96例儿童分泌性中耳炎的手术治疗

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1、第19卷第3期中国耳鼻咽喉颅底外科杂志 2013年6月Vol．19No．3ChineseJournalofOtorhinolaryngology－SkullBaseSurgeryJun．2013DOI:10．11798/j．issn．1007-1520．201303018·论著·96例儿童分泌性中耳炎的手术治疗马静，李正才，郭亚丽，娄凡，林垦，陆涛，张铁松(昆明市儿童医院昆明医科大学附属儿童医院耳鼻咽喉科，云南昆明650034)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(

2、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

3、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。关键词:儿童;分泌性中耳炎;手术干预中图分类号:Ｒ764．21文献标识码:A文章编号:1007－1520(2013)03－0250－04SurgicalinterventionforineffectivecasesofconservativelymanagedotitismediawitheffusioninchildrenMAJing，LIZheng-cai，GUOYa-li，etal．(Departmentof

4、Otolaryngology，KunmingChildren’sHospital，theAffiliatedChildren’sHospital，KunmingMedicalUniversity，Kunming650034，China)Abstract:ObjectiveToinvestigatethemethodandeffectofsurgicalinterventionforineffectivecasesofconservativelymanagedotitismediawitheffusion(OME)in

5、children．Methods96children(118ears)sufferingfromchronicOMEwereconductedmyringotomywithtubeinsertion，ormyringotomywithtubeinsertionplusadenoidectomyunderendoscope．Someofthemreceivedtonsillectomyduetochronictonsillitis．Allthepatientswerefollowedupmorethanhalfayea

6、rpostoperatively，andthetherapeuticeffectwasevaluated．ＲesultsMyringotomytubeinsertionwasconductedin35cases，myringotomytubeinsertioncombinedwithadenoidectomyin49，myringotomytubeinsertioncombinedwithadenoidectomyplustonsillectomyin12cases．Theaverageairconductionhe

7、aringthresholdsofspeechfrequencywere(42±5)dB，(34±4)dBand(22±2)dBrespectivelyatthetime-pointsbeforeoperation，oneweekafteroperationandonemonthpostoperatively．Thesymptomsincludingnasalobstruction，buccalrespirationandsnoreatnightwereobviouslyrelieved．ConclusionsSur

8、gicalmanagementforOMEinchildrenshouldbeindividualized，adenoidectomyandmyringotomytubeinsertionarebasicsurgicalstrategiesfortheineffectivepediatriccaseswithconservativetreatm