耳内镜下鼓膜穿刺与鼓膜置管及盐酸氨溴索冲洗中耳腔治疗鼻咽癌放疗后分泌性中耳炎的临床观察

Endoscope-guided myringocentesis and indwelling catheterization with ambroxol hydrochloride irrigation for secretory otitis media in patients with nasopharyngeal carcinoma after radiotherapy

目的观察耳内镜下鼓膜穿刺与鼓膜置管及局部应用氨溴索治疗鼻咽癌放疗后分泌性中耳炎的疗效。方法对112例、145耳鼻咽癌放疗后分泌性中耳炎患者分别行耳内镜下鼓膜穿刺与鼓膜置管及盐酸氨溴索冲洗中耳腔的治疗对照观察。结果A组(鼓膜置管+盐酸氨溴索冲洗中耳腔)52耳,治愈45耳(86.5%),好转5耳(9.6%),无效2耳,有效率为96.1%;B组(鼓膜置管)53耳,治愈32耳(60.3%),好转14耳(26.4%),无效7耳,有效率为86.7%;C组(鼓膜穿刺+盐酸氨溴索冲洗中耳腔)40耳,治愈20耳(50%),好转12耳(30%),无效8耳,有效率为80%。经Ridit分析,P<0.05,有显著性差异,A、B两组疗程经t检验,亦有显著性差异。结论应用盐酸氨溴索冲洗中耳腔结合鼓膜置管治疗放疗后分泌性中耳炎有较好的疗效。

Objective To report the outcomes of myringocentesis and indwelling catheterization with ambroxol hydrochloride irrigation in treating secretory otitis media （SOM） in patients with nasopharyngeal carcinoma （NPC） after radiotherapy. Methods 112 cases （ 145 ears） of SOM in NPC after radiotherapy were treated. Results Of the 52 ears that received indwelling tympanic membrane catheter and ambroxol hydrochloride irrigation, complete SOM resolution was achieved in 45 ears （86.5%） and improvement in 5 ears （9.6%）, resulting in an efficiency rate of 96.1%. In the 53 ears treated with indwelling tympanic membrane catheter only, there was complete resolution in 32 ears（60.3%） and improvement inl4 ears （26.4%）, with an efficiency rate of 86.7%. In the 40 ears receiving myringocentesis and one time Ambroxol hydrochloride irrigation, SOM resolved in 20 ears（50%） and improved in 12 ears （30%）, yielding an efficiency rate of 80%. The differences between different treatment outcomes was statistically significant. Conclusion Indwelling tympanic membrane catheterization combined with ambroxol hydrochloride irrigation proves to be effective in treating SOM in patients with NPC after radiotherapy.