Ventilation tubes in secretory otitis media. A randomized, controlled study of the course, the complications, and the sequelae of ventilation tubes.
Ventilation tubes in secretory otitis media. A randomized, controlled study of the course, the complications, and the sequelae of ventilation tubes.
复制标题
分泌性中耳炎的通气管。
DOI：
10.3109/00016488309105586
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发表时间：
1983
期刊：
影响因子：
--
通讯作者：
T. Lildholdt
中科院分区：
文献类型：
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作者：
T. Lildholdt
这项研究的目的是评估通风管在治疗主要分泌性中耳炎病例中的使用。选择双侧病例，并在一个耳朵中插入一个管，而另一只耳朵完好无损。对所有儿童进行腺样体切除术，扁桃体切除术在34％的病例中进行。在1976 - 1979年期间，总共包括150名儿童（平均年龄= 3.9岁），每3-6个月进行一次检查。随访率为89.3％。 5年后评估每个人的状况，平均观察期为3。2年。来自两种类型的耳朵的鼓膜法和听力计的结果平均相似。在17％的病例中进行了重复手术，后来的耳鼻镜检查显示这些耳膜的萎缩发生率更高（P小于0.01）。手术后2个月或更长时间，在25％的耳朵的25％的耳朵中发现了一个化脓时期；后来发现鼓膜硬化的发生率更高（p = 0.02）。在最终检查中，将20％的治疗耳膜通过耳鼻喉镜将其表征为“正常”，而完整的耳朵的83％相比之下。使用鼓膜测定法，听力法和耳镜检查估算每个耳朵的“最终结果”，并发现有利于完整耳朵的差异（P小于0.01）。对每个孩子的类似估计给出了一个结果，即31％的耳朵被归类为“病理”，而在9％的儿童中，这都是这种情况。接受初始扁桃体切除术的儿童表现出更严重的“最终结果”（P小于0.05）。可以得出结论，在初级分泌性中耳炎培养基儿童中使用通风管是没有道理的。观察结果表明，只有一小部分需要对中耳进行手术治疗。可以指示通风管以打击听力损失，但应牢记的是，其使用涉及并发症和后遗症的高风险，这可能导致慢性中耳病。
The purpose of this study has been to evaluate the use of ventilation tubes in the treatment of cases of primary secretory otitis media. Bilateral cases were selected and a tube inserted in one ear while the other ear was left intact. Adenoidectomy was performed on all children, tonsillectomy in 34% of the cases. A total of 150 children (mean age = 3.9 years) were included during the years 1976-1979 and check-ups performed every 3-6 months. The follow-up rate was 89.3%. The condition of each individual was assessed after a 5-year period, the mean period of observation was 3.2 years. The results of tympanometry and audiometry from the two types of ears were, on average, similar. Repeat operation was carried out in 17% of the cases and later otomicroscopy revealed a higher incidence of atrophy in these eardrums (p less than 0.01). A period of suppuration was noted in 25% of the ears with a ventilation tube, 2 months or more after operation; a higher incidence of tympanosclerosis was later found (p = 0.02). Twentythree per cent of the treated eardrums were characterized at the final check-up as "normal" by means of otomicroscopy, in contrast to 83% of the intact ears. The "end-result" of each ear was estimated using tympanometry, audiometry as well as otomicroscopy, and a difference in favour of the intact ears was found (p less than 0.01). A similar estimate for each child gave the result that 31% had one ear categorized as "pathological" while this was the case in both ears of 9% of the children. The children subjected to initial tonsillectomy showed a worse "end-result" (p less than 0.05). It is concluded that the use of ventilation tubes in children with primary secretory otitis media is not justified. Observation has shown that only a small proportion will require surgical treatment of the middle ear. A ventilation tube may be indicated in order to combat hearing loss, but it should be borne in mind that its use involves a high risk of complications and sequelae which may result in chronic middle ear disease.
DOI：
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发表时间：
1980
期刊：
The Annals of otology, rhinology & laryngology. Supplement
影响因子：
--
作者：
Schiff,M;Poliquin,JF;Catanzaro,A;Ryan,AF
通讯作者：
Ryan,AF