27例鼻咽癌患者合并分泌性中耳炎的临床分析

目的探讨鼻咽癌患者放疗前后分泌性中耳炎的临床特点及治疗措施。方法回顾性分析2003年一2006年我院经治的27例鼻咽癌患者，将其放疗前、放疗后的情况进行回顾分析。21例（32耳）中耳炎患者被分为鼓膜穿刺组与鼓膜置管组。结果27例患者放疗前有14例（17耳）并发分泌性中耳炎，放疗后分泌性中耳炎的患者增至21例（32耳），双耳发病11例，6例未发生分泌性中耳炎。鼓膜穿刺组12例（19耳），显效率为78.9％（15／19），1例患者发展为慢性化脓性中耳炎；置管组9例（13耳），有5例（7耳）疗效显著，显效率为54％（7／13），有2例患者鼓膜穿孔。MRI检查显示，21例分泌性中耳炎患者中，19例有明显咽鼓管挤压和腭帆张肌肿胀。结论MRI检查有助于鼻咽癌患者放疗前后并发分泌性中耳炎的评估；鼓膜穿刺抽吸是治疗鼻咽癌并发分泌性中耳炎的有效和实用的措施。

Otitis media with effusion in patients with nasopharyngeal carcinoma:a review of 27 cases

objective To report the clinical characteristics and treatment outcomes of otitis media with effusion(OME)in patients with nasopharyngeal carcinoma(NPC).Methods Twenty seven cases of NPC diagnosed and treated at the authors' hospital from 2003 to 2006 were analyzed retrospectively.Twenty one patients(32 ears)received either myringocentesis or myringotomy plus grommet insertion.Results Forteen patients(17 ears)were found to have OME before radiotherapy.The number of cases with OME increased to 21(32 ears)following irradiation.Of the 19 ears treated with myringocentesis,OME completely resolved in 15 ears(78.9%)by the end of the follow-up,with 1 ear being complicated with chronic suppurative otitis media.Among the 13 ears receiving myringotomy and grommet insertion,7(54%)ended in complete OME resolution and 2 developed dry eardrum perforation.MRI findings in the 21 cases showed eustachian tube compression or tensor veli palatini infiltration in 19 cases.Conclusion MRI is useful in the diagnosis of OME in patients with NPC.Myringocentesis may effectively reduce the incidence of OME in patients with NPC after radiotherapy.