鼓膜置管对分泌性中耳炎患儿咽鼓管功能的影响

doi:10.6040/j.issn.1673-3770.0.2020.476

摘要/Abstract

摘要： 目的分析分泌性中耳炎患儿实施鼓膜置管对咽鼓管功能的影响。方法研究纳入2019年1月~2019年6个月收治26例分泌性中耳炎患儿,所有患儿接受鼓膜置管术,统计术前、术后3个月、术后半年、随访1年患儿咽鼓管功能。结果本组26例患儿左耳道经治疗后,在不同压力下咽鼓管测压显示,术后3个月、6个月、1年,患儿测试结果与术前对比有升高(P<0.05);且患儿Valsalva法测试显示,术后3个月、6个月、1年均高于术前(P<0.05);术前、术后不同时间吞咽功能评价P>0.05;本组患儿术后3个月、6个月、1年咽鼓管功能评价ETS总分较术前明显升高P<0.05。本组患儿右耳道术后3个月、6个月、1年不同时间,患儿30 mbar、40 mbar、50 mbar下咽鼓管测压R值显示均升高,与术前对比P<0.05;且患儿Valsalva测试结果、咽鼓管功能ETS总评分均升高,与术前对比P<0.05;而吞咽功能术前、术后对比P>0.05。本组26例患儿,治疗结果显示,治愈20例、有效6例、无效0例,并发症发生率3.85%。结论分泌性中耳炎患儿在接受保守治疗无果的情况下,考虑患儿生长发育特殊性,采取鼓膜置管术治疗是一种较为可靠的措施,对改善患儿咽鼓管功能具有积极作用。

关键词: 儿童, 分泌性中耳炎, 咽鼓管功能, 鼓膜置管术

Abstract: Objective To analyze the effect of tympanic tube placement on the function of the Eustachian tube in children with secretory otitis media. Methods The study included 26 children with secretory otitis media admitted to our hospital from January 2019 to June 2019. All children underwent tympanic tube insertion. The statistics were collected before operation, 3 months after operation, half a year after operation, and 1 year follow-up. Eustachian tube function. Results After the treatment of the left ear canal of the 26 children in this group, the Eustachian tube pressure measurement under different pressures showed that the test results of the children were significantly higher at 3, 6 months, and 1 year after the operation(P<0.05); and the Valsalva method test showed that the children were higher than before the operation at 3 months, 6 months and 1 year after the operation(P<0.05); the evaluation of swallowing function at different times before and after the treatment(P>0.05); The total ETS scores of the eustachian tube function evaluation of the children in this group were significantly higher than those before the operation at 3 months, 6 months, and 1 year after operation(P<0.05). In this group of children with right ear canal at different times after 3 months, 6 months, and 1 year, the R values of 30 mbar, 40 mbar, and 50 mbar lower eustachian tube pressure of the children showed a significant increase, compared with preoperative(P<0.05); And the children's Valsalva test results and the total ETS score of Eustachian tube function were significantly increased, compared with preoperatively(P<0.05); while swallowing function was compared before and after surgery(P>0.05). In this group of 26 children, the treatment results showed that 20 cases were cured, 6 cases were effective, and 0 cases were ineffective. the complication rate was 3.85%. Conclusion Children with secretory otitis media in the case of failure of conservative treatment, tympanoplasty is a relatively reliable measure considering the particularity of growth and development of children, which has a positive effect on improving the function of eustachian tube

Key words: Children, Secretory otitis media, Eustachian tube function, Tympanic membrane catheterization

中图分类号:

R764.21

焦雪梅,杨扬,李春凤,张晓琳. 鼓膜置管对分泌性中耳炎患儿咽鼓管功能的影响[J]. 山东大学耳鼻喉眼学报, 2022, 36(1): 60-63.

JIAO Xuemei, YANG Yang, LI Chunfeng, ZHANG Xiaolin. Effect of tympanic membrane insertion on the function of eustachian tube in children with secretory otitis media[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(1): 60-63.

