鼻咽癌放射治疗对中耳功能的影响及分泌性中耳炎的预防

Influence of Radiotherapy for Nasopharyngeal Carcinoma on Middle Ear Functions and Prevention of Secretory Otitis

目的 探讨放射治疗对鼻咽癌患者中耳功能的影响 ,寻找有效的防治措施。方法 观察 163例鼻咽癌患者放疗前后分泌性中耳炎的发生及中耳压的改变。结果 鼻咽癌患者放疗后分泌性中耳炎的发生率为 41.6% ( 10 2 / 2 45只耳 ) ,其中放疗后 6个月之内分泌性中耳炎发生率达 47.1% ( 4 8/ 10 2只耳 ) ,放疗所致分泌性中耳炎与电离辐射对中耳的直接损伤和放疗前中耳负压的升高有密切的关系。结论 发生分泌性中耳炎是放射治疗对鼻咽癌患者中耳功能影响的原因之一 ,应改进放射治疗设野技术 ,使用有效药物和采取鼓室插管的方法进行防治。

Objective To investigate the influence of radiotherapy for nasopharyngeal carcinoma on middle ear functions and to find an effective management.Methods The development of secretory otitis and the change of middle ear pressure in 163 patients(326 ears) with nasopharyngeal carcinoma were observated before and after radiotherapy.Results Incidence of secretory otitis resulting from radiotherapy for nosopharyngeal carcinoma was 41.6%(102/245 ears),47.1%(48/102 ears) of them occured in 6 monthes after radiotherapy.The direct irradiation demage and the rising negative pressure of middle ear before raditherapy may be closely associated with it.Conclusion The secretory otitis is one of the causes which influence middle ear functions after radiotherapy for patients with nasopharyngeal carcinoma.Improvement of radiotherapy technique,effective drug and tympanum intubation may be helpful.