咽鼓管咽口周围炎症疾病与分泌性中耳炎的相关性研究

Causal correlation study on the inflammatory lesions around the pharyngeal orifice of Eustachian tube with secretary otitis media

目的观察分泌性中耳炎与咽鼓管咽口周围炎症性疾病的关系,探讨其病理联系,总结治疗经验。方法2000年1月～2005年9月诊断为SOM并伴有咽口周围炎症性病变者172例(284耳),针对其相关疾病进行积极治疗,并行咽鼓管扩张注药,分析疗效与咽鼓管咽口周围炎症性疾病变化的相关性。结果本组患者中,伴有慢性鼻咽炎52例(77耳),咽隐窝粘连23例(38耳),腺样体肥大15例(28耳),腺样体萎缩不全并感染28例(48耳),鼻咽囊肿7例(11耳),鼻咽结核2例(3耳),慢性鼻炎鼻窦炎45例(79耳)。不同的咽口周围疾病对分泌性中耳炎的预后影响不同。腺样体肥大者治疗后最好,鼻咽结核者治疗后最差。结论不同类型的咽鼓管咽口周围炎症性疾病对分泌性中耳炎的发生和发展具有不同的病理影响,临床上应当区别对待之。

Objective To investigate the causal correlation of the inflammatory lesions around the pharyngeal orifice of Eustachian tube with secretary otitis media （SOM） in order to sum up clinical experience with the treatment of this disease. Methods A retrospective analysis was made on a group of cases with SOM composed of 172 patients （284 ears）, treated in our Hospital from Jan. 2000 to Sep. 2005. These cases were positively treated by several routine therapies, combined with Eustachian tube inflation plus drugs injection into the middle ear cavity via the inflation tube. The emphasis of study was focused on the analysis of causal correlation of the inflammatory lesions around the pharyngeal orifice of Eustachian tube with the therapeutic effect on SOM. Results In this group of SOM cases, 52 （77 ears） were seen with chronic nasopharyngitis, 23 （38 ears） were with adhesion in pharyngeal recess, 15 （28 ears） with adenoidal hypertrophy, 28 （48 ears） with in-completed adenoidal atrophy complicated with infection, 7 （11 ears） with nasopharyngeal cyst, 2 （3 ears） with nasopharyngeal tuberculosis, and 45 （79 ears） with chronic nasosinusitis. Variable effects on the prognosis of SOM could be seen with different kinds of inflammatory lesion around the pharyngeal orifice of Eustachian tube, with the best one for the cases complicated from adenoidal hypertrophy and the worst one for those complicated from nasopharyngeal tuberculosis. Conclusions Different kinds of inflammatory lesion around the pharyngeal orifice of Eustachian tube will give rising variable pathological effects onthe genesis and development of SOM. Therefore, SOM complicated from different kinds of causal lesion should be treated with different therapeutic principles.