参考文献

[1] 秦欢, 何景春, 杨军. 应用咽鼓管压力测定观察儿童分泌性中耳炎鼓膜置管术后咽鼓管功能的研究[J]. 临床耳鼻咽喉头颈外科杂志, 2020, 34(3): 215-217. doi:10.13201/j.issn.2096-7993.2020.03.007. QIN Huan, HE Jingchun, YANG Jun. Application of Eustachian tube pressure measurement to observe the function of Eustachian tube after tympanostomy in children with otitis media with effusion[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2020, 34(3): 215-217. doi:10.13201/j.issn.2096-7993.2020.03.007.
[2] 熊素芳, 王美荣, 江恒, 等. 咽鼓管球囊扩张联合鼓膜置管术治疗慢性分泌性中耳炎的疗效观察[J]. 听力学及言语疾病杂志, 2019, 27(3): 326-328. doi:10.3969/j.issn.1006-7299.2019.03.022.
[3] 高燕, 马静, 明澄, 等. 咽鼓管球囊扩张联合鼓膜置管术在儿童复发性分泌性中耳炎中的疗效[J]. 昆明医科大学学报, 2020, 41(4): 132-136. GAO Yan, MA Jing, MING Cheng, et al. Analysis of balloon eustachiantuboplasty combined with tympanotomy tube insertion in the treatment of recurrent otitis media with effusion in children[J]. Journal of Kunming Medical University, 2020, 41(4): 132-136.
[4] 刘薇, 陈敏, 郝津生, 等. 咽鼓管球囊扩张及鼓膜置管治疗儿童复发性分泌性中耳炎的疗效分析[J]. 临床耳鼻咽喉头颈外科杂志, 2020, 34(3): 210-214. doi:10.13201/j.issn.2096-7993.2020.03.006. LIU Wei, CHEN Min, HAO Jinsheng, et al. The short-term and long-term efficacy of balloon dilatation Eustachian tuboplasty and tympanostomy tubes in children patients with recurrent otitis media with effusion[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2020, 34(3): 210-214. doi:10.13201/j.issn.2096-7993.2020.03.006.
[5] Ikehata M, Ohta S, Mishiro Y, et al. Usefulness of the saccharin test for assessment of eustachian tube function in patients with chronic otitis media with perforation[J]. Otol Neurotol, 2017, 38(1): 60-65. doi:10.1097/mao.0000000000001249.
[6] 周诗侗, 高明华, 邹帆, 等. 咽鼓管球囊扩张治疗慢性分泌性中耳炎—伴或不伴鼓膜穿刺[J]. 中华耳科学杂志, 2018, 16(1): 48-53. doi:10.3969/j.issn.1672-2922.2018.01.014. ZHOU Shitong, GAO Minghua, ZOU Fan, et al. Treatment of chronic otitis media with effusion using balloon eustachian tuboplasty with or without tympanocentesis[J]. Chinese Journal of Otology, 2018, 16(1): 48-53. doi:10.3969/j.issn.1672-2922.2018.01.014.
[7] Bhutta MF, Thornton RB, Kirkham LS, et al. Understanding the aetiology and resolution of chronic otitis media from animal and human studies[J]. Dis Model Mech, 2017, 10(11): 1289-1300. doi:10.1242/dmm.029983.
[8] 邹宇, 刘漪, 陈洽鑫, 等. 鼓膜置管及其合并腺样体切除治疗儿童分泌性中耳炎听力改善的疗效分析: Meta分析[J]. 实用医学杂志, 2018, 34(5): 842-846. doi:10.3969/j.issn.1006-5725.2018.05.036. ZOU Yu, LIU Yi, CHEN Qiaxin, et al. Comparative hearing outcomes of tympanostomy tubes and combined with adenoidectomy for pediatric otitis media effusion treatment: a Meta-analysis[J]. The Journal of Practical Medicine, 2018, 34(5): 842-846. doi:10.3969/j.issn.1006-5725.2018.05.036.
[9] 张楠, 彭洪, 石增霞. 自动咽鼓管吹张+球囊扩张术治疗鼻咽癌放疗患者分泌性中耳炎的研究[J]. 湖南师范大学学报(医学版), 2018, 15(3): 78-80. doi:10.3969/j.issn.1673-016X.2018.03.023. ZHANG Nan, PENG Hong, SHI Zengxia. Study on treatment of secretory otitis media in patients with nasopharyngeal carcinoma treated by spontaneous eustachian tube blowout and balloon dilatation[J]. Journal of Hunan Normal University(Medical Science), 2018, 15(3): 78-80. doi:10.3969/j.issn.1673-016X.2018.03.023.
[10] Luukkainen V, Kivekäs I, Silvola J, et al. Balloon eustachian tuboplasty: systematic review of long-term outcomes and proposed indications[J]. J Int Adv Otol, 2018, 14(1): 112-126.doi:10.5152/iao.2018.4769.
[11] 赖世佳, 童梓德. 咽鼓管球囊扩张术联合鼓膜切开置管术治疗慢性复发性分泌性中耳炎临床观察[J]. 解放军医药杂志, 2017, 29(7): 47-49. doi:10.3969/j.issn.2095-140X.2017.07.013. LAI Shijia, TONG Zide. Clinicalobservation of eustachian tube balloon dilation combined with tympanotomy in treatment of patients with chronic recurrent secretory otitis media[J]. Medical Pharmaceutical Journal of Chinese People, 2017, 29(7): 47-49. doi:10.3969/j.issn.2095-140X.2017.07.013.
[12] 吴华, 孙永明, 郑建华, 等. 腺样体消融联合鼓膜打孔术治疗儿童腺样体肥大合并分泌性中耳炎55例[J]. 山东大学耳鼻喉眼学报, 2021, 35(2): 71-75. doi:10.6040/j.issn.1673-3770.1.2020.097. WU Hua, SUN Yongming, ZHENG Jianhua, et al. Application of endoscopic adenoids cryoablation combined with low-temperature plasma tympanostomy in the treatment of 55 children with adenoid hypertrophy and secretory otitis media[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(2): 71-75. doi:10.6040/j.issn.1673-3770.1.2020.097.
[13] 朱珠, 郑国玺, 李琦, 等. 鼓膜置管或鼓膜穿刺对腺样体切除治疗儿童分泌性中耳炎的影响[J]. 重庆医学, 2017, 46(15): 2041-2044. doi:10.3969/j.issn.1671-8348.2017.15.009. ZHU Zhu, ZHENG Guoxi, LI Qi, et al. Effect of tympanostomy tube insertion or tympanocentesis on transnasal endoscopic adenoidectomy in the treatment of pediatric patients with secretory otitis media[J]. Chongqing Medicine, 2017, 46(15): 2041-2044. doi:10.3969/j.issn.1671-8348.2017.15.009.

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