改良Valsalva法(玩具式自家鼓气吹鸣器)治疗分泌性中耳炎临床观察

The efficacy of modified Valsalva maneuverwith a toy autoinflated device in treatingsecretary otitis media with effusion

目的评估使用玩具式自家鼓气吹鸣器治疗分泌性中耳炎的疗效。方法24名分泌性中耳炎患儿采用改良Valsalva法行咽鼓管吹张,每日3次以上,持续2周后复查,行耳科检查及听力学评估,包括耳镜检查、声导抗及纯音测听,无效者继续3月;另23名同样患儿作为对照组。结果治疗组患儿68%骨气导差减至小于15dB,对照组为26%,治疗组患儿有62%其声导抗鼓室峰压值恢复正常(大于-100dapa),对照组有29%,统计学分析两组差异有显著性。结论玩具式自家吹鸣器进行改良Valsalva吹张治疗分泌性中耳炎是有效的,儿童使用时有浓厚兴趣,可作为一种治疗分泌性中耳炎的辅助器械。

Object To evaluate the efficacy of Valsalva maneuver with a toy autoinflated device in the treatment otitis media with effusion. Methods The 24 patients in the treated group were inflated their ears with the autoinflation device more than three times a day for two weeks. Additional 23 children with otitis media with effusion who were not treated with Valsalva maneuver served as controls. Both groups were then seen at half monthly intervals for pneumatic otoscopy, tympanometry and audiometric evaluation and this was repeated in the 3rd month. Result After 2 weeks of autoinflation, reversion of the average air-bone gap to within normal limits was achieved in 68% of the treated group,versus 26% of the controls; the tympanometric peak pressure shifted to normal in 62% of the treated group, compared with only 29% of the controls. Statistically significant improvement was seen in those using modified Valsalva maneuver group. Conclusion The modified Valsalva maneuver with the toy autoinflated device is efficient for children with OME. The device is scientifically designed with music sound and a adjustable pressure, so many children were interested in it and cured in the playing time. It has the potential to be an effective home treatment of otitis media with effusion that can be administered by parents of the sick children .