茎突异常引发耳痛的茎突综合征38例  

Styloid syndrome with abnormal styloid process causing earache:a report of 38 cases

作　　者：王永福 宇雅苹 于伟 陈晓华 董茜茜 逄启然 宋晴 徐永向 于军 姜绍红[3] 张庆泉[3] Wang Yongfu;Yu Yaping;Yu Wei;Chen Xiaohua;Dong Qianqian;Pang Qiran;Song Qing;Xu Yongxiang;Yu Jun;Jiang Shaohong;Zhang Qingqua(Department of Otolaryngology,Yantai Yeda Hospital Yantai,Shandong,264006,China;Department of Otolaryngology,Yantai Zhifu Hospital Yantai,Shandong,264000,China;Department of Otolaryngology,Yuhuangding Hospital Yantai,Shandong,264000,China)

机构地区：[1]烟台业达医院,山东烟台264006 [2]烟台芝罘医院,山东烟台264000 [3]烟台毓璜顶医院,山东烟台264000

出　　处：《中国医学文摘（耳鼻咽喉科学）》2024年第4期57-59,87,共4页Chinese Medical Digest(Otorhinolaryngology)

摘　　要：目的探茎突异常引发耳痛的茎突综合征的诊断、治疗方式及治疗效果。方法对38例茎突异常引发耳痛的茎突综合征,进行咽部触诊及影像学检查明确诊断,根据患者的症状及意愿,行茎突截短术或加舌咽神经末梢切断术或封闭治疗和药物治疗,进行治疗方式分析。结果术后随访6个月~3年3个月,茎突异常刺激周围组织引起的耳部疼痛26例患者中21例手术患者中,治愈16/21例,占76.19%;显效3/21例,占14.28%;无效2/21例,占9.52%;5例行咽部封闭治疗和药物治疗疼痛明显好转,可以忍受,观察治疗;2例手术治疗无效者,咽部封闭治疗和药物治疗依然有效。茎突异常刺激舌咽神经引发的耳部疼痛12例患者中的9例手术者术后疼痛消失。7例患者未有疼痛发作,其中2例未找到舌咽神经末梢支的1例,在术后1年多时又出现剧烈疼痛,改行已状窦后进路舌咽神经切断术治愈,1例在7月后发生疼痛,但是较前明显减轻,局部封闭治疗和药物治疗好转。3例咽部封闭有效者因为疼痛可以忍受,继续观察治疗。全部手术患者无并发症发生。结论茎突异常引发耳痛的茎突综合征在临床上虽较为少见,但应避免漏诊,经咽部触诊及影像学检查明确诊断后,茎突截短术或加舌咽神经末梢切断术,手术确切。Objective To investigate the diagnosis,treatment and therapeutic effect of styloid syndrome caused by abnormal styloid process.Methods 38 cases of styloid syndrome caused by abnormal styloid process were diagnosed by pharyngeal palpation and imaging examination.According to the symptoms and wishes of the patients,styloid process truncation or hyphoglosopharyngeal nerve termination amputation or blocking treatment and drug treatment were performed,and the treatment methods were analyzed.Results After 6 months to 3 years and 3 months of follow-up,the ear pain caused by abnormal stimulation of the surrounding tissue of the styloid process was cured in 16/21 of the 26 patients,accounting for 76.19%.Obvious effect was found in 3/21 cases,accounting for 14.28%;Invalid cases were 2/21,accounting for 9.52%;5.The pain was obviously improved by pharyngeal block treatment and drug treatment,and could be tolerated.Pharyngeal block therapy and drug therapy were still effective in 2 patients who failed to receive surgical treatment.Ear pain caused by abnormal stimulation of glossopharyngeal nerve caused by styloid process disappeared after operation in 9 of 12 patients.The 7 patients did not have pain attack,among which 2 patients did not find the glossopharyngeal nerve terminal branch,and 1 case had severe pain more than 1 year after surgery,and was cured by retrosinusoid approach glossopharyngeal nerve amputomy.1 case had pain 7 months later,but it was significantly reduced,and local blocking treatment and drug treatment improved.The 3 cases with effective pharyngeal closure were continued to be observed and treated because the pain was tolerable.No complications occurred in all patients.Conclusion Although the styloid syndrome caused by abnormal styloid process is relatively rare in clinic,missed diagnosis should be avoided.After the diagnosis is confirmed by pharyngeal palpation and imaging examination,styloid process truncation or glossopharyngeal nerve termination amputation is accurate.

关 键 词：茎突 异常 耳痛 

分 类 号：R47[医药卫生—护理学]