膠狀性中耳積液之細菌學

The Bacteriology of Glue Ear

呂孟哲(Meng-Je Reed) ； 江秉穎(Rayleigh, Ping-Ying Chiang) ； 吳幸美(Hsing-Mei Wu) ； 謝憬欣(Ching-Hsin Hsieh) ； 梁家光(Jia-Guang Liang) ； 李宏生(Hong-Sheng Lee)

《台灣耳鼻喉頭頸外科雜誌》 41卷5期 (2006/10) Pp. 153-157

https://doi.org/10.6286/2006.41.5.153

摘要

背景：膠耳(glue ear)在耳鼻喉科是嬰幼兒及小孩常見的疾病之一，其細菌學研究到目前為止是較少被提及的，因其在中耳積液的治療和研究上有其重要性，因此本研究擬對膠耳之中耳積液細菌學做一探討。
方法：本研究自2001年1月至2006年2月共收集34名兩側膠耳病患，其中23例男性11例女性，年齡範圍為1歲到11歲，手術植入中耳通氣管時的平均年齡為4歲10個月。本研究收集病患右側之中耳膠狀積液，外耳道以優碘浸潤消毒，在鼓膜切開後，以自製的無菌裝置抽取。包括一支無菌的5ml針筒，於針筒末端接上真空抽吸設備，針筒前端接上無菌的耳部抽吸管，在無菌操作下將患耳的膠狀液體收集到針筒內，再以無菌的培養棉棒收集檢體後，進行需氧及厭氧性的細菌培養及抗生素敏感檢驗。
結果：在34例中共有4例的培養結果是陽性佔11.8%，30例的培養結果是陰性佔88.2%。所有陽性結果皆為需氧培養獲得，3例為革蘭氏陰性菌Haemophilus influenzae，1例為革蘭氏陽性菌Streptococcus pneumoniae。
結論：中耳膠狀積液的細菌學研究培養結果大部分為陰性，雖然越來越多研究顯示這些培養陰性的中耳腔內仍有細菌的基因遺傳物質，即使如此，我們不建議使用抗生素，中耳通氣管放置是為最有效的治療方法。

關鍵字

膠耳 ； 黏液性中耳炎 ； 細菌生物膜

並列摘要

BACKGROUND: Glue ear is mainly found among infants and young children and is one of the more common otolaryngological diseases. However, reports about the bacteriology of glue ear are few. Owing to its importance as a disease needing research and treatment, this study focused on the bacteriology of glue ear.
METHODS: From January 2001 to February 2006, thirty-four patients with bilateral glue ear became part of the study; these were, aged between one to eleven years and, included 23 males and 11 females. The average age of these patients who underwent ventilation tube insertion was four years and ten months old. We collected middle ear glue from each patient's right ear after myringotomy under sterile conditions using a collection system consisting of a 5ml syringe with vacuum suction equipment and a connected ear suction tube. The sample was then swabbed to allow culturing under aerobic and anaerobic conditions as soon as possible after collection.
RESULTS: Over the total of 34 cases, positive cultures were found in only four aspirates and all others were negative. Thus, the positive culture rate was only 11.8% and all of the positive cultures were obtained from aerobic culture. The species of bacteria present were Gram-negative Haemophilus influenzae in three cases and Gram-positive Streptococcus pneumoniae in one case.
CONCLUSIONS: The results show that most glue ear cases to be culture negative; nonetheless, other studies have revealed the presence of bacterial DNA in culture-negative middle ear fluid. Based on the culture results and taking into account other published research, it is suggested that antibiotic treatment is not an appropriate treatment for glue ear and that ventilation tube placement is the most effective treatment of choice.

並列關鍵字

glue ear ； mucoid otitis media ； biofilm