儿童鼓室成形术的回顾性长期分析

IF 1.3 4区 医学 Q3 OTORHINOLARYNGOLOGY
Osikhe Ejeah-Braimoh, Bastian Baselt, Christof Röösli
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引用次数: 0

摘要

目的鼓膜成形术是治疗儿童鼓膜穿孔(TMP)的一种成熟的外科治疗方法,旨在恢复患儿的解剖完整性,改善患儿的听觉功能。然而,长期结果仍然是可变的,影响手术成功的因素仍然存在争议。本研究评估了儿童鼓室成形术在5年随访期间的解剖和功能结果,特别关注年龄和其他预后因素的影响。方法在某三级转诊医院进行回顾性单中心队列研究,纳入2012年1月1日至2022年12月31日期间行TMP鼓室成形术的儿童患者(≤16岁)。数据从电子医院记录中检索,包括手术报告、听力评估和随访文件。主要结果是解剖上的成功(随访时鼓膜完好)和功能上的成功(气骨间隙<;20 dB)。次要结局包括术后并发症和影响手术成功的因素。结果共分析111耳(96例),平均随访17.9个月(3 ~ 60个月)。5年的总体解剖成功率为57.9%,5年的功能成功率为69.4%。年龄与解剖或功能结果之间没有明显的相关性,除了在12个月的随访中,年龄较大的患者在功能成功方面有统计学上显著的优势。穿孔大小和病因对成功率有显著影响,较小的穿孔和感染相关的穿孔效果更好。结论儿童鼓室成形术可获得良好的功能效果和中等程度的远期解剖成功。没有观察到一致的年龄相关影响,提示手术时机应基于个体临床因素,而不仅仅是年龄。穿孔的大小和位置以及病因成为更相关的预后因素。需要未来的前瞻性多中心研究来验证这些发现并指导患者选择。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Retrospective long-term analysis of tympanoplasty in children

Objective

Tympanoplasty is a well-established surgical intervention for tympanic membrane perforation (TMP) in children, aiming to restore anatomical integrity and improve auditory function. However, long-term outcomes remain variable, and factors influencing surgical success are still debated. This study evaluates anatomical and functional outcomes of pediatric tympanoplasty over a five-year follow-up period, with a particular focus on the influence of age and other prognostic factors.

Methods

A retrospective single-center cohort study was conducted at a tertiary referral hospital, including pediatric patients (≤16 years) who underwent tympanoplasty for TMP between January 01, 2012 and December 31, 2022. Data were retrieved from electronic hospital records, including operative reports, audiometric evaluations, and follow-up documentation. Primary outcomes were anatomical success (intact tympanic membrane at follow-up) and functional success (air-bone gap <20 dB). Secondary outcomes included postoperative complications and factors influencing surgical success.

Results

A total of 111 ears (96 patients) were analyzed, with a mean follow-up of 17.9 months (range 3–60 months). The overall anatomical success rate at five years was 57.9 % and functional success at five years was 69.4 %. No significant correlation between age and anatomical or functional outcomes was found, except at 12-months-follow-up, there was a statistically significant advantage for older patients in functional success. Perforation size and etiology significantly impacted success rates, with smaller and infection-related perforations demonstrating better outcomes.

Conclusion

Tympanoplasty in children can result in favorable functional outcomes and moderate long-term anatomical success. No consistent age-related effect was observed, suggesting that surgical timing should be based on individual clinical factors rather than age alone. Perforation size and location as well as etiology emerged as more relevant prognostic factors. Future prospective multicenter studies are needed to validate these findings and guide patient selection.
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来源期刊
CiteScore
3.20
自引率
6.70%
发文量
276
审稿时长
62 days
期刊介绍: The purpose of the International Journal of Pediatric Otorhinolaryngology is to concentrate and disseminate information concerning prevention, cure and care of otorhinolaryngological disorders in infants and children due to developmental, degenerative, infectious, neoplastic, traumatic, social, psychiatric and economic causes. The Journal provides a medium for clinical and basic contributions in all of the areas of pediatric otorhinolaryngology. This includes medical and surgical otology, bronchoesophagology, laryngology, rhinology, diseases of the head and neck, and disorders of communication, including voice, speech and language disorders.
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