Pediatric endoscopic ear surgery in clinical practice: Lessons learned and early outcomes
Pediatric endoscopic ear surgery in clinical practice: Lessons learned and early outcomes
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DOI：
10.1002/lary.25410
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发表时间：
2016-03-01
期刊：
影响因子：
2.6
通讯作者：
Lee, Daniel J.
中科院分区：
文献类型：
--
作者：
Cohen, Michael S.;Landegger, Lukas D.;Lee, Daniel J.
目的/假设只有少数报告描述了儿童慢性耳部疾病内镜耳手术（EES）的结局。我们区分经鼻内镜耳手术（TEES），其中的情况下，只进行内窥镜可视化，从非TEES，其中的内窥镜根本不使用或作为辅助显微镜。我们假设，在大多数情况下，EES是使用经肛入路管理中耳病变的有效方法，并且可以纳入儿科耳科实践，对结局产生中性或积极影响。在此过程中吸取的教训进行了分析和discussed.Study设计单机构，回顾性图表审查的结果后TEES和非TEES在儿童从2013年1月1日至2014.MethodsProcedures包括鼓室成形术，听骨成形术，和中耳乳突切除术。主要结果指标包括鼓膜穿孔的闭合率、听力测定结果和并发症。手术时间作为次要measures.Results94例患者进行了121中耳手术。在51/121例病例（42.1%）中进行了TEES。TEES与非TEES病例的比较显示鼓室成形术闭合率无显著差异（P> 0.99）。TEES鼓室成形术后的平均纯音改善为-7.8 dB，而非TEES病例为-1.33 dB（P=.03）。手术时间组之间是相似的。ConclusionsEES技术很容易纳入小儿耳科实践。标准化的EES分类系统对于分析机构间的利用模式和结果非常有用。鼓膜闭合率和听力结果在TEES和非TEES病例中相似。
Objectives/HypothesisOnly a few reports describe the outcomes following endoscopic ear surgery (EES) in children for chronic ear disease. We differentiate between transcanal endoscopic ear surgery (TEES), where the case is performed with only endoscopic visualization, from non-TEES, where the endoscope is not used at all or used as an adjunct to the microscope. We hypothesize that EES is an effective approach to manage middle ear pathology using a transcanal approach in most cases, and can be incorporated into a pediatric otology practice with a neutral or positive effect on outcomes. Lessons learned during this process are analyzed and discussed.Study DesignSingle-institution, retrospective chart review of outcomes following TEES and non-TEES in children from January 1, 2013 through July 1, 2014.MethodsProcedures included tympanoplasty, ossiculoplasty, and cholesteatoma resection. Primary outcome measures included closure rate of tympanic membrane perforations, audiometric outcomes, and complications. Surgical times were reported as secondary measures.ResultsNinety-four patients underwent 121 middle ear procedures. TEES was performed in 51/121 of cases (42.1%). Comparison of TEES versus non-TEES cases showed no significant difference in rate of tympanoplasty closure (P>.99). The mean pure-tone improvement following TEES tympanoplasty was -7.8 dB versus -1.33 dB for non-TEES cases (P=.03). Surgical times were similar between groups.ConclusionsEES techniques were readily incorporated into a pediatric otology practice. A standardized EES classification system is useful for analyzing utilization patterns and results across institutions. Tympanic membrane closure rates and hearing outcomes were similar in TEES and non-TEES cases.