鼓膜置管治疗鼻咽癌放疗后分泌性中耳炎疗效观察

The value of grommet insertion for middle ear effusion in the patients of nasopharyngeal carcinoma after radiotherapy

目的:探讨鼓膜置管对鼻咽癌(NPC)放疗后的分泌性中耳炎(SOM)的疗效。方法:对32例(51耳) NPC放疗后经鼓膜切开抽液冲洗治疗无效的SOM患者进行鼓膜置管和随访,对治疗耳的咽鼓管功能、听力及其 他症状的改变进行评估。结果:随访6个月～5年,治愈8耳,治愈率为15.7%,有效41耳,总有效率为96.1%。 7耳(13.7%)咽鼓管功能好转,所有重复置管耳的耳功能均得到不同程度的改善。置管后耳漏发生率为25.5%, 鼓膜穿孔发生率为9.8%。结论:鼓膜置管治疗SOM有利于咽鼓管功能的恢复,对于咽鼓管功能已经严重损害 的患耳,重复鼓膜置管是维持耳功能的可靠手段;鼓膜置管的并发症利大于弊。

Objective:To evaluate the value of grommet insertion for middle ear effusion in the patients of nasopharyngeal carcinoma after radiotherapy.Method:Thirty-two recrudescent cases(51 ears)with middle ear effusion after myringotomies were treated by grommet insertion again,and then,the eustachian tube function,hearing and the other symptoms were observed,the effect were evaluated.Result: 15.7%(8/51) ears were cured,the total efficiency rate is 96.1%(49/51).The eustachian tube function had been straightened up in 13.7%(7/51)ears,the other symptoms were improved in different degrees for the ears of setting grommet, 25.5% ears occurred otorrhea, 9.8% ears occurred perforation.Cconclusion:Grommet insertion is a favorable way for the eustachian tube function straightened up.For the ears that the eustachian tube function damaged seriously,repeated grommet insertion is a good measure for keeping the ear function.In a word,the benefit is more than the loss after grommet insertion.