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目的探讨腺样体的不同形态同分泌性中耳炎(OME)间的关系以及充分切除咽鼓管咽口周围的腺样体组织对OME患儿预后的影响。方法 2009年1月～12月行低温等离子射频消融手术腺样体的患儿,均行听力测试,手术中根据腺样体与咽鼓管圆枕间接触的紧密程度,作者将腺样体的形态依次分为以下4组:Ⅰ组(无压迫型)、Ⅱ组(挤压型)、Ⅲ组(紧贴型)及Ⅳ组(混合型),伴OME的患儿术后1个月行听力复查,分析各种分型在伴OME和不伴OME的患儿中的差异以及手术对OME预后的影响。结果 191例患儿中有145侧(包括54例双侧OME患儿和37例单侧OME患儿)伴OME,另237侧(100例)无OME;Ⅰ组无压迫型腺样体伴发OME比例较低(P<0.05),而Ⅱ组、Ⅲ组及Ⅳ组腺样体是否伴发OME无显著性差异;进一步对37例单侧OME的患儿进行比较,3侧无压迫型腺样体都位于无OME侧,Ⅱ组伴发OME的比例较低(P<0.05),而Ⅳ组以伴发OME为显著(P<0.05),Ⅲ组在两侧间无明显差异;OME患儿术后1个月复诊,痊愈率85.5%,总有效率92.4%。结论腺样体与咽鼓管咽口间存在的不同毗邻关系,压迫越严重越易导致与OME,有效切除压迫咽鼓管咽口的腺样体可有效治疗OME。
Objective To investigate the relationship between the different forms of adenoids and secretory otitis media (OME) and the effect of adenoid tissue around the pharyngeal orifice of the eustachian tube on the prognosis of children with OME. Methods From January 2009 to December 2009, children undergoing low temperature plasma radiofrequency ablation of the adenoid were undergoing hearing tests. According to the close contact between the adenoid and the eustachian tube during operation, The morphological changes were divided into the following 4 groups: group Ⅰ (no compression type), group Ⅱ (extrusion type), group Ⅲ (close type) and group Ⅳ (mixed type), with OME 1 month after operation Hearing reexamination was performed to analyze the differences in various subtypes between children with or without OME and the effect of surgery on the prognosis of OME. Results Of the 191 children, 145 (including 54 children with bilateral OME and 37 children with unilateral OME) had OME, and the other 237 patients (100 patients) had no OME. Group Ⅰ had no complication of adenoids OME was lower (P <0.05), but there was no significant difference between group Ⅱ, group Ⅲ and group Ⅳ with or without OME; further comparison was made among 37 children with unilateral OME (P <0.05), but there was no significant difference between the two sides in group Ⅲ (P0.05); while the incidence of OME in group Ⅱ was significantly lower than that in group Ⅱ One month after surgery referral, the cure rate was 85.5%, the total effective rate was 92.4%. Conclusions There is a different adjacent relationship between the adenoid and the pharyngeal orifice of the eustachian tube. The more severe the compression is, the more likely it is to cause the OME with the OME.