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Introdução: A presença de líquido na orelha médiapode causar perdas auditivas de condução e atrasos no desenvolvimento da criança. A timpanotomia e colocação do tubo de ventilação é o tratamento para casos em que o acúmulo de secreção é persistente. Objetivo: Avaliar o perfil epidemiológico e audiológico dos pacientes submetidos a timpanotomia e colocação do tubo de ventilação. Métodos: Estudo observacional, retrospectivo e transversal baseado em revisão de prontuários. Resultados: Foram incluídos 69 pacientes que realizaram o procedimento. O sexo masculino correspondeu a 64% e a média de idade foi de 8 anos. Otite média secretora foi o diagnóstico predominante. Pelo menos uma comorbidade foi encontrada em 63 pacientes, com predomínio de rinite alérgica. A maioria realizou apenas 1 operação. A bilateralidade da colocação do tubo ocorreu em 57%. Amigdalectomia e/ou adenoidectomia foram frequentemente adicionadas. Hipoacusia, roncopatia, prurido nasal, obstrução nasal e respiração oral noturna foram as queixas predominantes. Em relação à audiometria, 68% evoluíram para limiares normais; já na timpanometria 62% mostraram melhora no timpanograma. Conclusão: No tratamento com colocação de tubo de ventilação bilateral houve melhora pós-operatória na audiometria e timpanometria na maioria dos casos.
Introduction: The presence of fluid in the middle ear can cause conductive hearing loss and developmental delays in children. Tympanotomy and ventilation tube placement is the treatment for cases where secretion accumulation is persistent. Objective: To evaluate the epidemiological and audiological profile of patients submitted to tympanotomy and ventilation tube placement. Methods: Observational, retrospective and cross-sectional study based on medical records. Results: 69 patients who underwent the procedure were included. Males accounted for 64% and the mean age was 8 years. Secretory otitis media was the predominant diagnosis. At least one comorbidity was found in 63 patients, with a predominance of allergic rhinitis. Most performed only 1 operation. Bilateral tube placement occurred in 57%. Tonsillectomy and/or adenoidectomy were frequently added. Hypoacusis, snoring, nasal itching, nasal obstruction and nocturnal oral breathing were the predominant complaints. Regarding audiometry, 68% evolved to normal thresholds; in the tympanometry 62% showed improvement in the tympanogram. Conclusion: In the treatment with placement of a bilateral ventilation tube, there was postoperative improvement in audiometry and tympanometry in most cases.
Subject(s)
Humans , Child , Tympanic Membrane , Otitis Media with Effusion , Acoustic Impedance TestsABSTRACT
Based on the characteristics of clinical symptoms of secretory otitis media in traditional Chinese and Western medicine,by reference to clinical diagnostic criteria,efforts were made to analyze and establish the Western medical diagnostic criteria and traditional Chinese medicine( TCM) syndrome differentiation criteria for secretory otitis media,and summarize the modeling methods and model characteristics of secretory otitis media animal models. According to the clinical diagnostic criteria and symptom characteristics,the coincidence degree between the existing animal models and clinical symptoms was evaluated,and its advantages and disadvantages were defined. On the basis of the statistical results,there were fewer methods for modeling secretory otitis media animal models,and only a specific relevant pathogenic mechanism could be revealed. Among them,the model with a higher coincidence degree was genetic engineering technology modeling and injection into the middle ear vesicles. The two modeling methods of bacterial factors highly coincided with the clinical symptoms of Western medicine,but both failed to reflect the TCM syndrome type. Therefore,establishing an animal model that simultaneously reflects the characteristics of clinical symptoms of secretory otitis media in traditional Chinese and Western medicine,and improving the evaluation criteria of secretory otitis media based on animal models are the main tasks of future studies on secretory otitis media.
