慢性化脓性中耳炎患者咽鼓管功能及其影响因素分析  

Eustachian Tube Function in Patients with Chronic Suppurative Otitis Media

作　　者：宗小芳 胡国华[1] 黄江菊[1] 雷艳[1] 江黎珠[1] 康厚墉[1] Zong Xiaofang;Hu Guohua;Huang Jiangju;Lei Yan;Jiang Lizhu;Kang Houyong(Department of Otorhinolaryngology,the First Affiliated Hospital of Chongqing Medical University,Chongqing,400042,China)

机构地区：[1]重庆医科大学附属第一医院耳鼻咽喉科,重庆400042

出　　处：《听力学及言语疾病杂志》2020年第2期165-167,共3页Journal of Audiology and Speech Pathology

摘　　要：目的探讨慢性化脓性中耳炎患者的咽鼓管功能及其影响因素。方法回顾性分析150例(193耳)慢性化脓性中耳炎患者的临床资料,根据年龄分为三组:<45岁组(93耳),45~60岁组(73耳),>60岁组(27耳);根据病程长短分为三组:<1年组(31耳),1~10年组(73耳),>10年组(89耳);根据颞骨CT检查是否有乳突鼓窦炎性病变(软组织或高密度影,不伴骨质破坏)分为二组:有乳突鼓窦病变组(121耳)和无乳突鼓窦病变组(72耳);根据手术中探查鼓室鼓窦是否有肉芽分为二组:有肉芽组(72耳)和无肉芽组(88耳);以24例(48耳)无中耳疾病的慢性耳鸣患者(咽鼓管功能正常)作为正常对照组。采用咽鼓管功能评分(eustachian tube score,ETS)评价各组咽鼓管功能,比较各组咽鼓管功能评分结果。结果慢性化脓性中耳炎组及正常对照组ETS分别为5.37±3.06、8.17±2.27分,差异有统计学意义(P<0.05)。不同病程组之间以及不同年龄组之间ETS评分差异无统计学意义(P>0.05);有乳突鼓窦病变组及中耳有肉芽组的ETS评分分别低于无乳突鼓窦病变组及无肉芽组,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示有无中耳肉芽与咽鼓管功能相关(P<0.05)。结论慢性化脓性中耳炎患耳咽鼓管功能差,当颞骨CT显示有乳突鼓窦病变及术中探查中耳有肉芽者ETS评分低,可能存在咽鼓管功能障碍。Objective To study the function of eustachian tube in patients with chronic suppurative otitis media.Methods The clinical data of 150 patients(193 ears)with chronic auppurative otitis media retrospectively were studied.According to age,patients were divided into three groups:<45 years old group(93 ears).45~60 years old group(73 ears)and>60 years old group(27 ears).According to medical history time,they are divided into three groups:≤1 year group(31 ears),1~10 year group(73 ears)and>10 year group(89 ears).According to HRCT result whether there were inflammatory lesions of mastoid sinus(soft tissue or highdensity shadow,without bone destruction)they were divided into two groups:with meddle ear lesions(121 ears)and without middle ear lesions(72 ears).Accoding to intraoperative observation whether there was granulation they were divided into two groups:with granulation group(72 ears)and without granulation group(88 ears).Twenty-four patients(48 ears)with chronic tinnitus were used as normal control.The differences in eustachian tube function scores(ETS)between the above groups were compared.Results The ETS of chronic suppurative otitis media and normal ear were 5.37±3.06 and 8.17±2.27,respectively.The ETS of the affected ear was lower than that of the normal ear,the difference was statistically significant(P<0.05).There was no significant difference in ETS between different disease courses groups and between different age groups(P>0.05).There was a statistically signifecant difference in ETS between the middle ear lesions group and the middle ear granulation group(P<0.05).Multivariate logistic regression analysis showed whether there was a correlation between middle ear granulation and eustachian tube function(P<0.05).Conclusion Chronic suppurative otitis media patients have poor eustachian tube function.When there are localized lesions in the middle ear and intraoperative exploration of the presence of middle ear granulation,combined with low ETS score,eustachian tube dysfunction should be considered.

关 键 词：慢性化脓性中耳炎 咽鼓管功能评分 咽鼓管功能障碍 

分 类 号：R764.21[医药卫生—耳鼻咽喉科]