鼻内镜下咽鼓管扩张导管治疗慢性分泌性中耳炎13例分析

Endoscopic eustachian tube dilated catheter for chronic secretory otitis media in 13 cases

目的探讨鼻内镜下咽鼓管扩张导管治疗慢性分泌性中耳炎的方法和疗效。方法对13例（15耳）慢性分泌性中耳炎患者采用经鼻内镜下插入咽鼓管扩张导管至其峡部，加压并持续扩张其球囊2min，然后经外耳道行鼓膜穿刺抽液，用地塞米松冲洗鼓室，再用含丝裂霉素C明胶海绵涂擦鼓膜穿刺部5min。结果全部病例均一次插管成功，随访4～5个月，11例（11耳）疗效满意，耳闷胀感消失，声阻抗提示鼓室图由“B”型恢复为“A”型，纯音听阈测试提示听力提高10—20dB，内镜检查鼓室无积液，无感染、出血、鼓膜穿孔等并发症。2例伴有过敏性鼻炎患者（4耳）于术后3个月又出现闷胀感，轻度听力下降，但无鼓室积液，经抗炎和抗过敏治疗后症状消失。结论鼻内镜下咽鼓管扩张导管治疗分泌性中耳炎操作简便、微创，疗效好。

Objective To investigate the methodology and efficacy of endoscopic eustachian tube dilated catheter for chronic secretory otitis media. Methods 13 patients with chronic secretory otitis media were performed eustachian tube dilated catheter placement to the isthmus by endoscopy. The dilated catheter had been prelumed and dilted for two mi- nutes. After the auripuncture, the tympanic was washed by hexadecadrol. Then the tympanic wound has deen embroca- ted with mitomycin C spongio-golatine for five minutes. Results All patients were successfully operated and were fol- lowed up for 4 to 5 months. The fullness disappeared in 11 cases and types ＂A＂ tympanograms were found in all the ears. The pure-tone average of heating thresholds were significantly improved with an average elevation of 10 to 20 dB. No complications, such as middle ear infection, bleeding, tympanosclerosis or tympanic effusion were found by endos- copy. Stuffied turgidity and mild hearing disorder occurred in 2 cases of anaphylactic rhinitis while no sever tympanic effusion. Conclusion The treatment of endoscopic eustachian tube dilated catheter for chronic secretory otitis media is safe and easy for operation, in addition, it results in good effect and less injury.