腺样体肥大致分泌性中耳炎手术切除后复发的临床分析及防治

Recurrence of secretory otitis media after adenoid vegetation excision

目的 :探讨腺样体肥大所致分泌性中耳炎手术切除后复发的原因及防治措施。方法 :对 18例、35耳腺样体肥大所致分泌性中耳炎手术切除后复发的患者行常规声阻抗、纯音测听及鼻咽镜检查。在鼻内窥镜下切除增生组织 ,咽鼓管置管 ,并结合药物治疗。结果 :复发 18例、35耳中 10例腺样体有不同程度的增生 ,6例咽鼓管扁桃体增生 ,2例咽鼓管咽口形成瘢痕。经治疗 ,16例、32耳治愈 ,1例、2耳好转 ,有效率97.1%。结论 :传统腺样体手术由于不能在直视下进行 ,故手术切除增生组织的范围、深度不能确切保证 ,是术后复发的主要原因 ,周围淋巴组织代偿性增生也是重要因素。内镜下直视手术及咽鼓管置管 ,操作简便 ,疗效确切。

Objective:To investigate the cause and treatment of recurrence of secretory otitis media after adenoid vegetation excision.Method: Thirty-five ears in 18 cases were examined by acoustic impedance,pure tone audiometer and pharyngorhinoscopy, resected the lymphadenosis, inserted catheters into tympanum through eustachian tube, and taken systemic medication. Result:Followed up for 6 to 12 months, 32 ears (16cases) were cured,2 ears(1 case) were on the mend,the total validity rate was 97.1%.Conclusion:This technique is easy to operate and has good effect in treating secretory otitis media.