Eustachian tube function before recurrence of otitis media with effusion
Eustachian tube function before recurrence of otitis media with effusion
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DOI：
10.1001/archotol.131.2.118
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发表时间：
2005-02-01
影响因子：
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通讯作者：
Zielhuis, GA
中科院分区：
文献类型：
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作者：
Straetemans, M;van Heerbeek, N;Zielhuis, GA
目的：研究咽鼓管功能在接受鼓膜造口管治疗的儿童复发性渗出性中耳炎（OME）发展中的作用。设计：前瞻性队列研究。地点：三所学术医院和综合医院。患者：首次出现 OME 临床发作并持续至少 3 个月的 2 至 7 岁儿童； 168 名符合条件的儿童中有 136 名（81%）参加了。所有儿童在研究开始时均接受了用于双侧 OME 的鼓膜造口管。主要结果指标：管挤出后 6 个月内 OME 复发。结果：发生复发性 OME 的耳朵和未发生复发性 OME 的耳朵之间的咽鼓管功能测试结果不存在统计学显着差异。有和没有 CME 复发的耳朵之间被动通气功能的差异为 10 daPa（95% 置信区间，-24 至 43 daPa），开放压和关闭压力为 -3 daPa（95% 置信区间，-18 至 11 daPa）。无法平衡正负施加压力的有和没有 OME 复发的耳朵比例的总体差异为 12%（95% 置信区间，-2% 至 26%）。通过用力吸气引起中耳负压的有和没有 OME 复发的耳朵比例分别为 22% 和 31% (P = .75)。结论：使用用力反应测试、压力平衡测试和嗅测试测量通气和保护性咽鼓管功能对于预测儿童 CME 复发风险是否增加没有价值。
Objective: To study the role of eustachian tube function in the development of recurrent otitis media with effusion (OME) in children treated with tympanostomy tubes for OME. Design: Prospective cohort study.Setting: Three academic and general hospitals.Patients: Children aged 2 to 7 years with a first clinical episode of OME that persisted for at least 3 months; 136 (81%) of 168 eligible children participated. All children received tympanostomy tubes for bilateral OME at study entry.Main Outcome Measure: Recurrence of OME within 6 months of tube extrusion.Results: No statistically significant differences were present in eustachian tube function test results between ears that developed recurrent OME and those that did not.The difference in passive ventilatory function between ears with and without CME recurrence was 10 daPa (95% confidence interval, -24 to 43 daPa) for opening pressure and -3 daPa (95% confidence interval, -18 to 11 daPa) for closing pressure. The overall difference in the proportion of ears with and without OME recurrence that could not equilibrate positive and negative applied pressures was 12% (95% confidence interval, -2% to 26%). The proportions of ears with and without OME recurrence that induced negative pressure in the middle ear by forcefully sniffing were 22% and 31%, respectively (P = .75).Conclusion: Measurement of ventilatory and protective eustachian tube function using the forced response test, the pressure equilibration test, and the sniff test has no value in predicting whether children have an increased risk of CME recurrence.