儿童鼻-鼻咽部病变相关性分泌性中耳炎的综合治疗  

Comprehensive treatment of children with otitis media with effusion related to nasal and nasopharyngeal lesions

作　　者：怀德 徐敏[2] 谭长强[3] 王建武[1] 张亚龙[1] 张军[4] 周晓建[1] 饶青[1] 

机构地区：[1]灌南县人民医院耳鼻咽喉头颈外科中心,江苏省222500 [2]灌南县人民医院影像中心,江苏省222500 [3]南京大学医学院附属鼓楼医院耳鼻咽喉科 [4]灌南县人民医院麻醉科,江苏省222500

出　　处：《江苏医药》2013年第15期1778-1780,共3页Jiangsu Medical Journal

基　　金：国家自然科学基金项目(81070789)

摘　　要：目的总结儿童鼻-鼻咽部病变致分泌性中耳炎的综合治疗效果。方法经保守治疗无效的儿童分泌性中耳炎患儿32例,经CT、鼻内镜等检查确诊为鼻腔、鼻咽部存在病变。根据病情,32例住院接受相关综合治疗:肥大腺样体和扁桃体切除;开放上颌窦口、下甲骨折外移或肥大部分切除;局限性矫正切除严重偏曲的鼻中隔;耳内镜下行鼓膜穿刺抽液,激素冲洗中耳腔,放置鼓膜通气管。结果随访3-6个月。术后听力减退均明显好转;32例患儿听阈均在25dB以内,声导抗图均转为A型曲线。鼻阻、耳鸣、耳闭、头痛消失。结论综合治疗儿童鼻-鼻咽部病变相关性分泌性中耳炎的疗效满意。Objective To summarize the outcomes of comprehensive treatment of children with otitis media with effusion related to nasal and nasopharyngeal lesions.Methods The nasal and nasopharyngeal lesions were confirmed by CT and endoscopy in 32children with otitis media with effusion,who failed to conservative treatment.On the basis of different conditions,the patients received some of the comprehensive treatments such as electric suction or resection of adenoidal and tonsil hypertrophy,maxillary sinus openning,fractured turbinate shift or hypertrophy resection,correction of nasal septum deviation,tympanic membrane puncture,pumping fluid and flushing the middle ear cavity with hormones and placement of tympanostomy tubes.Results The patients were followed up for 3to 6 months,which showed a remarkable improvement of hearing with hearing thresholds within 25 dB acoustic impedance diagram into type A curve.The nasal obstruction,tinnitus,closed ear and headache were disappeared after treatment.Conclusion The therapeutic efficacy of comprehensive treatments was satisfied for the children with nasal and nasopharyngeal lesions-related otitis media with effusion.

关 键 词：分泌性中耳炎 儿童 

分 类 号：R764[医药卫生—耳鼻咽喉科]