Subject(s)
Animals , China , Disease Models, Animal , Medicine , Medicine, Chinese Traditional , Otitis Media with Effusion/drug therapyABSTRACT
Objective: To explore the effect of Longdan Xiegantang on serum inflammatory factors, related proteins and immune function in patients of secretory otitis media (SOM) with liver and gallbladder wetness-heat Syndrome. Method:Totally 76 cases of SOM with liver and gallbladder wetness-heat syndrome admitted to our hospital from July 2017 to May 2018 were randomly divided into two groups, with 38 cases in each group. Control group was treated with triamcinolone acetonide and ambroxol. In addition to the therapy of control group, observation group was also treated with Longdan Xiegantang. Immunoglobulin (Ig) A, IgG, IgM, CD3+, CD4+, CD8+and NK, interleukin-1 beta (IL-1β), IL-5, IL-8, tumor necrosis factor-α (TNF-α), platelet activating factor (PAF), calcitonin (PCT) and water channel protein-1 (AQP-1), AQP-4, fiber link protein (Fn) and soluble interleukin-2 receptor (SIL-2R) levels of two groups were observed before and after treatment. Curative effect and adverse reaction were observed. Result:①Curative effect, after treatment, the total effective rate of observation group was 92.11%, which was higher than 76.32% of control group, with statistically significant differences (Z=2.108, Pα, PAF, PCT, IL-1β and IL-8 in observation group were lower than those in control group after treatment (PPP+, IgA, IgG and IgM of observation group were lower than those of control group (P+, CD4+, CD4+/CD8+ and NK were higher than those of control group (PConclusion:Longdan Xiegantang has a remarkable effect in treating patients of secretory otitis media with liver and gallbladder wetness-heat syndrome, and can restore symptoms, inhibit inflammatory response, activate cell and humeral immune system, reduce the secretion of AQP-1, SIL-2R and other proteins, and increase the secretion of AQP-4 and Fn proteins.
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Objective:To analyze the effect of different glucocorticoid administration routes in the treatment of children's secretory otitis media and impacts on immunologic function.Methods:Clinical data of children with secretory otitis media received treatment at our hospital from January 2016 to June 2016 were analyzed.Patients were divided into two groups by different glucocorticoid administration routes,Group A:intratympanic injection;Group B:oral administration.After one week,clinical effects and immunologic functions were tested and compared between the two groups.Results:A total of 87 patients were analyzed,Group A 45 cases,Group B 42 cases.After one week treatment,both of the two groups got significantly improved in audiology indexe (P<0.05),however,these index were more better in Group A when compared with those of Group B(P<0.05).Meanwhile,Group A patients got higher cure rate than that of Group B (91.1%,41/45 vs 73.8%,31/42;X2=4.558,P=0.033).Both of the two groups got significantly improved in CD3+T,CD4+T and CD4/CD8 (P<0.05) and decreased in CD8,IL-4,IFN-γ and IL-4/IFN-γ(P<0.05),but these markers changed more significant in Group A (P<0.05).Group A patients had a lower recurrence rate than Group B patients one year after treatment, the difference was statistically significant (9.76%,4/41 vs 29.03%,9/31;Log-rank X2=4.698,P=0.030).Conclusion:The treatment of children's secretory otitis media,the intratympanic injection of glucocorticoid shows a better effect than that of oral cortico-steroids.
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Objective To study the correlation between laryngopharyngeal reflux (LPR) and secretory otitis media (SOM).Methods A total of 294 adult patients with reflux-related symptoms were recruited in this study.The patients were evaluated with reflux symptom index (RSI) and reflux finding score (RFS).Tympanometry was conducted to all the patients.The 54 patients with the otitis media effusion with type B tympanograms were tested by auripuncture.Results Among the 294 patients,168 cases showed RSI＜13,in which 128 cases,31 cases and 9 cases had type A,type C,and type B tympanograms,respectively.The other 126 patients showed RSI＞13 in which 52 cases,29 cases and 45 cases had type A,type C,and type B tympanograms,respectively.Among the 294 patiems,172 patients showed RFS＜7,in which 131,32 and 9 cases had type A,type C,and type B tympanograms,respectively.The left 122 patients showed RFS＞7,in which 49,28 and 45 cases had type A,type C,and type B tympanograms,respectively.The ratio of type B tympanograms in the patients with RSI＞13 and RFS＞7 were both significantly higher than those in the patients with RSI＜13 and RFS＜7 (P＜0.05).The RSI scores of patients with type A,C,and B tympanogram were 8.6± 3.8,15.9±7.5,and 23.9±8.6,respectively,and the RFS score were 5.6±2.6,9.6±4.7,and 15.3±6.6,respectively.Compared with type A and C,the patients with type B tympanogram had significantly higher RSI and RFS score (P＜ 0.05).Among the 54 patients of type B tympanograms,those with RSI＜13 were found to have serous fluid,grume fluid,glue fluid as in 6 cases,2 cases,and 1 case,while the patient of the RSI＞ 13 had serous fluid,grume fluid,glue fluid in 13 cases,23 cases,and 9 cases,respectively.The otitis media effusion of the patients with the RSI＜13 were mainly serous,while those with the RSI＞13 were mainly sticky.Conclusion The correlation between LPR and SOM was significant.LPRmay accelerate the progress of SOM.
