Abstract：
OBJECTIVE: This study aims to evaluate the demographic characteristics, indications for surgery, clinical follow-up results and complication rates of pediatric patients who have received a Paparella Type 1 tympanostomy tube (TT) insertion.
METHODS: Retropective review of 816 ears of 442 pediatric patients who received Paparella type 1 tympanostomy tube insertions was performed. The patients\' age, indication for surgery, middle ear effusion, time to extrusion and postoperative complications were analyzed retrospectively. Ears operated for chronic otitis media with effusion (COME) and recurrent acute otitis media (RAOM) were included in the study. Ears that underwent tympanostomy tube insertion for middle ear atelectasis and suppurative complications of acute otitis media were excluded from the study. Ears with middle ear effusion mucoid and serous were included. Ears without middle ear effusion or with purulent effusion were excluded from the study. Patients with a cleft palate, Down syndrome, craniofacial anomalies and those without regular follow-up until their tubes were extruded, were excluded from the study.
RESULTS: The mean age of surgery was 5.11 years. 54.3 % of the patients were male and 45.7 % were female. 734 (90 %) tube insertions were performed for patients with COME and 82 (10 %) for those with RAOM. Mucoid middle ear effusion was observed in 86.9 % and serous in 13.1 %. The mean extrusion time of the tubes was 7.16 months. 93.1 % of the tubes were extruded spontaneously within 1 year and 99.9 % within 2 years. Postoperative complications of patients that were included were 8.7 % with otorrhea, 7.7 % premature extrusion, 8.2 % tube occlusion, 0.2 % displacement into the middle ear, 8.2 % tympanic membrane changes (5.4 % sclerosis, 2.3 % retraction and 0.5 % atrophy), 1.2 % permanent perforation, 0.1 % cholesteatoma and 0.1 % retained their tube. Premature extrusion was found to be significantly higher in the RAOM group compared with the COME group (p = 0.042). Tube extrusion time did not affect tympanic membrane changes (p = 0.061).
CONCLUSIONS: Complication rates after Paparella Type 1 tube insertion are low. The incidence of complications such as otorrhea and tube occlusion were not significantly different between the indication and middle ear effusion groups. Compared to COME group, premature extrusion were found more frequently in the RAOM group. Complications of displacement into the middle ear, permanent perforation, cholesteatoma and retained tube were much rarer.
METHODS: Retropective review of 816 ears of 442 pediatric patients who received Paparella type 1 tympanostomy tube insertions was performed. The patients\' age, indication for surgery, middle ear effusion, time to extrusion and postoperative complications were analyzed retrospectively. Ears operated for chronic otitis media with effusion (COME) and recurrent acute otitis media (RAOM) were included in the study. Ears that underwent tympanostomy tube insertion for middle ear atelectasis and suppurative complications of acute otitis media were excluded from the study. Ears with middle ear effusion mucoid and serous were included. Ears without middle ear effusion or with purulent effusion were excluded from the study. Patients with a cleft palate, Down syndrome, craniofacial anomalies and those without regular follow-up until their tubes were extruded, were excluded from the study.
RESULTS: The mean age of surgery was 5.11 years. 54.3 % of the patients were male and 45.7 % were female. 734 (90 %) tube insertions were performed for patients with COME and 82 (10 %) for those with RAOM. Mucoid middle ear effusion was observed in 86.9 % and serous in 13.1 %. The mean extrusion time of the tubes was 7.16 months. 93.1 % of the tubes were extruded spontaneously within 1 year and 99.9 % within 2 years. Postoperative complications of patients that were included were 8.7 % with otorrhea, 7.7 % premature extrusion, 8.2 % tube occlusion, 0.2 % displacement into the middle ear, 8.2 % tympanic membrane changes (5.4 % sclerosis, 2.3 % retraction and 0.5 % atrophy), 1.2 % permanent perforation, 0.1 % cholesteatoma and 0.1 % retained their tube. Premature extrusion was found to be significantly higher in the RAOM group compared with the COME group (p = 0.042). Tube extrusion time did not affect tympanic membrane changes (p = 0.061).
