山东大学耳鼻喉眼学报 ›› 2010, Vol. 24 ›› Issue (4): 21-22.

• 论文 • 上一篇    下一篇

鼓膜置管术治疗分泌性中耳炎20例

吕梅,徐尔东,杜翠萍,姚艺文   

  1. 大连医科大学附属第一医院耳鼻咽喉科,辽宁  大连  116011
  • 收稿日期:2010-03-04 修回日期:2010-05-04 出版日期:2010-08-16 发布日期:2010-08-16
  • 通讯作者: 徐尔东。 Email: benxierdong@163.com
  • 作者简介:吕梅(1974- ),女,副主任医师,主要从事耳科基础和临床方面的研究。 Email: lv_mei@163.com

Therapeutic effects of tympanostomy tube emplacement in the treatments of  20 cases of otitis media with effusion

LV  Mei, XU Er-dong, DU Cui-ping, YAO Yi-wen   

  1. Department of Otolaryngology, the first affiliated hospital of Dalian Medical University, Dalian 116011, Liaoning, China
  • Received:2010-03-04 Revised:2010-05-04 Online:2010-08-16 Published:2010-08-16

摘要:

目的     探讨鼓膜置管术及鼓室药物灌洗治疗分泌性中耳炎的疗效。方法     分泌性中耳炎20例均为经门诊行药物治疗、鼓膜穿刺、鼓室注药保守治疗2~3个月后无效, 考虑主要为咽鼓管功能障碍所致。收入院行鼓膜置管术,并定期局部灌注药物冲洗,置管时间1~3个月后拔管。结果     术后随访6~12个月,获得良好效果,总有效率100%,治愈率75%(15/20)。 全部患者听力明显改善, 纯音测听术后平均提高20~30dBHL。声导抗检查恢复为“A”型曲线15例,“As” 型曲线5例。拔管后鼓膜均自然愈合,无遗留鼓膜永久性穿孔、鼓膜萎缩、化脓性中耳炎等并发症。结论     鼓膜置管术是治疗顽固性分泌性中耳炎的主要方法,其中术后的鼓室药物灌注冲洗尤其重要,同时要预防脱管、感染、鼓膜不愈合等并发症。

关键词: 分泌性中耳炎;咽鼓管;鼓膜置管术

Abstract:

Objective    To investigate the effectiveness of grommet insertion in the treatments of secretory otitis media. Methods     20 cases of secretory otitis media were chosen and hospitalized from the outpatients who had undertaken 2-3 months of conservative treatments, including medications, puncture of tympanum, or cavum tympani injection. All the cases received grommet insertion. Further, local drug perfusion to the cavum tympani was adminstered regularly. The grommets were kept for about 13 months. Results     The post-operative follow-up times were 6-12 months. The total effective rate was 100% and healing rate was 75%(15/20). The hearing levels of all the cases got improved while the average increase was 20-30 dBHL by pure tone test. Acoustic immitance test showed A type in 15 cases and As type in the other 5. All the tympanic membranes healed naturally without complications, i.e. perforation, shrinkage, or otitis media. Conclusions    Grommet insertion is the primary method to treat refractory secretory otitis media, and the local drugs perfusion is crucial. At the same time, the complications, such as exfoliation of tube, infection, or disunion of tympanium, should be prevented.

Key words: Otitis media with effusion; Eustachian tube; Tympanostomy tube emplacement

中图分类号: 

  • R764.21
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