중이 환기관 삽입 수술 후 환기관 조기 폐쇄의 요인

Background and Objectives: Postoperative tympanostomy tube (TT) blockage is relatively common and the reported incidence is 0.0—13.1%. The purpose of this study is to evaluate the contributing factors to immediate postoperative TT blockage. Materials and Methods: Retrospective chart review was done, comparing rates of TT blockage within postoperative weeks 2. Analyzed factors include otic drops, the nature and amount of middle ear effusion, presence of middle ear mucosa edema or granulation, bleeding during operation, number of previous TT insertion, and the status of tympanic membrane (TM). Results: One hundred and twenty eight ears from 79 patients were enrolled in this study. Eleven TTs (8.6%) were occluded within postoperative weeks 2. Ears using the otic drops, Ciprobay^® and Tarivid^®, showed significantly greater rate of tube blockage (14.1%) than ears without using otic drops (1.8%). Glue efüsion caused the greatest rate (14.8%) of tube blockage than mucoid (9.6%) or serous (3.0%) efüsion· The amount of efüsion, the presence of mucosal edema or granulation, bleeding during operation, number of previous TT insertion and the status of TM were not associated with postoperative TT blockage. Conclusion: The result of this study indicates that the routine use of antibiotic-containing otic drop after the insertion of TT may not be a necessary procedure. Viscosity of effusion and bulging position of TM appeared to have an effect on the postoperative TT blockage. Thus, afer the surgery more attention should be paid to the ears with thicker middle ear effusion and bulging TM. (J Clinical Otolaryngol 2007;18:72–78)