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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.
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Objective To investigate the diagnostic value of endotoscopy,tympanometry,pure tone audiometry (PTA) and high resolution temporal bone CT in children with secretory otitis media (SOM).Methods The study comprised 414 ears in 207 children with adenoid hypertrophy.Endotoscopy,tympanometry,PTA and high resolution temporal bone CT were conducted to evaluate the function of middle ear.Based on the imaging findings of tympanic cavity fluid by high resolution temporal bone CT,the diagnostic accordance rate of endotoscopy,tympanograms and PTA for SOM were studied.Results The diagnostic accordance rate of endotoscopy,tympanometry and PTA for SOM were 98.79％(409/414),98.07％ (406/414) and 88.41％ (366/414),respectively.The sensitivity of the three examinations were 99.20％(124/125),100％ (125/125),63.20％ (79/125),respectively.The specificity of the three examinations were 98.62％ (285/289),97.23％ (281/289),99.31％ (287/289),respectively.The diagnostic accordance rate of endotoscopy combined with tympanometry for SOM was significantly higher than any single examination or any combined examinations.Conclusion Endotoscopy combined with tympanometry shows a great value in diagnosing SOM,which is accurate and safe.
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Objective To investigate the effect of compound Shuanghua tablets combined with western medicine on serum secretions TNF-α,IL-6 and IL-10 of patients with secretory otitis media.Methods A total of 200 cases(244 ears) with acute secretory otitis media in Zhejiang Xinchang People’s Hospital from August 2014 to June 2016 were randomly divided into two groups.The control group with 100 case (120ears) were only given conventional western medicine therapy,and the treatment group with 100 case (124ears) were given compound Shuanghua tablets on the basis of the control group.Peripheral venous blood and middle ear effusion of each patient was collected before and after treatment ,and to detect the level of TNF-α, IL-6 and IL-10 by cytometric bead array,meanwhile the curative effect of the two groups were compared.Results The curative effect of the treatment group( 97.58%) was higher than the control group(85.00%),the difference were statistically significant(P<0.05).There were no significant difference on serum TNF-α,IL-6 and IL-10 between the two groups before and after treatment.The secretions TNF-α,IL-6 and IL-10 of the two groups after treatment were significantly reducing,and the treatment group were lower than the control group,the difference were statistically significant (P<0.05).Conclusion Compound Shuanghua tablets combined with western medicine in traetment SOM is effective distinctly,and can reduce secretions TNF-α,IL-6 and IL-10 effectly.
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OBJECTIVE:To investigate the effects of perioperative application of Eucalyptol,limonene and pinene(ELP)en-teric soft capsules on therapeutic efficacy and prognosis in children after grommet insertion of chronic secretory otitis media. METH-ODS:92 cases(145 ears)of chronic secretory otitis media were divided into 2 groups by random number table method,including 46 cases in observation group(68 ears)and 46 cases in control group(77 ears). Both groups received grommet insertion under gen-eral anesthesia by otomicroscope. Control group was not given any drugs;observation group was given ELP enteric soft capsules 1.2 g,bid,from 3 d before operation to 5 d after operation. Subjective therapeutic efficacy and pure tone audiometry of 2 groups were observed 3 days,5 days,2 weeks,1 month and 3 months after surgery as well as acoustic impedance monitoring in children with tube withdrawal from ear 1 month and 3 months after surgery. RESULTS:The total effective rates of observation group 3 days,5 days,2 weeks,1 month and 3 months after surgery were 72.06%,82.35%,85.29%,89.70%and 95.59%;those of con-trol group were 59.74%,66.23%,80.52%,87.01% and 92.21%,with statistical significance(P<0.05). The pure tone audiome-try score of observation group 3 days,5 days,2 weeks,1 month and 3 months after surgery were significantly lower than those of control group,with statistical significance(P<0.05). Therapeutic effective rates of acoustic impedance monitoring in children with tube withdrawal from ear 1 month and 3 months after surgery were 77.78% and 90.48% in observation group,which were signifi-cantly higher than 61.54% and 81.48% in control group,with statistical significance(P<0.05). CONCLUSIONS:The periopera-tive application of ELP enteric soft capsules can significantly improve function recovery and hearing level in children after grommet insertion of chronic secretory otitis media.
