鼓膜切开置管术在儿童分泌性中耳炎听力康复中的应用

INTRODUCTIONItisimportanttodiagnoseearlyandtreatproperlyforthechildrenpatientswithsecretoryotitismedia（SOM）becauseofthelanguage，educationandpsychologicaldysfunctionleadedbythehearinglossinthechildhood．MATERIALSANDMETHODSMaterials１９９５－１０／２００１－０９themyringotomyandventilationtubeinsertionsurgerieswereperformedin５６children，３４boysand２２girls，aged２years９monthsto１５years．Unilateraloperationswereperformedin１１cases．Theremainingcasesreceivedbilateraloperatio…     

耳内镜下鼓膜置管术治疗儿童分泌性中耳炎的疗效研究

目的 探讨耳内镜下鼓膜置管术治疗儿童分泌性中耳炎的效果.方法 选取广东省东莞市厚街医院2010年11月至2013年3月间入院治疗的136例儿童分泌性中耳炎患者为研究对象,对患者的相关临床资料进行比较分析,并对患者采用不同治疗方法后的治疗效果进行比较.结果 两组患者实施不同治疗方法后,治疗组患者总有效率高于对照组;中耳积液时间比较,治疗组患者优于对照组患者;复发率比较,治疗组低于对照组,且差异有统计学意义（P均＜0.05）.结论 采用耳内镜下鼓膜置管术联合腺样体切除术效果显著,是治疗儿童分泌性中耳炎的安全可靠选择.     

豚鼠分泌性中耳炎鼓室硬化进程

目的制作鼓室硬化豚鼠模型,验证分泌性中耳炎鼓膜置管是鼓室硬化的重要病因。方法选择健康豚鼠50只,鼓室内注射肺炎链球菌液。注射7 d后选取有中耳积液的30只豚鼠,左耳置入鼓膜通气管,右耳行鼓膜切开作为对照。1个月、3个月、6个月后分别取A、B、C组豚鼠的中耳粘膜,观察其组织形态变化。结果在制作模型3个月以及更长时间的实验耳中可出现鼓室硬化病理改变, 组织纤维化程度及钙质沉积与通气管放置时间成正比。结论鼓膜置管是鼓室硬化重要病因。临床鼓膜置管手术需谨慎。     

现代化护理干预在分泌性中耳炎患儿护理中的应用

目的:分析现代化护理干预在分泌性中耳炎患儿护理中的应用效果。方法:以2018年1月至2018年12月来本院接受的60例分泌性中耳炎患儿为研究对象,运用随机的方式分为对照组与研究组,每组各30例。对照组实施常规护理,研究组在实施常规护理手段的基础上加施现代化护理干预,以护理满意度、护理质量为具体指标进行对比,其中护理满意度包括满意、一般、不满意三个分支指标,护理质量包括基础护理评分、病房护理评分、健康教育评分三个分支指标。结果:在护理完成后,研究组分泌性中耳炎患儿的护理满意度高于对照组患儿,P<0.05,差异具有统计学意义;研究组分泌性中耳炎患儿在基础护理评分、病房护理评分、健康教育评分等方面皆高于对照组患儿,P<0.05,差异具有统计学意义。结论:现代化护理干预在分泌性中耳炎患儿护理中的应用具备良好的效果,不仅仅可以提升患儿的护理满意度,更能够通过不同的护理手段来促进患儿早日康复。     

Effects of increased payment for ventilation tube insertion on decision making for paediatric otitis media with effusion

Objective The National Health Insurance (NHI) in Taiwan raised the physician fee for myringotomy with ventilation tube insertion (VTI) from $61.5 to $117.6 in July 2004. This study aimed to evaluate if the increased payment affected the decision making of physicians. Methods This study is a retrospective analysis by using NHI databank in Taiwan. All children less than 12 years old who underwent VTI from 1 July 2003 to 30 June 2006 were included. Waiting time and case numbers before and after the increased VTI payment were compared. The waiting time between public and private hospitals was also examined. Results From the 7408 cases evaluated, there was no difference in waiting time before and after the raise of VTI payment, and no difference within each year group. The case number of VTI increased significantly after the increase in VTI payment (P < 0.05). The waiting time of VTI performed in private hospitals was shorter than that in public hospitals (P = 0.0001). Conclusion The waiting time of VTI for children with otitis media with effusion (OME) has not been shortened after the increase in VTI payment. Waiting time in private hospitals is shorter than that in public hospitals. Increased payment for VTI has no effect on the physicians' decision making regarding to waiting time for children with OME in Taiwan.     

