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題名 | 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 |
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作者 | 王怡芬; 蕭安穗; | 書刊名 | 中華民國耳鼻喉科醫學雜誌 |
卷期 | 34:3 民88.05-06 |
頁次 | 頁207-211 |
分類號 | 417.6821 |
關鍵詞 | 積液性中耳炎; 鼓膜切開術; Otitis media with effusion; Myringotomy; |
語文 | 中文(Chinese) |
中文摘要 | 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。 |
英文摘要 | Background: Ventilation tube insertion (VTI) is usually recommended for persistent 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 children, 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. |
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