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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.
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Objective To investigate the vestibular functions ,especially the semicircular canal function in children with secretory otitis media (SOM ) .Methods A total of 24 children with SOM of median age of 8 .5 years had effusion that lasted about 3 to18 months ,compared with 12 children without effusion in the middle ear with the median age of 7 .9 years .The two groups received pure tone audiometry ,acoustic immitance and semicircular canal functions ,including the saccadic test ,the tracking test ,the gaze test and spontaneous nystagmus test .Results The 24 children with SOM had conductive hearing loss ,including 11 mild cases and 13 moderate case .The 12 children without SOM had the normal hearing .There were significant differences in semicircular canal functions between the two groups (8/24 & 0/12 , P<0 .05) .Age ,genders ,hearing -loss degrees and vertigo were not the significant factors which affected the semicircular canal function .Conclusion The function of semicircular canal was affected in children with SOM ,but the mechanisms were still not clear .
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Objective:To evaluate efficacy of tympanic membrane PE tube placement combined with oral endoscopic adenoidectomy in treating otitis media with effusion(OME) in children. Methods:Selected 87 cases(102ears)patients of secretory otitis media as research subjects between January 2012 to August 2014, in department of Otolaryngology in Heilongjiang Province, randomly divided into observation group(45cases, 55ears) and control group(42cases, 47ears),observation group used tympanostomy tube siphon drainage method combined with adenoidectomy for treatment, control group alone tympanostomy tube siphon drainage therapy, postoperative complications recorded data of patients later from the hospital after six and twelve months. Results:Two groups of patients after six months treatment and after twelve months(x2=5.705, x2=7.460;P<0.05), the results were statistically significant(P<0.05);in the middle ear effusion time, recurrent ear number, the number of ear infections, the results were also statistically significant(t=7.662, x2=4.197, x2=4.752;P<0.05). Conclusion:Under the ear drum using endoscopic drainage siphon tube method combined with adenoidectomy can effectively reduce postoperative complications in patients with quick, injury, etc, with high short-term and long-term efficacy, worthy application.
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OBJECTIVE:To establish a method for content determination of phosphatidylcholine in eustachian tube lavage fluid of patients with secretory otitis media. METHODS:HPLC was used. The samples were pretreated by liquid-liquid extraction. It was performed on the column of Hypersil CN with mobile phase of acetoneitril-methanol-phosphoric acid (100∶10∶0.6,V/V/V)at the flow rate of 1.8 ml/min,the detection wavelength was 205 nm,temperature was 30 ℃ and volume was 20 μl. RESULTS:The lin-ear range of phosphatidylcholine was 11.99-119.9 μg/ml(r=0.999 6);RSDs of precision tests of intra-day and inter-day were no more than 15%;average recovery was 97.54%(RSD=9.36%,n=9);the average content of phosphatidylcholine in eustachian tube lavage fluid of patients was(24.43±3.61)μg/ml. CONCLUSIONS:The method is simple and accurate,and can be used for the content determination of phosphatidylcholine in eustachian tube lavage fluid of patients with secretory otitis media.
