96例儿童分泌性中耳炎的手术治疗
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张铁松,Email:zts68420@sina.com.

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Surgical intervention for ineffective cases of conservatively managed otitis media with effusion in children
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    摘要:

    目的探讨经保守治疗无效的儿童分泌性中耳炎患者外科手术干预的方式和效果。方法 对96 例(118耳)儿童分泌性中耳炎患者在内镜下行腺样体切除加鼓室置管术,部分合并扁桃体肥大的患儿行扁桃体切除术,术后随访半年以上并评价其治疗效果。结果96例患儿中行鼓室置管术35例, 腺样体切除加鼓室置管术49 例, 腺样体切除加扁桃体切除加鼓室置管术12 例;术前平均听阈为(42±5)dB,术后1周为(34±4)dB,与术前比较具有统计学差异(t=12.12,P<0.05);术后1个月为(22±2)dB,与术前比较具有统计学差异(t=15.27,P<0.01);术后听力明显改善,鼻塞、夜间张口呼吸和打鼾症状明显缓解。结论对患有分泌性中耳炎的儿童进行个体化的手术治疗,腺样体切除加鼓室置管术是经保守治疗无效的儿童分泌性中耳炎的基本术式。

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    ObjectiveTo investigate the method and effect of surgical intervention for ineffective cases of conservatively managed otitis media with effusion (OME) in children.Methods96 children (118 ears) suffering from chronic OME were conducted myringotomy with tube insertion, or myringotomy with tube insertion plus adenoidectomy under endoscope. Some of them received tonsillectomy due to chronic tonsillitis. All the patients were followed up more than half a year postoperatively, and the therapeutic effect was evaluated.ResultsMyringotomy tube insertion was conducted in 35 cases, myringotomy tube insertion combined with adenoidectomy in 49, myringotomy tube insertion combined with adenoidectomy plus tonsillectomy in 12 cases. The average air conduction hearing thresholds of speech frequency were (42±5) dB, (34±4) dB and (22±2) dB respectively at the timepoints before operation, one week after operation and one month postoperatively. The symptoms including nasal obstruction, buccal respiration and snore at night were obviously relieved.ConclusionsSurgical management for OME in children should be individualized, adenoidectomy and myringotomy tube insertion are basic surgical strategies for the ineffective pediatric cases with conservative treatment.

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马静 李正才 郭亚丽 娄凡 林垦 陆涛 张铁松.96例儿童分泌性中耳炎的手术治疗[J].中国耳鼻咽喉颅底外科杂志,2013,19(3):250-253

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  • 在线发布日期: 2013-06-30
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