鼻内镜下咽鼓管吹张注药鼻咽癌放疗后分泌性中耳炎的疗效观察

目的评价鼻内镜下咽鼓管吹张注药鼻咽癌(NPC)放疗后分泌性中耳炎(SOM)的治疗效果。方法将42例(62耳)NPC放疗后才发生的SOM患者随机分为2组。A组采用鼻内镜下咽鼓管吹张注药术;B组给予鼓膜穿刺抽液、鼓膜切开排液或鼓膜置管术;随访半年,对2组治疗SOM的临床疗效及并发症进行比较。结果A组治愈18耳(58.1%),好转9耳(29.0%),无效4耳(12.9%);B组治愈10耳(32.3%),好转10耳(32.3%),无效11耳(35.4%)。并发症发生率A组为9.7%(3/31),表现为耳闷胀感或短暂眩晕,B组为32.3%(10/31),表现为中耳感染或鼓膜穿孔或耳漏。2组临床疗效及并发症发生率差异均有统计学意义(P<0.05)。结论鼻内窥镜下咽鼓管扩张注药法治疗NPC放疗后SOM安全有效,并发症少。

Exploration of treatments for secretory otitis media after radiotherapy in nasopharyngeal carcinoma patients

Objective To investigate clinical treatments of secretory otitis media(SOM) after radiotherapy in nasopharyngeal carcinoma(NPC) patients.Methods Forty-two patients of NPC with post-irradiation SOM were divided into 2 groups randomly.Patients were treated by dilating eustachian tube and injecting medicine under nasal endoscopy in group A.Patients in group B were handled by puncturing drum membrane and suction or myringotomy or inserting ventilation tube.Therapeutic effects and complications were compared between 2 groups during the 6 months follow up period.Results The number of ears which were cured,effectively treated and ineffectively treated were 18(58.1%),9(29.0%),4(12.9%)in group A and 10(32.3%),10(32.3%),11(35.4%)in group B,respectively.The complication rate was 10% in group A and 29% in group B.There were significant differences in curative effect and incidence rate of complications between 2 groups(P<0.05).Conclusion Dilating eustachian tube and injecting medicine under nasal endoscopy are safe and efficient for post-irradiation SOM in NPC patients with fewer complications.