Objective To observe the short term effect,air-conduction thresholds and recurrence rate by intratympanic steroid aerosol inhalation via eustachian tube and intratympanic steroid injections via the tympanic puncture in patients with chronic secretory otitis media.
Methods Total 88 cases of chronic secretory otitis media in our hospital between January,2014 and January,2016 were enrolled into eustachian tube inhalation group and tympanic membrane puncture injection group with 44 cases in each group.After local anesthesia,the tympanic membrane puncture injection group performed tympanic puncture guided by nasal endoscope,followed by absorption of effusion and hormone injection;while the eustachian tube inhalation group performed the inflation of the eustachian tube guided by nasal endoscope,then budesonide aerosol inhalation delivery via eustachian tube into tympanic cavity.The course in both groups was 15 days.The 250,500,1 000,test 2 000,4 000 Hz air conduction threshold and listening ability were measured at 1-2 d before the treatment and 15 d after the treatment.The short term effect,air-conduction thresholds and recurrence rate were compared between the two groups.
Results There was no significant difference between the two groups in age,course of disease,symptoms and signs,pure tone test and acoustic impedance terms (
P>0.05).Six months after the treatment,the total effective rate of the eustachian tube inhalation group and tympanic membrane puncture injection group was 90.9% and 93.2%,respectively,there was no significant difference between the two groups (
P>0.05);however,the cure and effectiveness of the eustachian tube injection group showed significant difference to the eustachian tube inhalation group (
P<0.05).There was no significant difference in the recurrence rate between the two groups (
P>0.05).The air conduction threshold at 250,500,1 000,test 2 000,4 000 Hz in both groups decreased after the treatment (
P<0.05),but there was no statistical significance between the two groups (
P>0.05).
Conclusion Both intratympanic steroid aerosol inhalation via eustachian tube and intratympanic steroid injections via the tympanic puncture in the treatment of chronic secretory otitis media were obviously effective,with the approximate recurrence rate.They can reduce the air conduction threshold.The tympanic puncture injection is with a higher cure rate.
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