| Objective:Secretory otitis media is a nonsuppurative effusion in the middle ear that caus ed by multiple factors.The common clinical symptoms are conductive deafness,tinnit us and ear feeling of pressure.Therapies include medicine,operation and preventive care.Children's secretory otitis media whose clinical history or medicine treatment more than 3 months are addvised to implement operation.Traditional surgical metho ds,such as auripuncture,myringotomy and tympanostomy tube,technology is more mature,but there are still some risk and related complications.Hoever,it's very impor tant to reduce the risk and complication about the operation and improve the treat ment efficiency for patient's interest.Therefore,the purpose of this study is to discu ss the efficacy about secretory otitis media with low-temperature plasma tympanic membrane perforationdownside,compare with the two surgery about myringotomy an d tympanostomy tube at the same time.Materials and methods:This test is a retrospective analysis 79 patients with children's secretory otitis media,127 case were recruited for this study from January 2016 to April 2018 in the sixth affilated hospital of guangzhou medical university,with adenoid hypertrophy or not.All patients'ear endoscope diagnosised SOM and acoustic immitance measurement were B graph,nasal endoscope understanding the nasopharynx situation before the surgery.27 ears were applied to low-temperature plasma tympanic membrane perforationdownside,while48 ears were applied to myringotomy and 52 ears were apply to tympanostomy tube.the children who had adenoid hypertrophy were excised if it's necessary at the same time.the efficiency of treatment included cure and improvement,while the void cases were treatment failure.SPSS Statistics 19 software was applied to analyze all the data.According to characteristics of software analysis data,Pearson test and Fisher test were used respectively to analyze the data.The difference between P<0.05 was statistically significant.Results:1.There were total of 79 patients with SOM(127ears,31unilateral and 48 ailateral)were collected,including 93 males and 34 females,64 left ears,63 right ears,3-14 years old,and with a median age of about 6 years.2.27 ear(21.3%)underwent low-temperature plasma tympanic membrane perforationdownside(group A),48 ears(37.8%)underwent myringotomy(group B),52ears(40.9%)underwent myringotomy with grommet insertion(group C).3.All the case followed up three months and compared the result in the first month and third month.Collection the situation of clinical symptoms,tympanic membrane and external auditory canal damage during the operation,recidivation,otitis media and tympanic membrane perforation.4.In the time of one month and three month after the surgery,The effective rate of the group A were both 100 percent.The data of the group B were 66.67 percent and 89.58percent.The data of group C were 96.15 percent and 92 percent.The rusult meant that the effective rate of this three group were different.It was expressed in group B had statistical difference about the other two groups on the first month(?~2=11.44,P=0.001),but no statistical difference between group A and group C.The were no statistical differece about the effective rate of the three groups after the third month(?~2=3.291,P=0.193).While the operation damage of group A is less than group C(?~2=8.463,P=0.004).Conclusion:1.The operation time of low temperature plasma tympanic membrane perforation surgical was short.It caused lesser damage to tympanic membranous and exernal acoustic meatus,and has good clinical effecy.2.The eardrum healing time of low temperature plasma typanic membrane perforation usually need 1 to 3 months.3.The recurrence rate of low temperature plasma tympanic membrane perforation surgical was less than myringotomy.4.The clinical curative effect of low temperature plasma tympanic membrane perforation surgical as good as tympanostomy tube.But it can reduce the risk of operation and ventilation pipe loss. |
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