CONCLUSIONS: Complication rates after Paparella Type 1 tube insertion are low. The incidence of complications such as otorrhea and tube occlusion were not significantly different between the indication and middle ear effusion groups. Compared to COME group, premature extrusion were found more frequently in the RAOM group. Complications of displacement into the middle ear, permanent perforation, cholesteatoma and retained tube were much rarer.
摘要：
目的：本研究旨在评估人口统计学特征，手术适应症,接受Paparella1型鼓膜置管（TT）的儿科患者的临床随访结果和并发症发生率。
方法：对442例接受Paparella1型鼓膜置管的儿科患者的816耳进行回顾性分析。病人的年龄，手术指征,中耳积液,对患者的挤压时间及术后并发症进行回顾性分析。该研究包括因慢性渗出性中耳炎（COME）和复发性急性中耳炎（RAOM）而手术的耳朵。因中耳肺不张和急性中耳炎化脓性并发症而接受鼓膜置管术的耳朵被排除在研究之外。包括中耳积液粘液和浆液的耳朵。没有中耳积液或有脓性积液的耳朵被排除在研究之外。腭裂患者,唐氏综合症,颅面异常和那些没有定期随访，直到他们的管子被挤压，被排除在研究之外。
结果：手术平均年龄为5.11岁。54.3%的患者为男性，45.7%为女性。对COME患者进行了734例（90％）管插入，对RAOM患者进行了82例（10％）管插入。黏液性中耳积液占86.9%，浆液性中耳积液占13.1%。管的平均挤出时间为7.16个月。93.1%的管材在1年内自发挤出，99.9%在2年内挤出。纳入的患者术后并发症为耳漏8.7%，7.7%过早挤压，8.2%管闭塞,0.2％的位移进入中耳，8.2%鼓膜改变(5.4%硬化,2.3%回缩和0.5%萎缩)，1.2%永久性穿孔,0.1%的胆脂瘤和0.1%的胆脂瘤保留了他们的管子。与COME组相比，RAOM组的过早挤出明显更高（p=0.042）。管挤压时间不影响鼓膜变化（p=0.061）。
结论：Paparella1型导管插入后并发症发生率较低。在适应证组和中耳积液组之间，耳漏和管阻塞等并发症的发生率没有显着差异。与COME组相比，在RAOM组中发现过早挤压的频率更高。移位到中耳的并发症，永久性穿孔,胆脂瘤和保留管更为罕见。
方法：对442例接受Paparella1型鼓膜置管的儿科患者的816耳进行回顾性分析。病人的年龄，手术指征,中耳积液,对患者的挤压时间及术后并发症进行回顾性分析。该研究包括因慢性渗出性中耳炎（COME）和复发性急性中耳炎（RAOM）而手术的耳朵。因中耳肺不张和急性中耳炎化脓性并发症而接受鼓膜置管术的耳朵被排除在研究之外。包括中耳积液粘液和浆液的耳朵。没有中耳积液或有脓性积液的耳朵被排除在研究之外。腭裂患者,唐氏综合症,颅面异常和那些没有定期随访，直到他们的管子被挤压，被排除在研究之外。
结果：手术平均年龄为5.11岁。54.3%的患者为男性，45.7%为女性。对COME患者进行了734例（90％）管插入，对RAOM患者进行了82例（10％）管插入。黏液性中耳积液占86.9%，浆液性中耳积液占13.1%。管的平均挤出时间为7.16个月。93.1%的管材在1年内自发挤出，99.9%在2年内挤出。纳入的患者术后并发症为耳漏8.7%，7.7%过早挤压，8.2%管闭塞,0.2％的位移进入中耳，8.2%鼓膜改变(5.4%硬化,2.3%回缩和0.5%萎缩)，1.2%永久性穿孔,0.1%的胆脂瘤和0.1%的胆脂瘤保留了他们的管子。与COME组相比，RAOM组的过早挤出明显更高（p=0.042）。管挤压时间不影响鼓膜变化（p=0.061）。
结论：Paparella1型导管插入后并发症发生率较低。在适应证组和中耳积液组之间，耳漏和管阻塞等并发症的发生率没有显着差异。与COME组相比，在RAOM组中发现过早挤压的频率更高。移位到中耳的并发症，永久性穿孔,胆脂瘤和保留管更为罕见。
