ABSTRACT
OBJECTIVE:To compare therapeutic efficacy and safety of dexamethasone with different administration routes in the treatment of chronic secretory otitis media. METHODS:A total of 150 patients with chronic secretory otitis media were random-ly divided into control group(75 cases)and observation group(75 cases). Control group was given Dexamethasone sodium phos-phate injection 5 mg by auripuncture under endoscope. Observation group was given Dexamethasone sodium phosphate injection 5 mg via eustachian tube under endoscope. Both groups were given relevant medicine every 2 days,for 3 times in total. Clinical effi-cacies of 2 groups were observed as well as bone conduction threshold under 1,2,4,8 kHz,the levels of water channel protein 1 and water channel protein 4,recurrence,the occurrence of tympanic cavity effusion before and after treatment. The occurrence of ADR was recorded. RESULTS:The total response rate of observation group(93.33%)was significantly higher than that of control group(80.00%);recurrence rate and the incidence of tympanic cavity effusion of observation group were significantly lower than those of control group,with statistical significance(P0.05). After treatment, the levels of bone conduction threshold in 2 groups were significantly lower than before;the observation group was significantly lower than the control group. The levels of water channel protein 1 and water channel protein 4 in 2 groups were significantly high-er than before;the observation group was significantly higher than control group,with statistical significance (P0.05). CONCLUSIONS:The administration of dexa-methasone via eustachian tube under endoscope is significantly better than auripuncture in terms of therapeutic efficacy for chronic secretory otitis media,relieving clinical symptom,improving bone conduction threshold,up-regulating water channel protein level, reducing the risk of recurrence and tympanic cavity effusion. The two routes of adimistration have similar safety.
ABSTRACT
OBJECTIVE To compare the clinical efficacy between adenoidectomy combined with auripuncture (AT+A) and adenoidectomy combined with tympanostomy tubes (AT+T) in children wiht otitis media with effusion. METHODS 92 cases of children with otitis media with effusion were selected from September 2010 to September 2014 in our hospital which was divided into AT+T group and AT+A group, depending on therapy methods.There were 48 in AT+T group and 44 in AT+A group. Retrospective analysis were made on a series of clinical data ,including the therapeutic effect, hearing threshold before and after treatment, infection rate and recurrence rate. RESULTS The hearing threshold has been significantly reduced within one year of follow-up after treatment,however,there was no significant difference (P>0.05). Total efficiency rate was 97.9% in AT+T group and 95.4% in AT+A group, no significant difference was found (P>0.05). The average middle ear fluid duration, infection and recurrence rate of children in AT+T group and AT+A group was (7.3±0.8) days, 6.3%, 4.2% and (11.7±0.4) days, 15.9%, 11.4% respectively, there was significant differences (P<0.05). CONCLUSION Both AT+T and AT +A have a good therapeutic effect for children with otitis media with effusion, which can significantly improve the hearing. Compared to AT+A, AT+T have a higher recovery rate,significantly reduce the recurrence and infection rate,and may be more suitable for clinical treatment of children with otitis media with effusion.
ABSTRACT
OBJECTIVE:To observe the efficacy and safety of different administration of dexamethasone in the treatment of se-cretory otitis media. METHODS:Data of 92 patients with secretory otitis media was retrospectively collected and divided into ob-servation group(43 cases)and control group(49 cases)by different administration. Observation group received 5 mg Dexametha-sone injection by injection in the eustachian tube in the assisted by video laryngoscope,once every 2 day. Control group received 5 mg Dexamethasone injection by injection in the eustachian tube,once every 2 day. 7-day was regarded as 1 treatment course. 1 more course for uncured patients,and no more than 4 courses. Clinical efficacy,and tumor necrosis factor-α(TNF-α),C-reactive protein(CRP),interleukin-6(IL-6),IL-10 levels before and after treatment,and 1-year cumulative recurrence rate after cured and the incidence of adverse reactions in 2 groups were observed. RESULTS:The total effective rate in observation group was signifi-cantly higher than control group,1-year cumulative recurrence rate after cured was significantly lower than control group,the dif-ferences were statistically significant(P0.05). After treatment,TNF-α and IL-6 level in 2 groups were significantly lower than before, and observation group was lower than control group,the differences were statistically significant(P0.05). And there was no significant difference in the incidence of adverse reactions between 2 groups(P>0.05). CONCLUSIONS:The efficacy of dexamethasone by injection in the eustachian tube in the assisted by electron-nasopharyngolaryngoscopy is superior to auripuncture administration,it can reduce re-currence rate,with good safety.