| Objectives: The aim of this work is to investigate a new approach, adenoidectomy(AT) + the puncture of the ear drum combined with positive eustachian tube insufflation to the treatment otitis media with effusion(OME) children with adenoidal hypertrophy(AH). By comparing with the method of AT + the puncture of the ear drum, AT + the puncture of the ear drum combined with positive eustachian tube insufflation is proved to be an effective approach in the treatment of OME children with AH.Methods: A total of 80 OME children with AH were collected and were divided into two groups randomly, A and B. Group A(65 ears, 40 children) were underwent AT + the puncture of the ear drum, and group B(63 ears, 40 children) were underwent AT + the puncture of the ear drum combined with positive eustachian tube insufflation. Nasal spray hormone(Mometasone furoate nasal spray or Fluticasone propionate nasal spray) and drugs dissolving the secretions(Ou Longma) were applied to children both in two groups one time a day for 3 months. The recovery conditions after surgery in two weeks, three months and six months of the two groups are analyzed. Furthermore, in order to analyze the efficacy of the two treatments, patients taking on viscous ear effusions, including 43 ears 25 children in group A and 51 ears 32 children in group B, are picked out for specific studies. By applying nonparametric and rank sum test, we can take curative effect evaluation of the two kinds of treatments.Results: Group A: Two weeks later, the cure rate was 52.31%(34/65), the improvement rate was 26.15%(17/65), the ineffective rate was 21.54%(14/65), the effective rate was 78.46%(51/65); Three months later, the cure rate was 72.31%(47/65), the improvement rate was 12.31%(8/65), the ineffective rate was 15.38%(10/65), the effective rate was 84.62%(55/65); Six months later, the cure rate was 81.54%(53/65), the improvement rate was 9.23%(6/65), the ineffective rate was 9.23%(6/65), the effective rate was 90.77%(59/65). Group B: Two weeks later, the cure rate was 66.67%(42/63), the improvement rate was 14.29%(9/63), the ineffective rate was 19.05%(12/63), the effective rate was 80.96%(51/63); Three months later, the cure rate was 82.54%(52/63), the improvement rate was 7.94%(5/63), the ineffective rate was 9.52%(6/63), the effective rate was90.48%(57/63); Six months later, the cure rate was 92.06%(58/63), the improvement rate was 3.17%(2/63), the ineffective rate was 4.76%(3/63), the effective rate was 95.24%(60/63). According to statistics, the effective rate is equal to that the cure rate plus the improvement rate, and there were no statistically significant difference in the effective rate between groups A and B,(P>0.05).The therapeutic effect for the children taking on viscous ear two weeks, three months and six months after surgery are as follows. Group A: Two weeks later, the cure rate was 41.86%(18/43), the improvement rate was 27.91%(12/43), the ineffective rate was 30.23%(13/43), the effective rate was 69.77%(51/43); Three months later, the cure rate was 58.14%(25/43), the improvement rate was 18.60%(8/43), the ineffective rate was 23.26%(10/43), the effective rate was 76.74%(33/43); Six months later, the cure rate was 72.09%(31/43), the improvement rate was 13.95%(6/43), the ineffective rate was 13.95%(6/43), the effective rate was 86.05%(37/43). Group B: Two weeks later, the cure rate was 66.67%(34/51), the improvement rate was 9.80%(5/51), the ineffective rate was 23.53%(12/51), the effective rate was 76.46%(39/51); Three months later, the cure rate was 78.43%(40/51), the improvement rate was 9.80%(5/51), the ineffective rate was 11.76%(6/51), the effective rate was 88.24%(45/51); Six months later, the cure rate was 90.20%(46/51), the improvement rate was 3.92%(2/51), the ineffective rate was 5.88%(3/51), the effective rate was 94.12%(48/51). Comparing with Group A, the effective rate of B shows statistically significant(P<0.05).Conclusion: The results indicate that both of two treatments, AT + tympanotomy, AT + the puncture of the ear drum combined with positive eustachian tube insufflation, have definite therapeutic effect on the treatment of OME children with AH. AT + the puncture of the ear drum is appropriate for children with serous middle ear effusion, while AT + the puncture of the ear drum combined with positive eustachian tube insufflation is suitable for children with viscous middle ear effusions. |
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