CAJ | 학술논문

目的：探讨婴幼儿分泌性中耳炎的早期诊断方法及手术干预效果。方法将经226 Hz及1000 Hz声导抗、听性脑干反应、听觉稳态反应、畸变产物耳声发射和颞骨CT检查诊断为分泌性中耳炎，观察4～6个月未自愈的43例婴幼儿，分为手术干预组(22例)及继续观察组(21例)。手术干预组在全麻下行鼓膜切开置管术，继续观察组只指导家长进行家庭听觉语言康复。所有病例随访6～12个月，复查听力，并统计12个月内合并急性中耳炎的发生率。结果43例婴幼儿226 Hz及1000 Hz声导抗、听性脑干反应、听觉稳态反应、畸变产物耳声发射和颞骨CT检查均有不同程度异常；手术干预组在术后6个月及12个月时复查听阈明显低于继续观察组，12个月内并发急性中耳感染的发生率明显低于继续观察组。结论手术干预有助于减轻持续性婴幼儿分泌性中耳炎的听力损害并降低急性中耳感染的发生率。
목적：탐토영유인분비성중이염적조기진단방법급수술간예효과。방법장경226 Hz급1000 Hz성도항、은성뇌간반응、은각은태반응、기변산물이성발사화섭골CT검사진단위분비성중이염，관찰4～6개월미자유적43례영유인，분위수술간예조(22례)급계속관찰조(21례)。수술간예조재전마하행고막절개치관술，계속관찰조지지도가장진행가정은각어언강복。소유병례수방6～12개월，복사은력，병통계12개월내합병급성중이염적발생솔。결과43례영유인226 Hz급1000 Hz성도항、은성뇌간반응、은각은태반응、기변산물이성발사화섭골CT검사균유불동정도이상；수술간예조재술후6개월급12개월시복사은역명현저우계속관찰조，12개월내병발급성중이감염적발생솔명현저우계속관찰조。결론수술간예유조우감경지속성영유인분비성중이염적은력손해병강저급성중이감염적발생솔。
Objective To explore the early diagnosis and surgical intervention for secretory otitis media in infants. Methods Forty-three infants were diagnosed with secretory otitis media by 226 Hz and 1000 Hz acoustic immitance, auditory brainstem response, auditory steady-state responses, distortion products OAE with temporal bone CT and did not recover in 4-6 months. These infants were divided into surgical intervention group (22 cases) and observation group (21 cases). The surgical intervention group was treated with tympanostomy tube under general anesthesia and the observation group only received family-based hearing and speech rehabilitation. All the patients were followed up for 6-12 months to examine the hearing conditions and the incidence of acute otitis media was calculated within 12 months. Results All of the 43 infants had different degrees of abnormality in 226 Hz and 1000 Hz acoustic immitance, auditory brainstem response, auditory steady-state responses,distortion products OAE and temporal bone CT. The average hearing threshold of surgical intervention group was significantly lower than that of the observation group. The incidence of acute otitis media in one year was significantly lower than that of the observation group. Conclusion The surgical intervention can help to alleviate the hearing loss of chronic secretory otitis media in infants and can reduce the incidence of acute otitis media.