鼻窦内窥镜手术后分泌性中耳炎的临床分析

Secretory otitis media after functional endoscopic sinus surgery

目的:探讨鼻内窥镜手术后分泌性中耳炎发生的原因。方法:为50例、78侧慢性鼻窦炎患者行鼻内窥镜鼻窦手术,手术前后检查咽鼓管功能,术后随访检查咽鼓管咽口,分析分泌性中耳炎的发生率及原因。结果:50例7、8侧手术中,术前咽鼓管功能正常70耳,异常8耳,术后咽鼓管功能正常56耳,异常22耳,差异有统计学意义(P<0.05);术后咽鼓管功能正常组中咽鼓管咽口肿胀8耳,咽鼓管功能异常组中咽鼓管咽口黏膜肿胀16耳,差异有统计学意义(P<0.05);术后6例、10耳发生分泌性中耳炎中,9耳咽鼓管咽口肿胀,1耳咽鼓管咽口正常,差异有统计学意义(P<0.05)。结论:鼻内窥镜手术后可能会出现咽鼓管咽口炎性肿胀导致咽鼓管功能障碍至分泌性中耳炎。

Objective： To explore the reasons for secretory otitis media occurring after functional endoscopic sinus surgery. Methods： The eustachian tube function was examined in 50 cases（78 sides） of sinusitis at pre - and post - operation. Besides following- up, endoscopy of pharyngeal ostium of eustachian tube was peiformed to explore the rate and causes for secretory otitis media . Results ： Among the 78 ears, 70 ears got normal eustachian tube function and 8 abnormal preoperatively, whereas 56 ears got normal and 22 abnormal postoperatively, which was statistically significant （ P 〈 0.05） ;swelling pharyngeal ostium of eustachian tube was found in 8 ears having normal eustachian tube function and in 16 ears having abnormal postoperatively （ P 〈 0.05） ; secretory otitis media was found in 10 ears, of which swellimg pharyngeal ostium of eustachian tube was found in 9 and normal pharyngeal ostium of eustachian tube was found in 1 （ P〈0. 05）. Conclusion： It is possible to cause pathological change of pharyngeal ostium of eustachian tube and lead to eustachian tube disfunction or secretory otitis media after functional endoscopic sinus surgery.