儿科患者手术切除鼓室造口管后更换鼓室造口管的风险因素。

IF 2.6 3区 医学 Q1 OTORHINOLARYNGOLOGY
Otolaryngology- Head and Neck Surgery Pub Date : 2024-12-01 Epub Date: 2024-07-17 DOI:10.1002/ohn.909
Kathryn Wie, Shalini Shah, Paul Allen, Michael Castle, Margo McKenna, John Faria
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引用次数: 0

摘要

目的:耳管切除术和补片耳膜成形术是经常进行的手术。不同耳鼻喉科医生的手术指征和时机各不相同。本研究确定了耳管摘除术和耳膜成形术后需要更换鼓室造口管的相关风险因素:病例系列,病历回顾:研究设计:病例系列与病历回顾:2011年3月至2019年9月期间在罗切斯特大学医学中心接受鼓室造口术置管术和鼓膜成形术的12岁以下患者。结果:161 名患者(230 耳)接受了鼓室造口术:161 名患者(230 耳)符合纳入标准,并进行了充分的随访。鼓膜成形术的成功率为 94.8%。成功的鼓室成形术与较短的置管时间(32 个月)相比,不成功的鼓室成形术与较短的置管时间(40 个月)相比(P = .02)。9.6%的耳朵在鼓膜成形术后更换了鼓膜造口术管道。需要更换鼓膜造口术导管的患者与不需要更换导管的患者在平均年龄(P = .96)或导管持续时间(P = .74)方面没有差异。有裂隙畸形的患者更有可能需要更换鼓室造口术管道(P 结论:"有裂隙畸形的患者更有可能需要更换鼓室造口术管道":大多数儿童在切除鼓膜后无需更换鼓膜管。本研究发现,裂隙异常是增加更换导管需求的一个因素。置管时间超过 3 年会对耳膜成形术的成功率产生负面影响。大多数患者在植入鼓室造口术管道 2 到 3 年后就应考虑拔除管道,腭裂修复后的儿童则应考虑延长管道植入时间。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Risk Factors for Replacement of Tympanostomy Tubes After Surgical Removal for Pediatric Patients.

Objectives: Ear tube removal and patch myringoplasty are frequently performed. The indication and timing for surgery varies among otolaryngologists. This study identifies risk factors associated with the need for the replacement of tympanostomy tubes after tube removal and myringoplasty.

Study design: Case series with chart review.

Setting: Single institution academic otolaryngology practice.

Methods: Patients younger than 12 years of age who underwent tympanostomy tube removal and myringoplasty at the University of Rochester Medical Center from March 2011 to September 2019. Patients with tympanostomy tube removal due to chronic otorrhea were excluded.

Results: One hundred sixty-one patients (230 ears) met inclusion criteria and had sufficient follow-up. Myringoplasty success after tube removal was 94.8%. Successful myringoplasty was associated with shorter tube duration (32 months) versus unsuccessful myringoplasty (40 months) (P = .02). Replacement tympanostomy tubes after myringoplasty occurred in 9.6% of ears. There was no difference in average patient age (P = .96) or duration of tubes (P = .74) in patients who required replacement of tympanostomy tubes versus patients who did not require tube replacement. Patients with a cleft abnormality were more likely to require tympanostomy tube replacement (P < .001).

Conclusions: Most children do not need tubes replaced after removal. This study identified cleft abnormality as a factor that increased the need for replacement tubes. Longer tube durations of over 3 years negatively impacted myringoplasty success. Tympanostomy tube removal should be considered 2 to 3 years after placement in most patients with longer tube durations considered in children with a repaired cleft palate.

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来源期刊
Otolaryngology- Head and Neck Surgery
Otolaryngology- Head and Neck Surgery 医学-耳鼻喉科学
CiteScore
6.70
自引率
2.90%
发文量
250
审稿时长
2-4 weeks
期刊介绍: Otolaryngology–Head and Neck Surgery (OTO-HNS) is the official peer-reviewed publication of the American Academy of Otolaryngology–Head and Neck Surgery Foundation. The mission of Otolaryngology–Head and Neck Surgery is to publish contemporary, ethical, clinically relevant information in otolaryngology, head and neck surgery (ear, nose, throat, head, and neck disorders) that can be used by otolaryngologists, clinicians, scientists, and specialists to improve patient care and public health.
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