Pure tone hearing profiles in children with otitis media with effusion

Introduction: Otitis media with effusion (OME) is a common middle ear disease in children. The associated conductive hearing loss is a major concern for hearing health professionals. The aim of the present study was to describe the configuration of pure tone audiograms of children with OME and to design a statistical stratification algorithm to facilitate hearing loss profiling in children with OME.

Methods: School age children with OME were recruited. Bone and air conduction thresholds were obtained using standard procedures. Hierarchical cluster analysis was employed to determine audiometric profile groups. The Mandarin Hearing in Noise Test was used to measure sentence perception in children for cluster analysis validity assessment.

Results: Ninety-seven children (164 ears) aged between 72 months and 153 months were examined. Air conduction thresholds averaged for 500?Hz, 1000?Hz and 2000?Hz were in the range of 8.3–53.3?dB HL with a mean of 26.8?dB HL. Bone conduction thresholds were found to be influenced by middle ear pathology with a maximal elevation at 2000?Hz of 25?dB HL. Four audiometric profiles were identified. Cluster 1 contained 54 ears (32.9%) with normal or near normal hearing, Clusters 2 contained 37 ears (22.6%) with mild hearing loss, Cluster 3 included 48 ears (29.3%) and Cluster 4 included 25 ears (15.2%) with moderate hearing loss. Stability and validity of the four-cluster profiling procedure was examined and established with satisfactory results.

Conclusions: OME in children is associated with pure tone hearing thresholds ranging from normal to moderate hearing loss. The hierarchical clustering algorithm proved useful as a novel means of profiling hearing loss in children with OME and may assist in identifying affected children at greater risk of auditory disadvantage.

• Implications for rehabilitation

• A hierarchical cluster analysis method can be used to determine audiometric profiles in children with OME.

• This algorithm assists to identify children at greater risk of auditory disadvantage.

• Cluster groups with more elevated pure tone thresholds may be targeted for priority in clinical surveillance and medical/surgical intervention.

     

分泌性中耳炎骨导听阈提高的临床分析

分泌性中耳炎是以传导性聋及鼓室积液为主要特征的中耳非化脓性炎性疾病,是小儿和成人常见的听力下降原因之一。分泌性中耳炎引起的听力下降主要为传导性聋,但部分病人可合并骨导听阈的升高。本文通过回顾性分析,对分泌性中耳炎病人进行骨导听阈观察,以探讨分泌性中耳炎是否可引起感音神经性聋。     

顺尔宁佐治儿童分泌性中耳炎的临床疗效

目的探讨顺尔宁佐治儿童分泌性中耳炎的临床疗效。方法选择我院2013年3月~2014年3月保守治疗的分泌性中耳炎患儿100例,所有入组患儿均符合分泌性中耳炎诊断标准,随机分为对照组和治疗组,各50例,对照组患儿给予静脉滴注头孢哌酮治疗,2次/d,治疗组在对照组的基础上辅以顺尔宁口服治疗,1次/d,每天于患儿睡前口服。比较两组的患耳疼痛、鼓膜膨隆内陷、中耳腔渗液及听力好转、体征消失时间。结果治疗组在患耳疼痛、鼓膜膨隆内陷及中耳腔渗液消失、听力好转时间比对照组短,治疗组和对照组总有效率为98%、82%,两组差异有统计学意义（P<0.01）;治疗组与对照组患儿治疗后患儿及家属满意度分别为100%、84%,差异具有统计学意义（P<0.05）。结论顺尔宁佐治儿童分泌性中耳炎疗效确切,未见不良反应,值得临床推广使用。     

腺样体刮除术对分泌性中耳炎患儿的治疗疗效观察

目的了解腺样体刮除术对顽固性分泌性中耳炎患儿的治疗效果。方法回顾性调查分泌性中耳炎患儿23例(25耳)腺样体刮除术或腺样体刮除术结合鼓膜穿刺术后的疗效。结果治愈17例,好转5例,术后随诊半年至1年,1例(单耳)复发。有效率为96%(24/25)。结论腺样体刮除术适合顽固性分泌性中耳炎患儿的治疗。     

