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首页> 外文期刊>The Laryngoscope: A Medical Journal for Clinical and Research Contributions in Otolaryngology, Head and Neck Medicine and Surgery, Facial Plastic and Reconstructive Surgery .. >Otologic complications of cotton swab use: one institution's experience.
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Otologic complications of cotton swab use: one institution's experience.

机译：使用棉签的耳科并发症：一所机构的经验。

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OBJECTIVES/HYPOTHESIS: To evaluate the indications for observation versus surgery in the management of cotton swab-induced tympanic membrane perforations (TMP). STUDY DESIGN: Institutional review board-approved retrospective cohort study of 1,540 patients with a diagnosis of TMP from 2001 to 2010. Patients with a cotton swab injury were subdivided into two groups: observation and surgery. METHODS: Data collection included demographics, symptoms, surgery type, and pre- and postintervention audiometry. Successful outcomes were defined as healed TMP; resolution/improvement of vertigo, tinnitus, or facial nerve paralysis; and/or closure of the air-bone gap (ABG). RESULTS: Fifty-four of 1,540 patients presented with a cotton swab-induced TMP. Four of the 54 patients (7.4%) underwent delayed surgical repair with 100% success. Preoperatively, one patient had a facial nerve paralysis and two had vertigo with confirmed perilymphatic fistulae (PLF). Postoperatively, the facial nerve paralysis resolved, and one patient had mild vertigo. Fifty of 54 patients opted to forego surgery with 35 patients available for follow-up. Thirty-four (97%) of the 35 patients had spontaneous healing. The average time to perforation closure was 1.75 months. Twelve of 35 patients had no ABG after healing. CONCLUSIONS: Observation is an appropriate consideration for patients who have a TMP due to a cotton swab injury. Surgical intervention should be offered early when a PLF is suspected, or if facial paralysis, severe vertigo, and/or profound sensorineural hearing loss are present. As otolaryngologists, we should be reluctant to offer surgical intervention of an acute injury without significant symptoms as most patients will heal spontaneously within 2 months.
机译：目的/假设：为了评估在棉签诱发的鼓膜穿孔（TMP）处理中观察与手术的适应症。研究设计：机构审查委员会批准的2001年至2010年诊断为TMP的1,540例患者的回顾性队列研究。棉签损伤的患者分为两组：观察组和手术组。方法：数据收集包括人口统计学，症状，手术类型以及干预前后的听力测定。成功的结果被定义为治愈的TMP;解决/改善眩晕，耳鸣或面神经麻痹;和/或封闭气隙（ABG）。结果：1,540例患者中有54例表现出棉签诱发的TMP。 54例患者中有4例（7.4％）接受了延迟手术修复，成功率为100％。术前，一名患者面神经麻痹，两名眩晕伴确诊的淋巴瘘管（PLF）。术后，面神经麻痹消失，一名患者出现轻度眩晕。 54位患者中有50位选择了放弃手术，其中35位患者可以进行随访。 35例患者中有34例（97％）具有自愈能力。穿孔闭合的平均时间为1.75个月。 35名患者中有12名在治愈后没有ABG。结论：对于因棉签受伤而患有TMP的患者，观察是适当的考虑因素。当怀疑是PLF或出现面瘫，严重的眩晕和/或严重的感音神经性听力减退时，应及早提供手术干预。作为耳鼻喉科医生，我们应该不愿对没有明显症状的急性损伤进行手术干预，因为大多数患者会在2个月内自愈。

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