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Objective To observe the opening movement of eustachian tube pharyngeal orifice in patients with secretory otitis media(SOM) by cine CT to mearsure the thickness of the lateral ET wall ,and to evaluate the roles played by those peri-tube structure in the pathogenesis of ET obstruction .Methods Twenty -seven SOM patients as experiment group underwent low -radiation dose cine CT scans of the ET ,the image were reconstructed into a cine image to see the opening movement of the eustachian tube pharyngeal orifice .The CT scan of sixty-four non-SOM patient as control group was performed .The images were reconstructed to show the relationship among the in‐ferior turbinate ,the nasopharyngeal soft tissue and the eustachian tube .These serial images were analyzed to meas‐uring the thickness of the lateral wall of ET cartilage segment and to find out whether the gas exist in the pharyngeal recess .Results The opening movement of the pharyngeal orifice was observed in 23 SOM patients ,the mean thick‐ness of the lateral wall of ET cartilage segment in ithe ears studied and healthy ears of SOM patients are 8 .93 ± 1 .6 mm and 8 .89 ± 1 .2 mm ,respectively ,much larger than those of in non-SOM patients ,but with no static signifi‐cance .The pharyngeal recess in 69 .0% (29/42) affected ears of som patients and 58 .3% (7/12) in healthy ears were gas free .This rate in som patients was significantly higher than that in the non-SOM patient group .Conclusion The etiologies of dysfunction of eustachian tube may include hypertrophic inferior turbinate ,chronic inflammation of eustachian tube mucosa ,compression of the nasal pharyngeal soft tissue .The compression of the nasal pharyngeal soft tissue may play an important role in the obstruction of the specific cartilage segment of the ET .
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Objective To study the feasibility and rehabilitation outcomes of one -stage cochlear implantation (CI) in profound deaf children with secretory otitis media (SOM ) .Methods A total of 11 profound deaf children with soal receired one -soage unilateral cochlear implantation with a follow -up period from 13~60 months .In-flamed mucosa in the mastoid as well as exudates were removed radical1y at the time of implantation for adequate drainage of the middle ear .After the sugery ,the patients were followed up and the hearing and rehabilitating out-comes were eveluated .Results All 11 patients were successfully operated with 8 cases in the right ear and 3 cases in the left ear .Among them ,7 cases were nucleus 24 CA ,1 case losa clarion AB 90 K ,2 cases were medel combi 40+and 1 case was pulsar .All patients were successfully operated .No infectious complications occurred .No recurrence of secretory otitis media was observed .After initial stimulation and post regular fitting ,the status of the implant-able devices were all stable .All the implantees had satisfied hearing and entered normal kindergartens or schools . Conclusion Profound deaf pediatric patients with SOM are not an absolute contraindication for CI .With sufticient pre-operation preparontion ,proper trentment and nursing .Cochlear implantation should be condnote as early as possible better rehabilitation performance .
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Objective To explore the treatment using two different ventilation tubes insertion for secretory o-titis media ,and to determine which factors are associated with the tympanic membrane perforation after a extrusion or surgical removal of a ventilation tube(VT) .Methods A retrospective analysis of 121 cases (210 ears) with re-fractory secretory otitis media from 1998 June to 2013 March was carried out .There were 58 cases (105 ears ) and 63 cases (105 ears) in patients and control group ,respectively .All subjects had more than 2 years of history ,and were treated by two types of ventilation tube (Goode -T and Shepard tube) .Various factors were analyzed to deter-mine the factors associated with persistence of a tympanic membrane perforation after VT extrusion or removal ,in-cluding gender ,age ,medical history ,ventilation tube pattern ,location ,history of previous VT insertions ,intuba-tion period reason for VT insertion ,condition of the TM ,nature of the tympanic cavity effusion and previous ade-noidectomy ,et .Results Analysis factors of perforation group (105 ears) and the control group (without perfora-tion ,105 ears) ,were statistically significant in ventilation tube pattern (χ2 =6 .916 ,P<0 .01) ,history of previous VT insertions(χ2 =7 .325 ,P<0 .01) ,frequency of previous VT insertions (χ2 =13 .01 ,P<0 .01)and the nature of the tympanic cavity effusion(χ2 =7 .04 ,P<0 .01) .The proportion of perforation group about Goode - T ventilation tube ,history of previous VT insertions ,the frequency of tube (more than 3 times) ,mucus of the middle ear cavity were 58 .4% ,57 .3% ,66 .7% and 57 .9% respectively ,others had no significant difference between the two groups . The multivariate analysis showed that ,regardless of the ventilation tube ,the frequency of tube was the tympanic membrane perforation risk factor ;Goode-T tube increased the risk of perforation of tympanic membrane was 1 .637 times than Shepard tube(OR=1 .637 ,P<0 .01) .Conclusion Using the Goode - T type ventilation tube ,history of previous VT insertions ,the frequency of tube (more than 3 times) ,mucus of the middle ear cavity were four risk factors for persistence of a tympanic membrane perforation after VT insertion for secretory otitis media .