鼻内镜下腺样体切除联合鼓室置管治疗儿童阻塞性睡眠呼吸暂停低通气综合征伴分泌性中耳炎

目的探讨同期鼻内镜下低温等离子行腺样体切除联合鼓室置管治疗儿童阻塞性睡眠呼吸暂停低通气综合征(OSAHS)伴分泌性中耳炎的疗效。方法对92例(132耳)儿童OSAHS伴分泌性中耳炎患者分为两组:A组52例(70耳),采用鼻内镜下腺样体切除联合鼓室置管治疗;B组40例(62耳)仅在鼻内镜下腺样体切除而不行鼓室置管。结果 A组有效率为94.29%;B组有效率为65.15%。两组比较差异有显著性(χ8=18.122,P<0.05)。A组术后中耳积液平均时间为(5.34±1.35)d。B组术后中耳积液平均时间为(16.63±5.57)d。两组比较差异有显著性(t值=16.408,P<0.05)。结论鼻内镜下低温等离子行腺样体切除联合鼓室置管治疗儿童OSAHS伴分泌性中耳炎,在保证OSAHS疗效的同时,又缩短了中耳积液时间,提高了听力。     

预防性鼓室置管在治疗分泌性中耳炎中的应用

目的探讨预防性鼓室置管对分泌性中耳炎患者的疗效。方法选取76例分泌性中耳炎患者,随机分为试验组和对照组,各38例。试验组行鼓室置管术,对照组行鼓膜穿刺或鼓膜切开术,两周后比较疗效。随访2年,比较复发率。结果术后两周比较,试验组有30例治愈,其他均好转,有效率100％,但术后第3天出现2例患者通气管脱落,行保守治疗,未进行再次置管手术;对照组治愈25例,好转7例,无效6例,有效率为84．21％。随访期间,试验组复发3例,复发率7．89％,对照组复发15例,复发率26．32％。结论预防性鼓室置管能降低分泌性中耳炎的复发率,但对短期疗效优势不明显。     

腺样体消融术同期咽鼓管球囊扩张术治疗儿童慢性分泌性中耳炎伴咽鼓管功能障碍的短期疗效

目的 观察腺样体消融术同期咽鼓管球囊扩张术治疗儿童慢性分泌性中耳炎伴咽鼓管功能障碍的短期疗效.方法 选择本院2019年1月至2020年5月收治的96例慢性分泌性中耳炎伴咽鼓管功能障碍患儿为研究对象,随机将其分为对照组与观察组,各48例.对照组采取腺样体消融术治疗,观察组采取腺样体消融术同期咽鼓管球囊扩张术治疗.观察并比...     

电子鼻咽喉镜咽鼓管置管治疗分泌性中耳炎

目的 探讨电子鼻咽喉镜下咽鼓管置管治疗分泌性中耳炎的方法及疗效.方法 在电子鼻咽喉镜下经咽鼓管向鼓室方向置入硬脊膜外麻醉导管,留置7d,隔天注入空气及地塞米松与糜蛋白酶混合液0.5～1mL.随访3～18个月.结果 共治疗138耳,治愈71耳(51.45%),有效49耳(35.51%),无效18耳(13.04%),有效率86.96%.结论 电子鼻咽喉镜下咽鼓管置管治疗分泌性中耳炎,操作简便,效果可靠,无明显并发症.     

Literacy skills of Australian Indigenous school children with and without otitis media and hearing loss

Abstract

This study examined the relationship between reading, spelling, and the presence of otitis media (OM) and co-occurring hearing loss (HL) in metropolitan Indigenous Australian children, and compared their reading and spelling outcomes with those of their non-Indigenous peers. OM and HL may hinder language development and phonological awareness skills, but there is little empirical evidence to link OM/HL and literacy in this population. Eighty-six Indigenous and non-Indigenous children attending pre-primary, year one and year two at primary schools in the Perth metropolitan area participated in the study. The ear health of the participants was screened by Telethon Speech and Hearing Centre EarBus in 2011/2012. Participants’ reading and spelling skills were tested with culturally modified sub-tests of the Queensland University Inventory of Literacy. Of the 46 Indigenous children, 18 presented with at least one episode of OM and one episode of HL. Results indicated that Indigenous participants had significantly poorer non-word and real word reading and spelling skills than their non-Indigenous peers. There was no significant difference between the groups of Indigenous participants with OM and HL and those with normal ear health on either measure. This research provides evidence to suggest that Indigenous children have ongoing literacy development difficulties and discusses the possibility of OM as one of many impacting factors.     

