Nonsurgical Home Treatment of Middle Ear Effusion and Associated Hearing loss in Children. Part II: Validation Study
Nonsurgical Home Treatment of Middle Ear Effusion and Associated Hearing loss in Children. Part II: Validation Study
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儿童中耳积液和相关听力损失的非手术家庭治疗。
DOI：
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发表时间：
2005
期刊：
影响因子：
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通讯作者：
M. Emmer
中科院分区：
文献类型：
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作者：
S. Silman;D. Arick;M. Emmer
在这项前瞻性随访调查中，我们研究了一种改良的Politzer装置在家庭治疗持续性中耳积液（MEE）和相关听力损失的效果，这些儿童之前参加过类似的临床试验。我们的研究组由38名患者组成，他们是(1)在之前的研究中未经治疗的对照组参与者，他们的一只或两只耳朵的听力在他们最初的听力学预测后的11周内没有恢复正常(“前对照组”；N = 30)，或(2)在先前研究中积极治疗的参与者，治疗后至少一只耳朵的听力敏感性未改善到正常范围内，并选择继续治疗（“延长治疗组”；N - 8）。通过比较治疗前后空气传导阈值和耳镜检查结果的差异来确定治疗效果。治疗后，前对照组在所有频率的听力敏感性均有显著改善；在治疗后的测试中，60只耳中有43只（71.7%）的听力灵敏度在正常范围内，34只耳镜检查的耳朵中有30只（88.2%）的鼓膜正常或中度活动。延长治疗组10只受损耳中有9只听力恢复正常（90.0%）。这些发现进一步证实了我们改良的Politzer装置在改善MEE患儿中耳功能和听力敏感性方面的有效性，并支持了我们之前研究结果的可靠性。这些结果还表明，许多最初治疗不成功的患者可能会从延长治疗中受益。
In this prospective follow-up investigation, we examined the efficacy of a modified Politzer device in the home treatment of persistent middle ear effusion (MEE) and associated hearing loss in children who had previously participated in a similar clinical trial. Our study group was made up of 38 patients who had been either (1) untreated control participants in the previous study whose hearing in one or both ears had not returned to normal within 11 weeks of their initial audiologic pretest (“former control group”; n = 30), or (2) active-treatment participants in the previous study whose hearing sensitivity in at least one ear had not improved to within normal limits after treatment and who elected to undergo a continuation of treatment (“extended-treatment group”; n — 8). Treatment efficacy was determined by comparing differences in pre- and posttreatment air-conduction thresholds and otoscopic findings. Following treatment, the former control group experienced significant improvements in hearing sensitivity at all frequencies; at the posttreatment test, hearing sensitivity was within normal limits in 43 of 60 ears (71.7%), and normal or moderate tympanic membrane mobility was observed in 30 of 34 otoscopically examined ears (88.2%). In the extended-treatment group, hearing sensitivity returned to within normal limits in 9 of 10 impaired ears (90.0%). These findings further substantiate the efficacy of our modified Politzer device in improving middle ear function and hearing sensitivity in children with MEE, and they support the reliability of the findings reported in our previous study. These results also indicate that many patients in whom initial treatment is not successful may benefit from extended treatment.