中耳通氣管置放後併發耳膜持續性穿孔

Persisting Tympanic Membrane Perforation after Ventilation Tube Insertion

游景峰(Jiing-Fun You) ； 謝貞洲(Chen-Chou Hsieh)

《中華民國耳鼻喉科醫學雜誌》 37卷5期 (2002/08) Pp. 317-320

https://doi.org/10.6286/2002.37.5.317

摘要

背景：探討耳膜切開並置放中耳通氣管術後，導致耳膜永久性穿孔此一併發症形成的可能相關因子和治療方法。
材料與方法：自1996年1月到2000年12月間，經置放中耳通氣管術後患者，共278名（366手術耳），其中男性173名，女性105名，平均年齡為35.6歲，年齡大於12歲者為group 1（232手術耳），而年齡小於12歲者為group 2（134手術耳）。分析造成耳膜永久性穿孔和通氣管置放時間、耳漏次數、移除通氣管方法和手術技巧等相關性。
結果：總數366耳耳膜切開並置放通氣管術後有4.64%會發生耳膜永久性穿孔。在通氣管置放超過24個月的病患中，group 1及group 2各有66.7%及50%發生穿孔。術後發生耳漏的病患中，group 1及group 2各有16.7%及20.8%發生穿孔。以手術移除通氣管的病患中，group 1及group 2各有10.7%及10.4%發生穿孔。由住院醫師執行者有7.32%，主治醫師執行者有2.48%發生穿孔。
結論：術後避免發生耳漏及通氣管置放時間過長等，皆可能降低耳膜發生永久性穿孔的機率。

關鍵字

耳膜切開 ； 中耳通氣管 ； 永久性耳膜穿孔

並列摘要

BACKGROUND: This study is designed to assess the possible causes and managements of persisting tympanic membrane perforations ascribed to post myringotomy with ventila-tion tubes insertion.
METHODS: Between January 1996 and December 2000, myringotomy with ventilation tubes insertion were performed on 366 ears in 278 patients, there were 173 males and 105 females with an average age of 35.6 years. The age of group 1 was older than 12 years and group 2 was younger than 12 years. The following data were collected and analyzed: dura-tion, postoperative otorrhea, removal methods and technical skill.
RESULTS: The perforation rate after removal of ventilation tubes was 4.64%. The perfo-ration rates for cases with tube retention over 24 months in group 1 and group 2 were 66.7% and 50%, respectively, for cases with postoperative otorrhea were 16.7% and 20.8%, and for cases with surgical removal of ventilation tubes were 10.7% and 10.4%. The perforation rate was 7.32% by junior operators and 2.48% by senile operators.
CONCLUSIONS: It was possible to reduce the perforation rate by decreasing the frequency of otorrhea as well as the intubation period.

並列關鍵字

myringotomy ； ventilation tube ； persisting tympanic membrane perforation