非洲加蓬地区耵聍栓塞的临床特征分析

Characteristics of Impacted Cerumen in Gabon Region

目的探讨非洲加蓬地区耵聍栓塞的临床特征。方法收集960例外耳道耵聍栓塞患者的资料,分析其发病年龄和性别分布情况,患耳侧别、首发症状以及耵聍栓塞的颜色、硬度和阻塞的部位。结果960例耵聍栓塞患者中,男性多于女性;其中1-15岁患者最多,其次是60岁以上患者,各年龄段中性别之间有差异性,χ^2=14.510,P=0.013。不同性别间比较,单双耳之间有差异性,χ^2=14.017,P<0.002,双耳多见;左右耳之间无差异性,χ^2=1.980,P=0.159,但右耳多于左耳;不同年龄耵聍栓塞的各首发症状无有差异性,χ^2=48.232,P<0.001,以耳堵和听力下降常见;各阻塞部位间无差异性,χ^2=3.287,P=0.349,多位于软骨部;不同年龄患者耵聍栓塞的颜色无有差异性,χ^2=40.073,P<0.001,以黑色多见;耵聍栓塞的硬度无差异性,χ^2=2.509,P=0.474,以蜡状多见。结论非洲加蓬地区耵聍栓塞发病率较高,多见于儿童和青少年以及60岁以上老年患者;男性多于女性,双耳多于单耳;耵聍栓塞以黑色蜡块状多见,多阻塞于外耳道软骨部;其首发临床症状以耳堵和听力下降常见。这些特征将对国内耵聍栓塞的诊疗有一定的临床参考价值。

Objective To report characteristics of impacted cerumen in Gabon,Africa.Methods Data of 960 patients with impacted cerumen were collected and analyzed,including age and sex distribution,side and first symptoms,and color,hardness and location of impacted cerumen.Results Among the 960 cases,there were more male patients than female patients,with most patients in the 1-15 and over 60 years age groups.Gender distribution was significantly different among different age groups(χ^2=14.510,P=0.013).Distribution of unilateral and bilateral involvement was dif-ferent between different sexes(χ^2=14.017,P<0.002),and bilateral involvement was more common,although there was not difference between the left or right ear involvement(χ^2=1.980,P=0.159).There was statistically significant in dif-ference age groups regarding frequency of the initial symptoms(χ^2=48.232,P<0.001),but ear obstruction and hearing loss were common.There was no particular site of obstruction(χ^2=3.287,P=0.349),although cartilaginous canal impaction was more common.there was dominant difference in cerumen color(χ^2=40.073,P<0.001),and black color was more common;there was no significant variation in cerumen hardness(χ^2=2.509,P=0.474);and wax-like cerumen was the most commonly seen.Conclusion The incidence of impacted cerumen was high in Gabon region,mostly in children,adolescents and the elderly,more common in men than in women involving both ears.The impacted cerumen tends to be black wax-like in the cartilaginous external auditory canal with the initial symptoms of ear obstruction and hearing loss.These characteristics can help with diagnosis and treatment of domestic patients with impacted cerumen.