PDF(Pubmed)
Abstract：
UNASSIGNED: Although cutting-edges antineoplastic therapies increase survival in children with malignancies, the optimal surgical strategy to address associated comorbidities such as chronic tympanic membrane perforation is still poorly documented. The aim of this study is to evaluate the outcomes of type I tympanoplasty in pediatric cancer survivors who received chemo and/or radiotherapy to the skull and to identify potential associated risk factors.
UNASSIGNED: This case-control study included medical records review of oncologic patients (age <21) treated at the same Academic medical oncologic center between March 2015 and July 2021 and referred for conductive hearing loss and chronic tympanic membrane perforation. Patients and middle ear status-related variables were analyzed, and outcomes were compared with matched peers without any history of malignancies.
UNASSIGNED: A total of seven pediatric cancer survivors and seven paired children without any history of malignancies were included in this report. The mean age at tympanoplasty type I surgery was 10.2 years (range = 4.3-19.9; median = 7.9 years) for the pediatric cancer survivors\' group and 10.1 years (range = 5.5-19.2; median = 7.9 years) in the control group. Three pediatric cancer patients had received chemotherapy alone, one patient had radiotherapy to the skull base, and three patients had received chemoradiotherapy. On average, surgery was performed 3.9 years after chemo and/or radiotherapy termination, except for 1 patient for whom the tympanoplasty was performed during chemotherapy treatment. A retroauricular approach was used for one of the pediatric cancer patients, a transcanal approach was performed in one other and five patients benefited from an otoendoscopic approach. Tragal perichondrium with cartilage was used in most of the pediatric cancer survivor cases (four out seven cases) while xenograft (Biodesign) and Temporalis fascia without cartilage graft were used in five out of the seven control cases. Rate of tympanic membrane perforation recurrence was similar between groups (28.6%). Mean functional gain for air conduction Pure Tone Average (AC PTA) was 2.6 and 7.7 dB HL for the oncologic and control group, respectively. Mean postoperative air-bone gap (ABG) was 10.7 dB HL [median = 8.7; inter-quartile range (IQR) = 13.8] for the oncologic cohort and 10.1 dB HL (median = 10.7; IQR = 9.6) for the control group.
UNASSIGNED: Chemo- and chemoradiotherapy to the skull are associated with damages to the inner and middle ear structures with secondary eustachian tube dysfunction and chronic middle ear effusion. Although healing abilities and immunological defenses are compromised as part of the expected effects of antineoplastic therapies, type I tympanoplasty can be safe and effective in this population. While different approaches may be considered, otoendoscopy showed excellent results with less morbidity in this vulnerable population.
UNASSIGNED: This case-control study included medical records review of oncologic patients (age <21) treated at the same Academic medical oncologic center between March 2015 and July 2021 and referred for conductive hearing loss and chronic tympanic membrane perforation. Patients and middle ear status-related variables were analyzed, and outcomes were compared with matched peers without any history of malignancies.
UNASSIGNED: A total of seven pediatric cancer survivors and seven paired children without any history of malignancies were included in this report. The mean age at tympanoplasty type I surgery was 10.2 years (range = 4.3-19.9; median = 7.9 years) for the pediatric cancer survivors\' group and 10.1 years (range = 5.5-19.2; median = 7.9 years) in the control group. Three pediatric cancer patients had received chemotherapy alone, one patient had radiotherapy to the skull base, and three patients had received chemoradiotherapy. On average, surgery was performed 3.9 years after chemo and/or radiotherapy termination, except for 1 patient for whom the tympanoplasty was performed during chemotherapy treatment. A retroauricular approach was used for one of the pediatric cancer patients, a transcanal approach was performed in one other and five patients benefited from an otoendoscopic approach. Tragal perichondrium with cartilage was used in most of the pediatric cancer survivor cases (four out seven cases) while xenograft (Biodesign) and Temporalis fascia without cartilage graft were used in five out of the seven control cases. Rate of tympanic membrane perforation recurrence was similar between groups (28.6%). Mean functional gain for air conduction Pure Tone Average (AC PTA) was 2.6 and 7.7 dB HL for the oncologic and control group, respectively. Mean postoperative air-bone gap (ABG) was 10.7 dB HL [median = 8.7; inter-quartile range (IQR) = 13.8] for the oncologic cohort and 10.1 dB HL (median = 10.7; IQR = 9.6) for the control group.
UNASSIGNED: Chemo- and chemoradiotherapy to the skull are associated with damages to the inner and middle ear structures with secondary eustachian tube dysfunction and chronic middle ear effusion. Although healing abilities and immunological defenses are compromised as part of the expected effects of antineoplastic therapies, type I tympanoplasty can be safe and effective in this population. While different approaches may be considered, otoendoscopy showed excellent results with less morbidity in this vulnerable population.
