内镜下鼓室置管联合腺样体切除术治疗儿童复发性分泌性中耳炎的疗效研究

The Efficacy Study of Using Tympanic Catheterization Combined with Adenoidectomy to Treat Children with Recurrent Secretory Otitis Media

摘要: 目的：探讨内镜下鼓室置管联合腺样体切除术治疗儿童复发性分泌性中耳炎的疗效。方法：将解放军11医院耳鼻喉科近三年收治的32例(50耳)儿童复发性分泌性中耳炎患者纳入研究，均行内镜下鼓室置管术联合腺样体切除术，对治疗疗效、中耳积液时间、语频区气导平均听阈、复发率、愈合时间、感染率等因素进行评价，观察此术式对儿童复发性分泌性中耳炎的治疗效果。结果：术后6个月治疗总有效率为94.00%。术后12个月治疗总有效率为100.00%；中耳积液平均时间为(7.95 ± 1.44)d；语频区气导平均听阈改善至(19.15 ± 6.92)dB，与治疗前比较，(P < 0.05)有显著差异；共3耳复发，复发率为6.00%；6耳出现术后并发症，包括耳漏、感染、脱管，鼓膜钙化、穿孔不愈合，并发症发生率为12.00%，经处理后并发症均消失。结论：内镜下鼓室置管术联合腺样体切除术治疗儿童复发性分泌性中耳炎可有效降低复发率，减少术后患耳感染，总体疗效满意。

Abstract: Objective: To explore the tympanic cavity catheter combined adenoidectomy under endoscope treatment the curative effect of recurrent secretory otitis media in children. Methods: The 32 cases (50 ears) of children with recurrent secretory otitis media patients were enrolled and underwent endoscopic tympanostomy tube placement combined with adenoidectomy. The curative effects in the treatment of middle ear effusion, time and frequency region average air conduction hearing threshold, recurrence rate, healing rate and the factors such as time, infection evaluation were evaluated. The operation of secretory otitis media in children with recurrent treatment was observed. Results: The total effective rate was 94% within 6 months after operation. After 12 months of treatment the total effective rate was 100%; the average time for middle ear effusion (7.95 ± 1.44) d; frequency region mean air conduction threshold to improve the (19.15 ± 6.92) dB, compared with before treatment (P < 0.05) there are significant differences; there are a total of 3 ears of recurrence, and the recurrence rate was 6%; 6 ears had postoperative complications, including otorrhea, infection, catheter removal, tympanic membrane perforation and calcification of nonunion, and the complication rate was 12% after treatment, complications disappeared. Conclusion: Using tympanic catheterization combined with adenoidectomy in children can effectively reduce the recurrence rate and reduce postoperative risk of ear infections, and the therapeutic effect is satisfactory.