儿童鼻窦炎对咽鼓管与中耳传音功能的影响

Injury of the eustachian tube and middle ear by sinusitis in children

目的:探讨儿童鼻窦炎对咽鼓管与中耳传音功能的影响及程度,观察治疗鼻窦炎后,中耳传音功能障碍的恢复情况。方法:对儿童鼻窦炎100例和正常儿童50例行耳科检查、咽鼓管咽口观察、声阻抗检查、纯音测听,对比结果;对鼻窦炎合并耳病变的68例患者(128耳)行有针对性的治疗。结果:鼻窦炎患者中鼓膜异常率为64%、咽鼓管咽口异常率为62%、咽鼓管功能异常率为63.5%、鼓室导抗图异常率为62.5%,听力减退47.5%,与正常儿童组相比,差异有统计学意义(P<0.01)。急性鼻窦炎、亚急性鼻窦炎与慢性鼻窦炎中耳病变的发生率和程度相比,差异有统计学意义(P<0.05)。治疗鼻窦炎后,中耳传音功能障碍有明显改善。结论:儿童鼻窦炎引起咽鼓管功能的改变,中耳病变发生率较正常儿童显著增高;随病程的延长,发病率增高且程度加重。

Objective： To investigate injury of the eustachian tube and middle ear by sinusitis in children and observe the recovery of the acoustic dysfunction after treatment for sinusitis. Methods： Examination of the ear, observation of the pharyngeal ostium of the eustachian tube, acoustic impedance tests, and pure tone audiometry were performed on 100 children with chronic sinusitis and 50 normal children. Of them, in 128 ears of 68 children sinusitis was found combined with ear diseases and then treated. Results： In children with sinusitis, the abnormal rate of the eardrum, the pharyngeal ostium of the eustachian tube , the function of the eustachian tube and the acoustic impedance tests was 64%, 62%, 63.5%, and 62.5% ,respectively, and the rate of hearing loss was 47.5%. Compared with the normal children, the differences were statistically significant（ P 〈 0.01 ）. The differences of the incidence of middle ear disease and acute sinusitis, sub-acute sinusitis and chronic sinusitis were statistically significant between the two groups （ P 〈 0.05）. The acoustic dysfunction had a significant improvement after the treatment for sinusitis. Conclusion： The changes of the eustachian tube function caused by sinusitis lead to a significantly high incidence of middle ear disease.