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Objective To explore the relationship between adenoid vegetation children with different types of tympanograms and secretory otitis media in children and diagnosis of secretory otitis media .Methods A retrospec-tive study was carried out among 328 cases with adenoid vegetation in children ,including simple adenoid vegetation and associated with chronic tonsillitis and tonsillar hypertrophy ,from August 2010 to May 2012 .The incidence of secretory otitis media and outcomes of tympanometry for the diagnosis were analyzed .Results 104 cases were diag-nosed with secretory otitis media by tympanic membrane puncture or tympanostomy tube in 328 cases with adenoid vegetation (32 .31% );86 cases (147 ears) were finally diagnosed as secretory otitis media among 89 cases (152 ears) with type B tympanogram (147/152 ,96 .63% );16 cases (20 ears) were finally diagnosed secretory otitis media among 33 cases (49 ears) with type C tympanogram (20/49 ,40 .82% );2 cases (2 ears) with type As tympa-nogram were finally diagnosed .Conclusion With or without complaint of hearing loss ,children with adenoid vegeta-tion should be checked by routine tympanometry .Careful physical examinations and electric otoscope or ear endosco-py combined tympanometry can greatly reduce the rate of misdiagnosis of secretory otitis media .
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Objective To investigate and contrastive analyse the respective value of tympanograms and high resolution CT scan of temporal bone in the diagnosis of secretory otitis media .Methods The clinical data of 150 hos-pitalized patients with secretory otitis media in Department of ENTHNS ,Tongji Hospital ,Wuhan from 2009 to 2012 were retrospectively analyzed .Based on the surgical finding of tympanic cavity fluid ,the diagnostic accordance rate of tympanograms and temporal bone CT for middle ear effusion were calculated respectively ,and their diagnos-tic value were evaluated .Results The diagnostic accordance rate of tympanogram B for the middle ear effusion in secretory otitis media was 94 .5% (138/146 ears) ,the rate of abnormal tympanograms was 91 .6% (206/225 ears) , while temporal bone CT with a rate of 99 .2% (117/118 ears) .The difference between the latter two data was statis-tically significant(P<0 .01) .Conclusion The temporal bone CT scan ,with a higher diagnostic value for middle ear effusion in secretory otitis media ,could be used as a supplement to the acoustic immittance measurement ,especially to non-B tympanograms for the diagnosis of secretory otitis midia .
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Objective To investigate the technique and curative effect of later-period secretory otitis media treated with the eardrum incision,injecting medicine and compression. MethodsTo select 58 cases with later-period secretory otitis media in our hospital,all the patients were treated with eardrum incision and injecting medicine,moreover acoustic duct compression and go together with medicine treating. Results33cases(51 ears)were cued,10 cases(16 ears)were improved remarkablely;6 cases(9 ears)were improved;9 cases(16 ears)were ineffective.Total effective rate was 84.5%. ConclusionLater-period secretory otitis media treated with the eardrum incision,injecting medicine and compression had remarkable curative effect.
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Objective To explore the correlation between adenoid hypertrophy and secretory otitis media.Methods The cases of adenoid hypertrophy were screened and selected by nasopharyngeal lateral X ray.We chose 58 normal children after the clinical examination as control group.In accordance with the degree of adenoid hypertrophy,they were divided into three groups:the normal group,middle-grade and high-grade groups of adenoid hypertrophy with the association between the degree of adenoidal hypertrophy and the incidence rate of secretory otitis media analyzed.Results There was no difference in the incidence rate of secretory otitis media between the normal and middle-grade groups.The incidence rates of secretory otitis media were significantly different between the normal and high-grade groups(P＜0.01).Conclusion The incidence of secvetory otitis media and the degree of adenoid hypertrophy showed positive correlation.The greater is the size of adenoids, the severer is the degree of obstruction of the nasopharyngeal cavity and the higher is the incidence of secretory otitis media.