咽鼓管异常开放伴习惯性抽鼻与后天性中耳胆脂瘤的关系

Correlation between patulous Eustachian tube with habitual nasal extraction and acquired middle ear cholesteatoma

目的通过比较咽鼓管异常开放伴习惯性抽鼻患者与非咽鼓管异常开放患者的临床特点，探讨咽鼓管异常开放伴抽鼻与后天性中耳胆脂瘤发病的关系。方法回顾性分析2011年11月至2016年11月在青岛大学附属医院就诊的218例行手术治疗且资料完整的后天性中耳胆脂瘤患者的临床资料。根据咽鼓管状态分为咽鼓管异常开放伴习惯性抽鼻组与非咽鼓管异常开放组，比较二者在发病年龄、侧别、声导抗特点、临床表现、随访预后等方面的差异，并采用SPSSl9．0软件进行统计学分析。结果218例后天性胆脂瘤患者中，诊断为咽鼓管异常开放并伴有习惯性抽鼻者22例，平均年龄（35．7±7．5）岁；非咽鼓管异常开放者196例，平均年龄（47．8±20．1）岁；异常开放组患者平均发病年龄明显低于非异常开放组，差异有统计学意义（t=4．25，P〈0．01）。咽鼓管异常开放组胆脂瘤双侧发病的比例[68．2％（15／22）]明显高于非异常开放组[18．9％（37／196）]，差异有统计学意义（X^2=26．47，P〈0．01）。结论部分后天性中耳胆脂瘤的发生可能与咽鼓管异常开放并伴习惯性抽鼻有关，这部分患者年龄相对偏低，易双侧发病。

Objective By comparing the clinical characteristics of patulous Eustachian tube with habitual nasal extraction and those of non-Eustachian tube abnormalities, we aimed to investigate the relationship between patulous Eustachian tube and acquired cholesteatoma of middle ear. Methods A total of 218 patients in Affiliated Hospital of Qingdao University from November 2011 to November 2016 who underwent surgical treatment and with complete data of acquired cholesteatoma of middle ear were enrolled. The patients were divided into two groups： patulous Eustachian tube with habitual nasal extraction and non- Patulous Eustachian tube. Their ages of onset , sides, characteristics of acoustic immitance, clinical manifestations, prognosis and complications were compared. The statistical analysis was carried out with SPSS 19. 0 software. Results Among the 218 cases of acquired eholesteatoma of the middle ear, 22 cases were diagnosed as patulous Eustachian tube with habitual nasal extraction [ with average age of （ 35.7 _＋ 7.5 ） years] ; 196 cases were diagnosed as non-patulous Eustachian tube [ with average age of （47. 8 ± 20. 1 ） years ]. The average age of the patulous Eustachian tube with habitual nasal extraction was significantly lower than that of the non-patulous Eustachian tube group （ t = 4. 25, P 〈 O. 01 ）. Ratio of bilateral middle ear cholesteatoma in patulous Eustachian tube [68.2% （15/22） ] was significantly higher than that of the non- patulous Eustachian tube group [ 18.9% （37/196）] （ X2 = 26.47, P 〈 0.01 ） . Conclusions Some acquired cholesteatoma patients are associated with the patulous Eustachian tube with habitual nasal extraction. The patients have a lower age, and are susceptible for bilateral middle ear cholesteatoma.