慢性化脓性中耳炎术后眼周并发症

Ocular complications following surgery of chronic suppurative otitis media

目的:报道慢性化脓性中耳炎术后眼周并发症,探讨其可能的发生机制。方法:对4 012例慢性化脓性中耳炎手术治疗的患者进行回顾性分析,收集患者的年龄、性别、手术时间、手术路径、出现眼部症状的时间、症状持续的时间、治疗方式及愈后的相关信息。结果:109例(2.72%)患者有眼周并发症,其中68.81%(75/109)表现为视力模糊(症状分级为1级);24.77%(27/109)只出现轻度眼睑瘀斑或眼睑水肿(2级);4.59%(5/109)出现轻度眼睑瘀斑伴眼睑水肿(3级);1.83%(2/109)出现明显青瘀斑伴眼睑水肿(4级)。所有并发症均自行恢复,未留后遗症。结论:慢性化脓性中耳炎术后的眼周并发症少见,耳前切口伴同切口取筋膜,静脉、淋巴回流受阻以及眶隔蜂窝组织炎是可能的病因。术后视力模糊可能与体位、术中眼部损伤以及麻醉使用抗胆碱类药物有关。

Objective：To investigate the rarely reported ocular complications following surgery of chronic suppurative otitis media（CSOM）,and explore the possible mechanisms.Method：The clinical data of 4 012 cases of CSOM treated with surgery were analyzed retrospectively,including age,sex,operation time,surgical approach,time of ocular symptoms presentation,duration of ocular symptoms,treatment and prognosis.Result：Among the4 012 cases,109patients（2.72%）developed ocular complication,of which 68.81%（75/109）suffered from blurred vision,24.77%（27/109）presented only erythema on eyelids or mild periorbital edema,4.59%（5/109）had erythema on eyelids with periorbital edema,and 1.83%（2/109）complained of periorbital ecchymosis and edema.All of these complications recovered themselves without any sequela.Conclusion：Ocular complications following surgery of CSOM are rarely reported.Pre-auricular incision and fascia harvesting,turbulence of venous and lymphatic drainage and preseptal cellulitis might be the risk factors.Blurred vision might be associated with eye injury during surgery and the use of anticholinergic agent.