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Objective To investigate the hearing outcome efficiency of tympanostomy tubes and when combined with adenoidectomy for otitis media with effusion treatment. Methods A systematic literature review of tympanostomy tubes and tympanostomy tubes combined with adenoidectomy were performed using PubMed, EMBASE,the Cochrane Library,MEDLINE,all of the included studies were randomized controlled trial. The quality of included studies was evaluated according to the Risk of Bias Table of the Cochrane Handbook. Data were analyzed with Review Manager 5.02 software. Heterogeneity was examined,and forest plot was drawn. Results All of the included 4 studies were randomized controlled trials. At 6 month follow-up patients,the tym-panostomy tubes and tympanostomy tubes combined with adenoidectomy had no difference in hearing improvement (WMD = 1.06,95%CI-0.18 ~ 2.29,P = 0.09). At 12 month follow-up patients,the tympanostomy tubes com-bined with adenoidectomy were better than tympanostomy tubes alone(WMD = 3.03,95%CI 0.91 ~ 5.14,P =0.005). Conclusions The meta analysis result reveals that tympanostomy tubes combined with adenoidectomy have an advantage in long term follow up time for hearing improvement in children's otitis media with effusion treatment.
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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.
RESUMO
Introducción: La obstrucción del lumen de las colleras es un evento infrecuente, pero que anula la efectividad del dispositivo en la ventilación del oído medio. Existen múltiples opciones de tratamiento tópico para esta situación clínica, sin embargo, los reportes en la literatura al respecto presentan resultados contradictorios. Objetivos: Analizar la efectividad de distintos tratamientos tópicos para destapar una collera ocluida con coágulo de sangre. Material y método: Modelo experimental ex vivo, 184 tubos de ventilación obstruidos con coágulo de sangre. Tratamiento tópico, 8 grupos experimentales (agua oxigenada 3 por ciento, ácido acético 5 por ciento, ciprofloxacino 0,3 por ciento, vinagre de mesa, heparina, mezcla de H2O2/acetato 1:1, suero fisiológico 0.9 por ciento) y 2 grupos control (sin tratamiento). Revisión de permeabilidad de lumen de colleras a los 3, 7 y 10 días. Resultados: El agua oxigenada (H2O2) resulta ser el tratamiento más efectivo (88 por ciento y 92 por ciento de efectividad a los 7 y 10 días). Ciprofloxacino, vinagre de mesa, suero fisiológico y heparina son inefectivos, sin diferencias significativas con grupo control. Ciprofloxacino y suero fisiológico sedimentan más, e incluso tapan colleras previamente permeables. Conclusiones: H2O2 es un tratamiento seguro, efectivo y económico para destapar colleras obstruidas con coágulos de sangre.
Introduction: Blocked tympanostomy tubes (TT) are an uncommon event, but avoids the effectiveness of this device in middle ear ventilation. Many topical treatment options are available for this clinical situation, however, reports in literature show conflicting results. Aim: Analyze the effectiveness of various topical treatments to open blood clot blocked TT. Material and Method: Ex vivo experimental model. 184 blood clot blocked TT. Topical treatment, 8 experimental groups (3 percent hydrogen peroxide, 5 percent acetic acid, 0,3 percent ciprofloxacin, vinegar, heparin, mixture 1:1 H2O2/acetate, 0.9 percent saline) and 2 control group (no treatment). Review of tube permeability at 3, 7 and 10 days of treatment. Results: H2O2 is the most effective treatment (88 percent & 92 percent effectiveness at 7 & 10 days). Ciprofloxacin, vinegar, saline and heparin are ineffective, with no statistical differences with control group. Ciprofloxacin and saline even blocked previously opened TT. Conclusions: H2O2 is a safe, effective and economic treatment to clear blood clot blocked TT.