摘要：
未经证实：虽然尖端的抗肿瘤治疗提高了儿童恶性肿瘤的生存率，解决相关合并症如慢性鼓膜穿孔的最佳手术策略仍然缺乏文献.这项研究的目的是评估接受头颅化疗和/或放疗的儿科癌症幸存者的I型鼓室成形术的结果，并确定潜在的相关风险因素。
UNASSIGNED：这项病例对照研究包括2015年3月至2021年7月在同一学术肿瘤医学中心接受治疗的肿瘤患者（年龄<21岁）的病历回顾，并转诊为传导性听力损失和慢性鼓膜穿孔。分析患者和中耳状态相关变量，并将结果与没有任何恶性肿瘤史的配对同行进行比较.
UNASSIGNED：本报告共纳入了7名儿科癌症幸存者和7名没有任何恶性肿瘤病史的配对儿童。小儿癌症幸存者组的I型鼓室成形术的平均年龄为10.2岁（范围=4.3-19.9；中位数=7.9岁），对照组为10.1岁（范围=5.5-19.2；中位数=7.9岁）。三名儿童癌症患者仅接受化疗，一名患者接受了颅底放射治疗，三名患者接受了放化疗。平均而言,化疗和/或放疗终止后3.9年进行手术，除了1例患者在化疗期间进行鼓室成形术。其中一名儿科癌症患者采用了耳后入路，另外1例患者行经耳道入路,5例患者受益于耳内镜入路.在大多数儿科癌症幸存者病例（7例中的4例）中使用了带软骨的Tragal软骨膜，而在7例对照病例中的5例中使用了异种移植物（Biodesign）和无软骨移植物的颞筋膜。两组鼓膜穿孔复发率相似(28.6%)。肿瘤组和对照组的空气传导平均功能增益纯音平均（ACPTA）为2.6和7.7dBHL，分别。肿瘤队列的术后平均气骨间隙（ABG）为10.7dBHL[中位数=8.7；四分位数间距（IQR）=13.8]，对照组为10.1dBHL（中位数=10.7；IQR=9.6）。
未经证实：对颅骨的化疗和放化疗与继发性咽鼓管功能障碍和慢性中耳积液在内耳和中耳结构的损害有关。尽管作为抗肿瘤治疗的预期效果的一部分，愈合能力和免疫防御能力受到损害，Ⅰ型鼓室成形术在该人群中是安全有效的.虽然可以考虑不同的方法，在这个脆弱人群中，耳内镜检查显示出优异的结果，发病率较低。
UNASSIGNED：这项病例对照研究包括2015年3月至2021年7月在同一学术肿瘤医学中心接受治疗的肿瘤患者（年龄<21岁）的病历回顾，并转诊为传导性听力损失和慢性鼓膜穿孔。分析患者和中耳状态相关变量，并将结果与没有任何恶性肿瘤史的配对同行进行比较.
UNASSIGNED：本报告共纳入了7名儿科癌症幸存者和7名没有任何恶性肿瘤病史的配对儿童。小儿癌症幸存者组的I型鼓室成形术的平均年龄为10.2岁（范围=4.3-19.9；中位数=7.9岁），对照组为10.1岁（范围=5.5-19.2；中位数=7.9岁）。三名儿童癌症患者仅接受化疗，一名患者接受了颅底放射治疗，三名患者接受了放化疗。平均而言,化疗和/或放疗终止后3.9年进行手术，除了1例患者在化疗期间进行鼓室成形术。其中一名儿科癌症患者采用了耳后入路，另外1例患者行经耳道入路,5例患者受益于耳内镜入路.在大多数儿科癌症幸存者病例（7例中的4例）中使用了带软骨的Tragal软骨膜，而在7例对照病例中的5例中使用了异种移植物（Biodesign）和无软骨移植物的颞筋膜。两组鼓膜穿孔复发率相似(28.6%)。肿瘤组和对照组的空气传导平均功能增益纯音平均（ACPTA）为2.6和7.7dBHL，分别。肿瘤队列的术后平均气骨间隙（ABG）为10.7dBHL[中位数=8.7；四分位数间距（IQR）=13.8]，对照组为10.1dBHL（中位数=10.7；IQR=9.6）。
未经证实：对颅骨的化疗和放化疗与继发性咽鼓管功能障碍和慢性中耳积液在内耳和中耳结构的损害有关。尽管作为抗肿瘤治疗的预期效果的一部分，愈合能力和免疫防御能力受到损害，Ⅰ型鼓室成形术在该人群中是安全有效的.虽然可以考虑不同的方法，在这个脆弱人群中，耳内镜检查显示出优异的结果，发病率较低。
