鼓膜置管术：置管位置对管保留时间和穿孔风险的影响
Tympanostomy Tube Placement: The Effect of Location on Tube Retention and Risk of Perforation.
文献信息
| PMID | 42859552 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Jason G May |
| 作者单位 | Department of Otolaryngology - Head and Neck Surgery Medical College of Georgia at Augusta University, Children's Hospital of Georgia Augusta Georgia USA. |
| 期刊 | Laryngoscope investigative otolaryngology |
| SCI 分区 | Q2 |
| IF | 2.1 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 耳科 |
中文摘要
目的： 本回顾性队列研究比较了鼓膜置管位于前下象限与后下象限的管保留时间以及早期脱出和穿孔的风险。研究假设认为，前下象限置管和后下象限置管均是同样有效且安全的置管位置，具有相同的管保留时间和鼓膜穿孔风险。
方法： 在一家主要学术中心的儿童医院完成了经IRB批准的回顾性病历审查。研究纳入了2019年2月至2021年2月期间接受置管术的6个月至16岁儿童的数据。收集了人口统计学和临床因素。
结果： 在905名患者和1800只耳中，共有1584只耳在前下象限置管，216只耳在后下象限置管。前下象限的管保留时间为487天，后下象限为456天。前下象限的穿孔风险为1.4%，而后下象限在本研究中为0%。单变量分析显示有差异但无统计学显著性（1.10 [0.95, 1.27]）。多变量分析证实了这一微小差异，HR=1.11 [0.96, 1.30]。
结论： 本研究表明，鼓膜置管位于前下象限与后下象限在管保留时间或鼓膜穿孔风险方面没有差异。与早期脱管相关的因素包括年龄较大、腭裂以及复发性急性中耳炎的诊断。T型管脱出较慢，符合预期。
证据等级： 3。
英文摘要
OBJECTIVE: The retrospective cohort study compares tube location in the anterior-inferior quadrant versus the posterior-inferior quadrant and time of tube retention along with the risk of early extrusion and perforation. The study hypothesis holds that both anterior-inferior placement and posterior-inferior placement are equally effective and safe locations for tube placement with equal tube retention and risk for tympanic membrane perforation.
METHODS: An IRB-approved retrospective chart review was completed at a major Academic Center's Children's Hospital. The study included data from children who underwent tube placement between 6 months and 16 years old between February 2019-February 2021. Demographics and clinical factors were collected.
RESULTS: Of the 905 patients and 1800 ears, a total of 1584 ears had tubes placed in the anterior-inferior quadrant and 216 were placed in the posterior-inferior quadrant. Tubes remained in place for 487 days in the anterior-inferior quadrant and 456 in the posterior-inferior quadrant. The risk of perforation was 1.4% in the anterior-inferior quadrant and 0% in our study for the posterior-inferior quadrant. Univariate analysis showed a difference but was not significantly different (1.10 [0.95, 1.27]). This slight difference was confirmed by multivariate analysis HR = 1.11 [0.96, 1.30].
CONCLUSION: This study shows that there is no difference in tube retention or risk of tympanic membrane perforation based on location of tympanostomy tube placement either in the anterior-inferior quadrant versus the posterior-inferior quadrant. Factors associated with earlier tube extrusion included older age, cleft palate, and recurrent acute otitis media as the diagnosis. T-tubes had slower extrusion, as expected.
LEVEL OF EVIDENCE: 3.