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目的:评估改良Politzer仪治疗儿童慢性分泌性中耳炎(otitis media with effusion,OME)的临床疗效.方法:将确诊为双耳慢性OME伴听力损失的43例患儿随机分为A、B组.A组22例使用改良Politzer仪行咽鼓管吹张治疗;B组21例行观察随访.4周后,两组交叉.两组患儿在入组、4周及8周接受耳内镜检查、声导抗及纯音昕阈测试.结果:治疗4周后A组有20耳(45％)中耳压力和纯音听阈恢复正常,14耳(32％)有好转,B组中6耳(14％)恢复正常,4耳(10％)好转,两组疗效差异有统计学意义(P＜0.005).两组交叉后,B组经过4周吹张治疗后有17耳(40％)恢复正常,13耳(31％)有好转;A组有24耳(55％)恢复正常,14耳(32％)有好转,两组疗效差异有统计学意义(P＜0.05).两组共有8例(19％)接受鼓膜置管术.结论:利用改良Politzer仪进行咽鼓管吹张能有效治疗患儿慢性OME,越早吹张治疗效果越好,从而降低手术机率.“,”Objective:To use of modified Politzer device in the management of chronic otitis media with effusion(OME) in children and evaluate the clinical efficacy.Methods:Forty-three Children diagnosed with bilateral chronic OME and hearing loss were randomly divided into A and B groups.Tweenty-two Children in group A,aged 4～11 years started as the treatment group underwent modified Politzer device for inflation.Another 21 Children in group B,aged 5～12 years were included as the control group underwent careful observation.After 4 weeks,a cross-over was performed.Both groups underwent otoendoscopy,tympanometry and audiometry at inclusion and after 4 and 8 weeks for evaluating the treatment efficacy.Results:In group A,the middle ear pressure and pure tone threshold were normalized in 20(45％)and improved in 14(32％) ears after 4 weeks treatment.While in B group,6(14％) ears were normalized and 4 ears were improved(10％).Statistically significant differences were demonstrated between children with modified Politzer device for inflation and children with observation.After cross-over,17(40％) normalization and 13(31％) improvement of ears were achieved in B group,and 24(55％) normalization and 14(32％) improvement of ears were achieved in A group.Statistically differences were demonstrated between two groups (P＜0.05).There were 8(19％) children were submitted to grommet surgery after 8 weeks treatment.in two groups.Conclusion:Efficiency were demonstrated in children with chronic OME inflated with Modified Politzer.The earlier treatments were given,the better effects could be achieved.It can reduce the need for surgery.