两种位置鼓膜置管疗效比较

Comparison of outcomes between two different positions of tympanostomy tube in secretory otitis media

目的研究将鼓膜通气管置于鼓膜紧张部前下象限及后下象限时其疗效有无差别。方法选取双侧分泌性中耳炎患儿40例,每例均随机选取一侧在鼓膜紧张部前下象限置管,对侧在鼓膜紧张部后下象限置管。术后1周,1、6、12个月分别行门诊复查。术后1周复查纯音听力测试,其余每次复查均记录通气管是否脱落。统计分析两个位置的疗效有无差异。结果术后1周前下象限组与后下象限组气导听阈平均值配对t检验,P=0.006,差异有统计学意义。前下象限组均值10.4575,后下象限组均值10.2300,后下象限组气导平均听阈较前下象限组低。术后12个月两组间脱管率两独立样本率比较的卡方检验,P=0.034,差异有统计学意义,前下象限组较后下象限组脱管率高。结论将通气管放置于鼓膜紧张部后下象限较将其放置于前下象限对听力的改善程度更大,且操作更方便,术后更稳固。

OBJECTIVE To invest igate the outcomes in children with secretory otitis media who received tympanostomy tubes bilaterally in different positions. METHODS Forty cases of children with bilateral secretory otitis media were selected in our study. One ear of each patient was selected randomly to receive tympanotomy tube in the anteroinferior quadrant of tympanic membrane, while the other side received the tube in posteroinferior quadrant. Follow-ups were ordered in 1 week, 1 month, 6 months and 12 months after surgery, respectively. The tympanic membrane was inspected by otoscopic examination to ensure whether there is expel of the tube during all the follow-ups, while hearing was evaluated with pure tone audiometry only in 1 week after surgery. The different outcomes between the two positions of tympanostomy tube were statistically analyzed. RESULTS One week after the surgery,the average hearing thresholds in group of patients who received tympanostomy tube in posterioinferior quadrant were significantly lower than the other group with tympanostomy tube in anteroinferior quadrant.CONCLUSION Tympanostomy tube in posterioinferior quadrant could improve hearing better, and the operation is more convenient and stable.