鼻内镜下咽鼓管球囊扩张术对鼻咽癌放疗后分泌性中耳炎患者咽鼓管功能的影响

Effect of endoscopic balloon dilatation of eustachian tube on eustachian tube function in patients with secretory otitis media after radiotherapy for nasopharyngeal carcinoma

目的探讨鼻内镜下咽鼓管球囊扩张术对鼻咽癌放疗后分泌性中耳炎患者咽鼓管功能的影响。方法选取2020年1月至2021年1月于陕西省第四人民医院就诊的鼻咽癌放疗后分泌性中耳炎患者124例为研究对象,随机分成常规组及试验组,每组62例。常规组患者采取鼓膜切开置管术治疗,试验组患者接受鼻内镜下咽鼓管球囊扩张术治疗。在术前、术后1个月、6个月及12个月比较两组患者咽鼓管功能、听力情况,术后比较两组患者鼓膜愈合、干耳情况及临床疗效。结果术前,两组患者咽鼓管功能评分比较,差异无统计学意义(P>0.05)。术后1个月、6个月及12个月,试验组患者咽鼓管功能评分均低于常规组(P<0.05)。术前及术后1个月两组患者气导和骨导听阈比较,差异无统计学意义(P>0.05)。术后6个月及12个月,试验组患者气导和骨导听阈低于常规组(P<0.05)。试验组患者鼓膜愈合率、干耳率高于常规组(P<0.05),干耳时间长于常规组(P<0.05)。试验组患者总有效率高于常规组(P<0.05)。结论鼻内镜下咽鼓管球囊扩张术治疗鼻咽癌放疗后分泌性中耳炎患者能提升临床疗效,改善咽鼓管功能及听力情况,建议使用。

Objective To investigate the effect of endoscopic balloon dilatation of eustachian tube on eustachian tube function in patients with secretory otitis media after radiotherapy for nasopharyngeal carcinoma.Methods A total of 124 patients with secretory otitis media after radiotherapy for nasopharyngeal carcinoma were selected from the Fourth People′s Hospital of Shaanxi Province from January 2020 to January 2021.They were randomly divided into conventional group and experimental group,with 62 cases in each group.The conventional group was treated with tympanic membrane incision and catheterization,and the experimental group was treated with endoscopic balloon dilatation of eustachian tube.The eustachian tube function and hearing of the two groups were compared before surgery,1 month,6 months and 12 months after surgery.The healing of tympanic membrane,dry ear and clinical effect of the two groups were compared after surgery.Results Before surgery,there was no significant difference in eustachian tube function score between two groups(P>0.05).1 month,6 months and 12 months after surgery,the eustachian tube function score of experimental group were lower than those of conventional group(P<0.05).There was no significant difference in the threshold of gas conductance and bone conductance between two groups before and 1 month after surgery(P>0.05),6 months and 12 months after surgery,the threshold of gas conductance and bone conductance of experimental group were lower than those of conventional group(P<0.05).The healing rate of tympanic membrane and dry ear rate of experimental group were higher than those of conventional group(P<0.05),and the dry ear time was longer than that of conventional group(P<0.05).The total effective rate of experimental group was higher than that of conventional group(P<0.05).Conclusion Endoscopic balloon dilatation of eustachian tube in the treatment of secretory otitis media after radiotherapy for nasopharyngeal carcinoma could improve clinical efficacy and improve eustachian tube function and hearing function condition,so it is recommended to use.