The Analysis Of Risk Factors Of Tympanic Membrane Perforation And Recurrence After Grommet Insertion For The Treatment Of Secretory Otitis Media

Objective:To investigate the risk factors for tympanic membrane perforation and recurrence after grommet insertion for the treatment of secretory otitis media.Methods:The clinical data of 50 patients(66 ears)with otitis media who were admitted to the hospital from October 2014 to February 2017 were retrospectively analyzed.There were 10 ears(15.2%)in the perforation group and 56 ears(84.8%)in the non-perforation group;There were 17 ears(25.8%)in the recurrence group and 49 ears in the non-recurrence group(74.2%).All patients were treated with T-tube grommet insertion,analyzing the risk factors that may affect tympanic membrane perforation and recurrence which include gender,age,course of disease,auripuncture,tympanic membrane surface,nature of middle ear fluid,whether there was the removal of adenoids or not,whether extubated or not and the breather pipe retention time.Results:1.This study included 50 patients with a total of 66 ears,of which 39 ears(59.1%)were cured,10 ears(15.2%)were perforated,and 17 ears(27.8%)recurred.Nearly less half of the affected ears did not heal after surgery.2.There were 38 ears(57.6%)that were manually removed T-tubes,of which 9 ears(23.7%)were perforated;there were 28 ears(42.4%)that were spontaneously extubated,among which 1 ear(3.6%)was perforated.The difference was statistically significant(P<0.05).3.12 ears(18.2%)had breather pipe retention for longer than 12 months,including perforation of 4 ears(33.3%);34 ears(51.5%)had breather pipe retention for 6 months to 12 months,with 6 ears were perforated(17.6%);There were 20 ears(30.3%)which were spontaneously extubated within half a year,of which 0 ear perforated,and the difference in perforation rate between the groups was statistically significant(P<0.05).4.Gender,age,course of disease,auripuncture,tympanic membrane surface,nature of middle ear fluid,whether there was the removal of adenoids or not had no significant correlation with postoperative tympanic membrane perforation and recurrence of secretory otitis media.5.Whether extubated or not and the breather pipe retention time had no significant correlation with postoperative tympanic membrane recurrence of secretory otitis media.Conclusion:The risk of permanent perforation after grommet insertion is greater in patients with manually extubated than spontaneously extubated.Among them,the risk of permanent perforation in patients with T-tube retention for longer than 12 months is increased.It is recommended for patients who are not extubated to shorten the return interval after surgery for six months,then shorten the time of extubated according to their individual differences after surgery and in the condition of comprehensively assessing the nasal cavity and sinus conditions as well as avoiding the peak of upper respiratory tract infections.The influencing factors of this study have no correlation with the recurrence of secretory otitis media,which may be affected by the sample size or other relevant factors that need us to continue to explore.