Abstract：
OBJECTIVE: To characterize postoperative pain after tympanoplasty and tympanomastoidectomy and correlate between pain severity and various technical aspects of the surgery.
METHODS: We carried out a prospective cohort study of patients undergoing ear surgery in a tertiary referral center between 7/2018 and 7/2019. Patients filled in a pain questionnaire and scored pain intensity on a visual analog scale preoperatively and on postoperative days (POD) 1-4, 21, and 49. The responses were correlated with clinical and operative data, including surgical technique-related details.
RESULTS: Sixty-two patients participated in the study (27 males and 35 females, average age 41.1 ± 20.02 years [range 18-68]). The median preoperative VAS was 5, followed by 6 on POD1, 5 on POD3, and 1 at 3 and 9 weeks. The preoperative questionnaire score normalized to 10 was 4.5 (32/70), 5.1 on POD1, 4.7 on POD3, 0.85 at 3 weeks and 0.85 at 9 weeks. The predictive factors for increased postoperative pain were younger age, the presence of a comorbidity, revision surgery, preoperative dizziness or tinnitus and postoperative tinnitus. The predictive factors for decreased pain were smoking and the addition of a mastoidectomy. None of the factors related to the surgical technique (e.g., surgical approaches, type of reconstruction, specific surgeon) significantly affected the questionnaire responses or the pain VAS intensity scores.
CONCLUSIONS: We demonstrated that younger age, the presence of a comorbidity, revision surgery, preoperative dizziness or tinnitus and postoperative tinnitus were predictors of increased pain after tympanoplasty and tympanomastoidectomy, while the inclusion of a mastoidectomy was a predictor of decreased pain.
METHODS: We carried out a prospective cohort study of patients undergoing ear surgery in a tertiary referral center between 7/2018 and 7/2019. Patients filled in a pain questionnaire and scored pain intensity on a visual analog scale preoperatively and on postoperative days (POD) 1-4, 21, and 49. The responses were correlated with clinical and operative data, including surgical technique-related details.
RESULTS: Sixty-two patients participated in the study (27 males and 35 females, average age 41.1 ± 20.02 years [range 18-68]). The median preoperative VAS was 5, followed by 6 on POD1, 5 on POD3, and 1 at 3 and 9 weeks. The preoperative questionnaire score normalized to 10 was 4.5 (32/70), 5.1 on POD1, 4.7 on POD3, 0.85 at 3 weeks and 0.85 at 9 weeks. The predictive factors for increased postoperative pain were younger age, the presence of a comorbidity, revision surgery, preoperative dizziness or tinnitus and postoperative tinnitus. The predictive factors for decreased pain were smoking and the addition of a mastoidectomy. None of the factors related to the surgical technique (e.g., surgical approaches, type of reconstruction, specific surgeon) significantly affected the questionnaire responses or the pain VAS intensity scores.
CONCLUSIONS: We demonstrated that younger age, the presence of a comorbidity, revision surgery, preoperative dizziness or tinnitus and postoperative tinnitus were predictors of increased pain after tympanoplasty and tympanomastoidectomy, while the inclusion of a mastoidectomy was a predictor of decreased pain.
摘要：
目的：描述鼓室成形术和鼓室乳突切除术后的疼痛特征，以及疼痛严重程度与手术各个技术方面的相关性。
方法：我们在2018年7月7日至2019年7月7日在三级转诊中心对接受耳部手术的患者进行了一项前瞻性队列研究。患者填写疼痛问卷，在术前和术后第1-4、21和49天（POD）的视觉模拟量表上对疼痛强度进行评分。反应与临床和手术数据相关，包括手术技术相关的细节。
结果：62名患者参与了这项研究（男性27名，女性35名，平均年龄41.1±20.02岁[范围18-68])。术前VAS中位数为5，POD1为6，POD3为5，3周和9周为1。术前问卷标准化为10分，为4.5(32/70)，POD1为5.1，POD3为4.7，3周为0.85，9周为0.85。术后疼痛增加的预测因素是年龄较小，合并症的存在，翻修手术,术前头晕或耳鸣及术后耳鸣。疼痛减轻的预测因素是吸烟和增加乳突切除术。没有与手术技术相关的因素(例如，手术方法,重建类型，特定外科医生）显着影响问卷回答或疼痛VAS强度评分。
结论：我们证明年龄较小，合并症的存在，翻修手术,术前头晕或耳鸣和术后耳鸣是鼓室成形术和鼓膜切除术后疼痛增加的预测因素，而乳突切除术是疼痛减轻的预测指标。
方法：我们在2018年7月7日至2019年7月7日在三级转诊中心对接受耳部手术的患者进行了一项前瞻性队列研究。患者填写疼痛问卷，在术前和术后第1-4、21和49天（POD）的视觉模拟量表上对疼痛强度进行评分。反应与临床和手术数据相关，包括手术技术相关的细节。
结果：62名患者参与了这项研究（男性27名，女性35名，平均年龄41.1±20.02岁[范围18-68])。术前VAS中位数为5，POD1为6，POD3为5，3周和9周为1。术前问卷标准化为10分，为4.5(32/70)，POD1为5.1，POD3为4.7，3周为0.85，9周为0.85。术后疼痛增加的预测因素是年龄较小，合并症的存在，翻修手术,术前头晕或耳鸣及术后耳鸣。疼痛减轻的预测因素是吸烟和增加乳突切除术。没有与手术技术相关的因素(例如，手术方法,重建类型，特定外科医生）显着影响问卷回答或疼痛VAS强度评分。
结论：我们证明年龄较小，合并症的存在，翻修手术,术前头晕或耳鸣和术后耳鸣是鼓室成形术和鼓膜切除术后疼痛增加的预测因素，而乳突切除术是疼痛减轻的预测指标。
