鼻咽癌放疗后分泌性中耳炎的临床观察和防治探讨  

Study of secretory otitis media after radiotherapy in nasopharyngeal carcinoma and inquisition of prevention and treatment

作　　者：莫浩元[1] 麦海强[1] 李宁炜[1] 李娟[1] 黄文瑾[1] 郭翔[1] 洪明晃[1] 

机构地区：[1]中山大学肿瘤防治中心鼻咽科,广东广州510060

出　　处：《中华肿瘤防治杂志》2007年第13期1005-1007,共3页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的:探讨鼻咽癌患者放疗后分泌性中耳炎发生的原因和防治对策。方法:观察176例鼻咽癌患者放疗前后分泌性中耳炎的发生情况,对中耳积液耳聋者行鼓室穿刺抽液处理。采用χ2检验比较患者年龄、性别、鼻咽原发病灶大小、部位以及放疗前后有否分泌性中耳炎等因素与放疗后产生分泌性中耳炎的关系。结果:鼻咽癌患者放疗后分泌性中耳炎的发生率为48.9%,而放疗后6个月内的发生率为51.2%。患者年龄(P=0.367)、性别(P=0.126)及鼻咽原发灶大小(P=0.147)等因素对放疗后分泌性中耳炎的发生无显著影响,而放疗前有分泌性中耳炎和鼻咽肿瘤侵及侧壁与放疗后分泌性中耳炎的长期存在显著相关,P值均为0.000。结论:放疗前有分泌性中耳炎、鼻咽肿瘤侵犯侧壁是鼻咽癌放疗后分泌性中耳炎长期存在的危险因素。对放疗后分泌性中耳炎患者的耳聋实行多次鼓室穿刺抽液和适当选择助听器是目前可行的处理方法。OBJECTIVE： To discuss systemically the etiology of secretory otitis media in nasopharyngeal patients after radiotherapy and to search the strategy for prevention and treatment. METHODS： The data of 176 nasopharyngeal carcinoma （NPC） patients with secretory otitis media after radiotherapy were observed. Tympanic puncture and drainage were done to the patients with media ear effusion. The age, gender, tumor size, site and the secretory media otitis history of the 176 patients were reviewed to see if these factors had any relationship with the secretory media otitis after the radiotherapy. RESULTS： The incidence of the secretory media otitis occurred after the radiotherapy to the NPC patients was 48.9%, the incidence of the secretory media otitis occurred within 6 months after the radiotherapy was 51.2%. The age（P=0. 367）, gender（P=0.126） and the tumor size （P=0. 147） had no observable correlation with the secretory media otiti＇s occurrence, while the history of otitis before the radiotherapy and the invasion of lateral wall had positive correlation with the long term existence of the secretory media otitis after the radiotherapy, P=0. 000. CONCLUSIONS：The history of otitis before the radiotherapy and the invasion of lateral wall are danger factors to the long term existence of secretary media otitis after NPC radiotherapy. Nowdays, the tympanic drainage and proper ear aids are practical deaf treatments to NPC patients with secretary media otitis after radiotherapy.

关 键 词：鼻咽肿瘤/病理学 鼻咽肿瘤/放射疗法 中耳炎 防治 

分 类 号：R739.63[医药卫生—肿瘤]