Department of Otolaryngology,The 909th Hospital of PLA,South-East Hospital Affiliated to Xiamen University
目的 分析伴耳后骨膜下脓肿的儿童急性中耳炎临床特点和治疗方案。方法 回顾性分析2010年9月～2020年8月收治住院治疗“急性中耳炎，耳后骨膜下脓肿”9例患儿的临床资料，分析可能的致病原因、致病菌和治疗措施。结果 9例患儿发病前均有上呼吸道感染史，出现耳部症状至入院治疗病程2～3周。2例鼓膜完整患儿采用乳突切开并鼓膜切开置管术，另7例鼓膜穿孔溢脓患儿采用脓肿切开引流及每日换药。脓液细菌培养示肺炎链球菌5例，咽峡链球菌2例，2例未见细菌生长。术后住院7～10d，耳后肿胀消退，外耳道流脓停止。随访12～18个月，9例疗效均满意。结论 儿童急性中耳炎并发耳后骨膜下脓肿，治疗方法以脓肿切开引流或乳突切开术为主，辅以静滴抗生素，绝大部分预后良好。
Objective To analyze the clinical characteristics and treatment of acute otitis media with subperiosteal abscess in children. Method Nine children with the diagnosis of "acute otitis media, retroauricular subperiosteal abscess" from September 2010 to August 2020 were retrospectively analyzed, inluding the possible etiology, pathogenic bacteria and treatments. Result All nine children had a history of upper respiratory tract infection before the onset, and the course of otodynia was 2-3 weeks before admission. Two case with intact tympanic membrane was treated with mastoidectomy, myringotomy and ventilation tube insertion. Seven cases with tympanic membrane perforation and pyorrhea were treated with abscess incision and drainage. The results of bacteriology culture in pus showed that five cases of Streptococcus pneumoniae, two cases of Streptococcus eustachians. After hospitalization for 7-10 days, the swelling subsided and the purulence stopped. The patients were followed up for 12-18 months. Conclusion Acute otitis media with subperiosteal abscess in children is mainly treated by abscess incision or mastoidotomy, supplemented with intravenous antibiotics. Most of the children can be cured.