Dugotrajne komplikacije implantacije ventilacionih cevčica u lečenju hroničnog sekretornog otitisa u dečjem uzrastu

Vladimir Živorad Djordjević; Bojana Bukurov; Nenad Arsović; Snežana Ješić; Jovica Milovanović; Vladimir Nešić

doi:10.2298/5092

Vladimir Živorad Djordjević School of Medicine, University of Belgrade, Clinic for Otorhinolaryngology and Maxillofacial Surgery, Clinical Centre of Serbia, Belgrade
Bojana Bukurov Clinic for Otorhinolaryngology and Maxillofacial Surgery, Clinical Center of Serbia, Belgrade, Serbia.
Nenad Arsović Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Clinic for Otorhinolaryngology and Maxillofacial Surgery, Clinical Center of Serbia, Belgrade, Serbia
Snežana Ješić Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Clinic for Otorhinolaryngology and Maxillofacial Surgery, Clinical Center of Serbia, Belgrade, Serbia
Jovica Milovanović Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Clinic for Otorhinolaryngology and Maxillofacial Surgery, Clinical Center of Serbia, Belgrade, Serbia
Vladimir Nešić Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Clinic for Otorhinolaryngology and Maxillofacial Surgery, Clinical Center of Serbia, Belgrade, Serbia

DOI: https://doi.org/10.2298/5092

Ključne reči: otitis media with effusion||, ||otitis media, serozni, otologic surgical procedures||, ||hirurgija, otološka, procedure, middle ear ventilation||, ||uvo, srednje, aeracija, treatment outcome||, ||lečenje, ishod, child||, ||deca,

Sažetak

Uvod/Cilj. Hronični sekretorni otitis definiše se kao produženo prisustvo sekreta (duže od 12 nedelja) različite gustine u srednjem uvu, bez perforacije na bubnoj opni ili znakova zapaljenja. Kako konzervativno lečenje često ne daje zadovoljavajuće rezultate, hirurška intervencija može biti neizbežna. Cilj ovog rada bio je da se odredi incidencija, tip i učestalost komplikacija nakon hirurškog lečenja (implantacije ventilacionih cevčica) kao dela lečenja dece sa ovim oboljenjem, kao i da se proceni evolucija ovih promena u produženom vremenskom periodu. Metode. Tokom petogodišnjeg perioda (1986–1991) 84 dece sa obostranim sekretornim otitisom, uzrasta od 6 meseci do 12 godina bilo je uključeno u studiju i lečeno implantacijom ventilacionih cevčica. Sva deca su praćena i periodično kontrolisana 3–8 godina nakon intervencije (otomikroskopski pregled, audiometrija, timpanometrija) i ponovo pregledana tokom 2013. godine, odnosno 22–27 godina nakon primarne hirurške intervencije. Rezultati. Registrovane komplikacije u ovoj studiji (51%) bile su atrofični ožiljci, timpano- i miringoskleroza, različiti stepeni retrakcije bubne opne, granulaciono tkivo, razvoj hroničnog otitisa i pojava senzorineuralne nagluvosti. Zaključak. Učestalost pojave komplikacija nakon implantacije ventilacionih cevčica vrlo je visoka, u našoj studiji iznosila je 51%. Najčešće komplikacije bili su atrofični ožiljci na bubnoj opni i miringoskleroza. Iako je broj komplikacija veliki, implantacija ventilacionih cevčica i dalje ostaje terapija izbora u lečenju dece sa hroničnim sekretornim otitisom.

Biografija autora

Vladimir Živorad Djordjević, School of Medicine, University of Belgrade, Clinic for Otorhinolaryngology and Maxillofacial Surgery, Clinical Centre of Serbia, Belgrade

Načelnik laringolokog - onkološkog odeljenja docent

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