Study Of The Efficacy On Otitis Media With Effusion By The Adenoidectomy Of Plasma-based Radiofrequency Combined With Middle Ear Treatment

Objective:In this paper,through a retrospective study of adenoid hypertrophy(AH)in children with Otitis media with effusion(OME),we explored the specific efficacy of OME which had different course and different character secretion after the adenoidectomy of low temperature plasma-based radiofrequency combined with different surgical methods,to further define the selection criteria of auripuncture and tympanostomy tube.Methods:Collecting 183 cases(aged from 2 to 12 years old,average 4.85 + 2.51 years old.male 102 cases,female 81 cases),which were diagnosed as AH with OME and treated in Otolaryngology Head and neck surgery department of XX Hospital during from September 2014 to March 2016,as the research object.All these patients were treated with the adenoidectomy of low temperature plasma-based radiofrequency in nasal endoscopy.According to the patient’s ear history,we divided them into 3 groups.group 1:ear history is unknown;Group 2:the period of the disease is less than 3 months;the 3 group:the course of the disease is for three months and above.The 3 group were divided into A,B groups.The 1、2 and A groups were all treated combining with auripuncture and injection,while the B group was treated combining with tympanostomy tube.Then the patients were divided into two groups(Serous group and Mucus group)according to hydrotympanum characters in operation.The total effective rate was calculated at 3 months postoperatively,following up untill cured or 6 months after operation.The patients with tympanostomy tube were even followed up for six months after removing the tube.The curative effect is divided into cure,valid treatment and invalid treatment according to the evaluation standard of OME.When 3 months after the operation,the invalid patients were to be further treated with tympanostomy tube,and the total effective rate of them was calculated after the surgery for 3 months.The incidence of postoperative complications was statistically analyzed.SPSS19.0 software was used to analyze the total effective rate of the four groups and the total effective rate of different hydrotympanum characters at 3 months after operation.By analyzing the history and related signs,we were exploring the selection criteria of auripuncture and tympanostomy tube in patients with AH and OME at the same time of the adenoidectomy of low temperature plasma-based radiofrequency.Results:After investigation and analysis,the total effective rate was 97.5%,92.0%,78.2%and 95.7%respectively in the 1,2,A and B groups at 3 months after operation.The total effective rate of group 1,2 and A was significantly correlated with the course of disease(X2=14.713 P<0.05),and the effective rate was significantly reduced for the patients who have 3 months and above of ear disease.The difference between the A and B groups was statistically significant(X2 = 5.202 P<0.05).The patients with auripuncture and injection by different hydrotympanum characters is divided into serous group and mucus group,and the counter part of the total effective rate when 3 months after the operation was 98.1%、71.4%;The B group with tympanostomy tube is also divided into the two groups above,and the total effective rate was 100%and 93.1%at 3 months after operation.Statistical analysis:the total effective rate in the groups of serous and mucus of the patients with auripuncture and injection was statistically significant(X2=34.939 P<0.05).There was no significant difference of the serous groups in the A and B groups(P>0.05),and the total effective rate of the mucinous group in the A and B groups was statistically significant(X2 =4.022 P<0.05).In the l、2 and A groups,21 patients who were invalid when 3 months after operation were further treated with tympanostomy tube,and the total effective rate was 85.7%at 3 months after the operation.The incidence of postoperative complications in group 1,2,A,B was 3.6%,10.2%,23.6%and 14.9%,respectively.Conclusion:1.The treatment of the adenoidectomy of low temperature plasma-based radiofrequency to AH with OME is simpler,less invasive and more effective.It is more conducive to the recovery of OME by removing the obstruction of pharynx nasalis completely which can avoid the damage caused by excessive tympanostomy tube.2.To the children who have AH with OME,the treatment options,which based on the adenoidectomy of low temperature plasma-based radiofrequency,is closely related to the course of the ear and the effusion of the middle ear.