可视内窥镜下腺样体切除联合鼓膜置管术治疗儿童分泌性中耳炎

Adenoidectomy Combined with Grommet Insertion under Visual Endoscopy for the Treatment of Secretory Otitis Media in Children

【目的】观察可视内窥镜下腺样体切除术联合鼓膜置管术治疗儿童分泌性中耳炎的临床疗效。【方法】对本院96例（152耳）分泌性中耳炎并腺样体肥大患儿行可视内镜下腺样体切除和鼓膜切开置管术，观察治疗后有无并发症发生及临床疗效等情况。【结果]96例（152耳）患儿治愈80例，有效15例，无效1例。无效的1例发生于拔除通气管鼓膜愈合后1个月，再次手术切除加置管而愈。所有患儿获随访6～12个月。无中耳感染、出血，纯音测听平均为21．5dBHL，听阈平均提高25dBHL。复查电子鼻咽镜：鼻咽部创面光滑、无残留，咽鼓管咽口及圆枕无损伤。【结论】可视内窥镜下腺样体切除联合鼓膜置管术治疗儿童分泌性中耳炎疗效显著，是一种治疗儿童分泌性中耳炎并腺样体肥大安全有效的方法。

[Objective] To observe the clinical efficacy of adenoidectomy combined with grommet insertion under visual endoscopy for the treatment of children with secretory otitis media. EMethodsl Totally 96 pediatric patients（152 ears） with secretory otitis media and adenoid hypertrophy in our hospital underwent adenoidectomy combined with grommet insertion under visual endoscopy. The incidence of complications and clinical efficacy were observed after operation. [Resultsl Among 96 patients（152 ears）, 80 patients were cured in which 15 patients were effective and 1 patient was ineffective. One ineffective patient occurring 1 month after extubation of tympanostomy tube and eardrum healing was cured by the surgical resection and tube insertion again. All the patients were followed up for 6-12 months. No middle ear infections and bleeding were found. The average pure tone test was 21.5dBHL, and auditory threshold was increased by 25dBHL averagely. The reexamination by electronic nasopharyngeal endoscopy showed smooth nasopharyngeal wound, no residue and no injury of pharyngeal opening of auditory tube and torus. [ConclusionlAdenoidectomy combined with grom- met insertion under visual endoscopy for the treatment of children with secretory otitis media has obvious effi- cacy. Therefore it is a safe and effective method for the treatment of secretory otitis media and adenoid hypertrophy.