and Eustachian tube function before surgery and 1 month,6 months,9 months,12 months,18 months,24 months and 36 months after surgery were recorded.Statistical software was used to evaluate the recovery of Eustachian tube function and the prognosis of OME.Result:The average pure tone audiometry(PTA)of 29 patients was 17.5,22.5,18.5,22.5,18.5,22.5,22.5 dB at 1 month,6 months,9 months,12 months,18 months,24 months and 36 months postoperatively.All the 29 patients’PTA was normal.ETS before surgery was 2.404±2.168.ETS of 1 month,6 months,9 months and 12 months after surgery was 4.064±3.003,5.230±2.790,5.787±2.170,6.490±2.292 respectively.There was significant difference between preoperative and postoperative(P<0.01).Conclusion:BET was a safe and reliable surgery for the treatment of OME in children.Its obvious effect was manifested at least 9 months after surgery.Therefore,tympanostomy tubes and BET were recommended doing at the same time for the treatment of OME with eustachian tube dysfunction.At the same time,in order to decrease the risk of recurrent OME,we recommended to take the tubes out until 12 months after surgery.
作者
刘薇
陈敏
郝津生
刘冰
杨扬
邵剑波
张杰
LIU Wei;CHEN Min;HAO Jinsheng;LIU Bing;YANG Yang;SHAO Jianbo;ZHANG Jie(Department of Otolaryngology Head and Neck Surgery,Beijing Children's Hospital,Capital Medical University,National Center for Children's Health,Beijing,100045,China)
出处
《临床耳鼻咽喉头颈外科杂志》
CAS
北大核心
2020年第3期210-214,共5页
Journal of Clinical Otorhinolaryngology Head And Neck Surgery
基金
北京市医院管理中心儿科学科协同发展中心专项经费资助(No:XTYB201828)
首都卫生发展科研专项重点攻关项目(No:2016-1-5014)。
关键词
中耳炎
伴渗出液
咽鼓管球囊扩张
鼓膜置管
otitis media with effusion
balloon dilatation Eustachian tuboplasty
tympanostomy tubes
