目的:探讨腺样体切除术治疗儿童分泌性中耳炎及鼾症的临床疗效。方法:对住院行腺样体切除术的120例分泌性中耳炎及鼾症患儿的临床表现、治疗方法和预后进行回顾性分析。结果:120例患儿经切除肥大的腺样体,辅以相应的药物治疗,临床症状均明显好转。结论:腺样体肥大较易成为儿童分泌性中耳炎及鼾症发病的基础因素。切除肥大的腺样体是治疗儿童分泌性中耳炎及鼾症有效、安全的方法。
【摘要】目的探讨鼓膜置管对鼻咽癌(NPC)患者放疗前后分泌性中耳炎(SOM)的疗效。方法2005年3月2010年1月将60例(84耳)NPC并发SOM患者分为两组:A组30例行鼓膜切开鼓膜置管;B组30例保守治疗为对照组,并行随访,对两组患者有效率和并发症发生率进行统计。结果60例中58例存活,1例死于全身衰竭,1例死于大出血。存活患者中治疗SOM有效率为:A组85.4%(35/41),B组为30.2%(13/43),两组差异有统计学意义(Plt;0.05);并发症发生率A组为14.6%(6/41),B组为69.8%(30/43),B组并发症高于A组,差异有统计学意义(Plt;0.05)。结论NPC患者在放疗后,咽鼓管功能受到严重损害,是不可逆的病变,鼓膜置管治疗NPC并发SOM较保守治疗效果好,并发症的发生率低。
目的 系统评价标准桃金娘油治疗分泌性中耳炎的疗效及安全性。 方法 电子检索Cochrane图书馆、PubMed、EMBASE、中国期刊全文数据库(CNKI)、维普(VIP)、中国生物医学文献数据库(CBM)六大数据库,检索时间自建库截止至2012年2月。根据Cochrane协作网手册评估纳入随机对照试验(RCT)的方法学质量,采用RevMan 5.0软件对数据进行Meta分析。 结果 共纳入8个RCT,研究结果显示,标准桃金娘油联合常规治疗分泌性中耳炎的总有效率优于单用常规治疗,但差异无统计学意义[RR=1.21,95% CI(0.98,1.50),P=0.08]。 结论 标准桃金娘油治疗分泌性中耳炎有一定疗效,但并不显著。因纳入研究质量较低,上述结论还需高质量、大样本的研究进一步验证。
Objective To assess the effectiveness and safety of adenoidectomy on otitis media with effusion (OME) in children. Methods Electronic databases were searched including Medline (1966-2001), EMbase (1974-2001), the Cochrane Controlled Trials Register (CCTR), Chinese Biomedical Database (CBM, 1989-2001). Five Chinese otolaryngology journals were handsearched. References of eligible studies were also screened for inclusion. Selection criteria were restricted to randomized controlled trials comparing adenoidectomy with other treatments in patients with OME in children. At least two reviewers independently assessed trial quality and extracted data. RevMan 4.1 was used for statistical analysis. Results Of the 248 literatures identified, 13 trials with 1 430 patients were eligible and were included in the systematic review. Overall, the methodological quality of the included trials was high, all from developed countries. None of the trials showed that the effects of adenoidectomy better than those of myringotomy and no treatments for OME in children. Four trials comparing adenoidectomy with grommets showed that the effects of grommets were better than those of adenoidectomy. Ten trials described post-surgical bleeding, velopharyngeal incompetence and nasopharyngeal stenosis. Conclusions At present, there is no evidence to either ascertain that adenoidectomy is better than other treatments for OME, or to suggest which type of surgery is the most effective one. Current trials indicate that early administration of adenoidectomy concomitant with grommets might be the most appropriate therapy for OME in children who fail to response to drug treatment, if multiple risk factors exist.
Objective To evaluate the diagnosis value of temporal Done high-resolution computed tornography (HRCT) in cholesteatoma. Methods There were 30 causes that had received the mastoid surgery because of cholesteatoma. Each patient’s mastoid plain films (Schuller’s and Mayer’s ) and HRCT had been taken and compared with each other and surgical findings and evaluated with health economic evaluation methods. Results The sensitivity rate in diagnosing cholesteatoma with HRCF was much higher than that with mastoid film (Plt;0.005). The more important benefit with HRCT was that it can afford the detail information in ear such as the ossicular chain, facial nerve canal, tympanic sinus, etc. which were basis for otologist in surgery to remove the focus thoroughly and reconstruct the middle ear function at the same time. In the view of health economic evaluation, HRCT is also much better than mastoid X-ray film. Conclusion HRCT should replace masloid Schuller’s and Mayer’s film in diagnosis cholesteatoma and HRCT should use as ordinary examination in chronic otitis media.