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1、儿童分泌性中耳炎手术治疗远期转归【摘要】目的观察鼓室置管对分泌性中耳炎儿童患者的远期效果及对听力及鼓膜形态的影响。方法回顾性分析2003年9月至2007年6月治疗的78例儿童分泌性中耳炎患者。采用鼓室置管术，合并腺样体肥大者同时行鼻内镜下腺样体切除术。通气管留置时间4〜28个月，随访4〜7年。结果56例(718%)自觉听力恢复正常，18例(231%)觉听力明显改善，仅有4例(51%)无明显改善，平均听力提高约20dBHLo42耳(447%)鼓膜形态正常，16耳(170%)出現鼓膜钙化，25耳(266%)鼓膜局部变薄、18耳(
2、191%)鼓膜内陷，3耳(32%)鼓膜穿孔，2耳(21%)鼓膜肉芽，0例胆脂瘤，8耳(85%)鼓室积液并再次手术。鼓室置管后患者听力提高将近20dBHL,但高达532%的患儿鼓膜出现异常改变。结论鼓室置管导致近一半患儿鼓膜出现异常改变，严格的掌握手术适应证很重要，术后需严格随访及跟进处理。【关键词】中耳炎;外科手术；鼓室置管LongtermeffectsoftympanostomytubeinsertiononchildrenwithotitismediawitheffusionCHENGuangui,ZHAIJinming
3、DepartmentofOtorhinolarygology,SecondAffiliatedHospitalofGuangzhouMedicalcollege,Guangzhou510260,China【Abstract】ObjectiveTostudythelongtermeffectsoftympanostomytubeinsertiononthetympanicmembraneandhearingresuItsMethodsFromSeptember2003toJune2007,tympanostomytubeswe
4、reinsertedin78childrenforotitismediawitheffusion,adenoidectomywereperformedin10casescombinedbyadenoidhypertrophyVentilatingtubeswereretainedfor4~28months,andallpatientswerefollowedupfor4〜7years,audiometrictestingandtympanicmembraneabnormalitieswererecordedResultsSu
5、bjectively718%ofthepatientsnoticedhearingrecovery,while231%improved,51%noimprovementTheimprovementofhearingwasabout20dBHLonaverage447%patientsshowednormaltympanicmembrane,whiletympanosclerosiswasobservedin16ears(170%),Segmeritalatrophychangesofthetympanicmembranewe
6、reseenin25ears(266%),Retractionwereseenin18ears(191%),theeardrumwasperforatedin3ears(32%),granulationhappenedto2ears(21%),andnocholesteatomawasfoundinallcasesRepeatedintubationwasperformedin8ears(85%)forrecurreneeTympanostomytubeinsertioncameffectivelyimprovehearin
7、ginalargepercentageofchildrenforotitismediawitheffusionHowever,tympanicmembraneabnormitywerefoundin532%patientsConclusionTympanicmembraneabnormitywerefoundinaboutonehalfofpatientsaftertympanostomytubeinsertion,sosurgerymustbeunderstrictindicationandfollowinguptimel
8、ywithappropriatemanagementwhennecessary.[Keywords]Otitismediawitheffusion；Surgery；Tympanostomytubeinsertion作者单位：510260广州医学院第二附属医院耳鼻咽喉科分泌性中耳炎是导致儿童