应用自制咽鼓管导管治疗分泌性中耳炎

分泌性中耳炎以耳阻塞感、耳鸣、听力下降、中耳腔内(昨)化脓性积液等为特征,治疗多采用咽鼓管吹张,鼓膜穿(测)或鼓膜切开置管等.通常经咽鼓管导管吹张,只能给气,为经该导管同时给药、方便治疗,我们对导管作了一些改进,2005年2月～2007年10月应用此改进导管治疗分泌性中耳炎66例(73耳),效果较好,报告如下.     

纤维鼻咽镜下经咽鼓管鼓室内注药治疗分泌性中耳炎

目的：探讨纤维鼻咽镜下经咽鼓管口鼓室内注药治疗分泌性中耳炎的疗效。方法：回顾性分析50例(58耳)分泌性中耳炎患者，纤维鼻咽镜下用直径1mm的塑料管从咽鼓管咽口插入，行咽鼓管扩张和疏通后抽液并在鼓室内注入α-糜蛋白酶和地塞米松混合液1ml，每2周1次，治疗2次。结果：随访3个月后痊愈29耳(29／58)，好转13耳(13／58)，无效16耳(16／58)，总有效率是72．4％(42／58)。结论：纤维鼻咽镜下经咽鼓管口鼓室内注药治疗分泌性中耳炎安全有效；操作简便，可作为分泌性中耳炎的治疗选择之一。     

变态反应在分泌性中耳炎中的作用

分泌性中耳炎的致病因素复杂多样,其中变态反应在这一过程中扮演了重要角色。近年来,随着分子生物学及免疫学研究进展,中耳作为独立免疫防御系统的理论逐渐被接受,本文就分泌性中耳炎与变态反应的关系进行综述。     

Sobrerol in the treatment of secretory otitis media in childhood

The therapeutic activity and tolerability of sobrerol, a muco-active agent, were evaluated in 30 children (aged 5-10 years) with secretory otitis media. The drug was administered once daily by inhalation for 10 days consecutively at a dose of 40 mg/3 ml. Clinical assessments showed a significant improvement in the objective measures together with good tolerability. Moreover, sobrerol was shown to improve impedance values; this is an important aspect of the modifications induced by this drug in diseases involving the ear.     

鼻内镜在鼻咽癌放疗后分泌性中耳炎中的应用

目的 探讨鼻内镜在鼻咽癌放疗后分泌性中耳炎治疗中的应用价值。方法 对47例68耳放疗后确诊为分泌性中耳炎的患者，在鼻内镜下清除鼻咽脓痂，鼻咽冲洗，分离咽鼓管咽口粘连，咽鼓管导管吹张，鼓膜穿刺、切开，鼓室置管等。结果 随访1年后，47例存活39例，存活患者中分泌性中耳炎治疗的有效率为89．1％。结论 鼻内镜是治疗鼻咽癌放疗后分泌性中耳炎较为理想的辅助工具。     

鼻内镜下切割吸引器行腺样体切除术治疗儿童分泌性中耳炎的临床研究

目的 探讨鼻内镜下用切割吸引器行腺样体切除术治疗儿童分泌性中耳炎的临床疗效.方法 50例(96耳),采用气管插管吸入加静脉复合全身麻醉,在4 mm0°鼻内镜下用切割吸引器行腺样体切除术,10例同时行扁桃体切除术.结果 50例随访半年,治愈:38例(76耳)听力明显改善,纯音听阈恢复正常,声导抗检查"A"型图;好转:8例(16耳)听力较术前改善,纯音听阈提高15dB;无效:4例(4耳),术后听力无明显提高.结论 鼻内镜下切割吸引器行腺样体切除术治疗儿童分泌性中耳炎,方法简单,疗效确切,无并发症,无副作用.