分泌性中耳炎和慢性鼻-鼻窦炎患儿咽鼓管咽口形态及功能的观察与分析

目的：观察分泌性中耳炎及慢性鼻-鼻窦炎患儿咽鼓管咽口及其周围形态的改变并检测其功能,为临床治疗提供客观依据。方法：将150例患儿分为分泌性中耳炎组（50例）、慢性鼻-鼻窦炎组（50例）及对照组（50例,无分泌性中耳炎及慢性鼻-鼻窦炎的声嘶患儿）,在电子鼻咽喉镜直视下观察各组咽鼓管咽口及其周围形态的改变,用声导纳仪检测各组患儿的咽鼓管功能状态,并进行统计学分析。结果：①分泌性中耳炎组咽鼓管咽口的形态学改变高达94%,慢性鼻-鼻窦炎组则为80%,2组差异无统计学意义（P〉0.05）,但与对照组比较均差异有统计学意义（均P〈0.05）。②分泌性中耳炎组70%存在咽鼓管功能障碍,慢性鼻-鼻窦炎组26%存在咽鼓管功能障碍,2组比较差异有统计学意义（P〈0.05）,且2组与对照组（2%）比较均差异有统计学意义（均P〈0.05）。结论：分泌性中耳炎及慢性鼻-鼻窦炎患儿存在咽鼓管功能障碍、咽鼓管咽口及其周围形态的改变;咽鼓管功能障碍在分泌性中耳炎的发病中占主导作用,与慢性鼻-鼻窦炎比较,咽鼓管功能障碍较咽鼓管咽口的形态改变更有差异性。

The observation and analysis the function and morphology of the eustachian tube in secretory otitis media and chronic rhinosinusitis in children

Objective：To observe and analyze the function and morphology of pharyngeal ostium of the eustachian tubes in secretory otitis media and chronic rhinosinusitis in children under direct vision,in order to provide an objective basis for clinical treatments.Method：Fifty cases of secretory otitis media,50cases of chronic rhinosinusitis and a control group of 50cases with hoarseness were examined under video laryngoscope to observe the pharyngeal ostium morphological changes of the eustachian tubes,and their functional statuses were tested by using acoustic impedance instrument.All the data were analyzed by statistical methods.Result：①In the secretory otitis group,the abnomal rate of the pharyngeal ostium of the eustachian tubes was 94% while the chronic rhinosinusitis group was 80%,and between them there was no significant differences（P〉0.05）.But both of them had significant differences with the control group（P〈0.05）.②In the secretory otitis group,the rate of the eustachian tube dysfunction was 70% while the chronic rhinosinusitis group was 26%,and between them there was significant differences（P〈0.05）,and both of them have significant differences when compared with the control group（P〈0.05）.Conclusion：There are some abnormal points exist in the function and the morphology of the eustachian tube in secretory otitis media and chronic rhinosinusitis in children.Eustachian tube dysfunction played a dominant role in the pathogenesis of secretory otitis media in children rather than the morphological change did compared to the chronic rhinosinusitis in children.