耳部真菌病临床分析(附187例报告)  

Clinical characteristics of otomycosis:187 case reports

作　　者：杨琼[1] 高春生[1] 孙彩波[2] 黄丽葵[1] 李杜若[1] 韩小璐[1] 

机构地区：[1]广东医学院第二临床医院深圳第六人民医院耳鼻咽喉科,深圳518052 [2]山东威海市立医院耳鼻咽喉科,威海250021

出　　处：《中华耳科学杂志》2007年第2期161-163,共3页Chinese Journal of Otology

摘　　要：目的探讨耳部真菌病的临床特征和防治策略。方法回顾性分析187例(257耳)耳部真菌病患者的临床资料及耳内镜表现。耳内镜检查可见外耳道深部有灰白色上皮堆积、霉样痂皮或污秽物附着、黄或黑色颗粒物贴附。耳局部清洁后将达克宁散剂(粉末)均匀喷洒于外耳道。结果全部病例随访半年～1年,1次治愈85例(99耳),复发1至2次共61例(101耳),复发3次及3次以上25例(38耳),失访16例。本组引起复发的86例(139耳)中,合并慢性中耳炎39例(48耳),外耳道狭窄(11耳),未坚持上药19例(23耳),有挖耳习惯的82例次。耳部真菌培养多为黑曲霉菌。治疗后耳内镜检查可见外耳道干燥,皮肤充血消失。结论纠正不良挖耳习惯有助于预防耳部真菌病;耳内镜的使用有助于耳部真菌病的诊断和疗效评估;积极治疗慢性中耳炎、保持患耳干燥及首次治疗坚持足够疗程用药都非常重要。Objective To explore the clinical characteristics and the treatment of otomycosis. Methods The clinical data and otoendoscopic figures of 187 cases （257 ears） with otomycosis were retrospectively analyzed. There were lots of humid epidermic piles in the deep part of external auditory canal under otoendoscope. The external auditory canals were sprinkled with miconazole after local cleaning. Results The follow-up period was half to one year. Eighty-five cases healed after one period of treatment, 61 cases recrudesced one or two times, 25 cases recrudesced 3 times or more. In the 86 recrndescent cases （139 ears）, there were 48 ears combined with chronic otitis media, 11 ears with stenosis of external auditory canal. Nineteen cases did not keep on treatment. Eighty-two cases had the habit of digging ear. Aspergillus was the most common isolated fungi after culturing. After therapy, external auditory canal was dry and the swelling of skin was alleviated in otoendoscopic findings. Conclusion Otomycosis is easy to be misdiagnosed and mistreated. Getting rid of the habit of excavating ear-canal is the key to preventing from otomycosis. Otoendoscopic examination is beneficial to the diagnosis of otomycosis. Meanwhile curing chronic otitis media, keeping the external auditory canal dry and using antifungal drugs for enough time are also important.

关 键 词：耳真菌病 耳内镜 临床特点 

分 类 号：R764.16[医药卫生—耳鼻咽喉科] R764.04[医药卫生—临床医学]