鼓室成形术后的咽鼓管功能检测及意义

Detection of Eustachian Tube Function and Its Significance After Tympanoplasty

目的探讨咽鼓管功能对慢性化脓性中耳炎鼓室成形术后疗效的影响。方法用咽鼓管鼓室-气流动态图(tube-tympanoaerodynamicgraphy,TTAG)法及音响法对53耳鼓室成形术后的咽鼓管功能进行检测,并分析鼓室成形术后咽鼓管功能正常耳与异常耳的鼓膜生长及听力变化情况;并用鼻窦镜观察咽鼓管咽口,分析咽鼓管咽口与咽鼓管功能的关系。结果53耳鼓室成形术后咽鼓管功能正常37耳,其中29耳鼓膜生长良好;咽鼓管功能异常16耳中,有4耳鼓膜生长良好,比较咽鼓管功能正常耳与异常耳鼓膜生长良好耳数,两者有显著性差异(P<0.05);53耳术后有9耳咽鼓管咽口充血肿胀,其中2耳咽鼓管功能正常,7耳咽鼓管功能不良,提示术后咽鼓管功能障碍与咽鼓管咽口病变有关。结论慢性化脓性中耳炎鼓室成形术后咽鼓管功能与疗效关系密切,术后咽鼓管功能障碍可能是导致手术失败的原因之一。

Objective To explore the changes of eustachian tube function in chronic suppurative otitis media after tympanoplasty and its influence on operative effects. Methods Eustachian tube function was measured in 53 ears after tympanoplasty by tube-tympanoaerodynamic graphy (TTAG) and sonotubometry.Audition and the tympanic membranes were compared between the ears with nomala and abnormal eustachian tube function after tympanoplasty.The pharyngeal opening of eustachian tube was observed by nasoendoscope to analyse the relationship between it and the eustachian tube function.Results Among 53 ears after tympanoplasty ,there were 37 ears with normal tube function and 16 ears with abnormal tube function.The tympanic membranes of 29 ears with normal tube function and 4 ears with abnormal tube function were better.The difference was significant(P<0.05).The pharyngeal opening of eustachian tube in 9 ears was swelling,including 2 ears with normal tube function and 7 ears with abnormal tube function.There was relationship between the eustachian tube dysfuction after tympanoplasty and the damage of the pharyngeal opening.Conclusion There is relationship between the curative effect and the eustachian tube function in ears with chronic suppurative otitis media.The eustachian tube dysfunction may be an important factor on curative effects in patients with chronic suppurative otitis media after tympanoplasty.