腺样体切除联合耳内镜下鼓膜置管术治疗儿童分泌性中耳炎

Adenoidectomy with Eardrum Catheterization under Otoscope for the Treatment of Secretory Otitis Media in Children

目的观察腺样体切除联合耳内镜下鼓膜置管治疗儿童分泌性中耳炎的疗效,探讨耳内镜下鼓膜置管的优点。方法回顾性分析38例(66耳)腺样体肥大合并分泌性中耳炎儿童的临床资料,采用电动吸引切割法切除腺样体,并同期行耳内镜下鼓膜置管术。结果所有病例耳内镜下置管顺利,术后鼓室图A型57耳,C型9耳,其中,由B型转为A型42耳,由B型转为C型4耳;C型转为A型15耳,C型无变化5耳,平均听阈由41.5±16.8 dB HL下降至11.7±9.2 dB HL。结论腺样体切除联合耳内镜下鼓膜置管治疗儿童分泌性中耳炎疗效确切,耳内镜下鼓膜置管方便快捷、视野好。

Objective To investigate the clinical outcomes of adenoidectomy cum video-otoscopy-guided tympanostomy tube placement in treating children with adenoid hypertrophy and otitis media with effusion, and to discuss the advantages of video-otoscopy-guided tympanosotomy tube placement. Methods We reviewed medical records of 38 children （66 ears） with adenoid hypertrophy and otitis media with effusion, who were treated using the electric suction coagulator （diathermy） for adenoidectomy cum video-otoscopy-guided tympanosotomy tube placement. Results Tympanosotomy tubes were successfully placed in all the cases （n=38） under video-otoscopic guidance. All cases had improved in hearing ability post operation. The tympanograms of 57 ears were changed to type A, and 9 ears were type C, 42 ears to type A and 4 ears type C from type B. 15 ears changed from type C to type A and 5 ears remained type C. The average audiometry results dropped to 11.7±9.2 dB from 41.5±16.8 dB. Conclusion The adenoidectomy cure video-otoscopy-guided tympanostomy tube placement is effective in treating children with adenoid hypertrophy and otitis media with effusion. The video-otoscopy- guided tympanostomy tube placement is indicated as convenient, fast and providing a better view for surgeons.