鼓膜切開術治療學齡兒童之積液性中耳炎

Myringotomy for Otitis Media with Effusion in School-Aged Children

王怡芬(Yi-Fen Wang) ； 蕭安穗(An-Suey Shiao)

《中華民國耳鼻喉科醫學雜誌》 34卷3期 (1999/05) Pp. 207-211

https://doi.org/10.6286/1999.34.3.207

摘要

背景：一般處理兒童的積液性中耳炎是在藥物治療並觀察3個月後沒有改善，便建議置放中耳通氣管，並不重視鼓膜切開術的角色。由於中耳通氣管的置放常造成許多後遺症，而學齡兒童的耳咽管功能也漸趨成熟，因此我們針對學齡兒童的病例，經抗生素治療無效後，才以鼓膜切開術引流。本研究即對此種作法之結果作出評估。
方法20名罹患積液性中耳炎經抗生素治療無效的6至12歲學齡兒童，包括10名單側及10名雙側病例，共30耳，於局部麻醉或重度鎮靜下接受鼓膜切開術，術後於門診追蹤至少1年，以評估鼓膜切開術治療學齡兒童之積液性中耳炎的療效。
結果：術後有14耳無積液性中耳炎復發的情形，佔全數的46.7%。另外16耳，術後1年期間仍有積液性中耳炎復發的現象，佔全數的53.3%。
結論：針對6至12歲學齡兒童之積液性中耳炎的處理，初步結果顯示：約一半的病例在接受鼓膜切開術後，至少1年期間沒有復發。因此我們建議對年齡較長學童之積液性中耳炎的處理，若藥物治療無效，可優先考慮鼓膜切開術。

關鍵字

積液性中耳炎 ； 鼓膜切開術

並列摘要

Background: Ventilation tube insertion (VTI) is usually recommended for persis-tent otitis media with effusion (OME) in children if medical therapy fails to improve the condition in 3 months. Myringotomy is not recommended in this condition. However, because VTI carries a higher complication rate than myringotomy and the Eustachian tube function improves in school-aged chil-dren, myringotomy may be more proper than VTI for treating OME in school-aged children.
Methods: The study included twenty children (ages 6 to 12 years) with OME (thirty ears involved) for more than 1 month. All had at least one 14-day course of antibiotics which failed to cure the OME. A myringotomy was then performed. The operation was done under local anesthesia or heavy sedation. Postoperatively, these patients were followed for at least one year.
Results: During the follow-up period, 14 ears remained free of OME, yielding a success rate of 46.7% (14/30). Another 16 ears had recurrence, yielding a failure rate of 53.3% (16/30).
Conclusions: In this preliminary study, we found that about one half of the school-aged children with OME were cured after myringotomy. Therefore, myringotomy is a useful therapeutic option in school-aged children in whom medical treatment fails to cure the OME.

並列關鍵字

otitis media with effusion ； myringotomy