| 苗红玲 于海玲 孙美红 朱富高 秦昌秀.儿童腺样体肥大程度与分泌性中耳炎发生的相关性研究[J].,2014,14(11):2083-2087 |
| 儿童腺样体肥大程度与分泌性中耳炎发生的相关性研究 |
| Study of the Relationship between Adenoidal Hypertrophy andSecretory Otitis Media |
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| DOI： |
| 中文关键词: 腺样体肥大 分泌性中耳炎 鼻内镜 |
| 英文关键词: Adenoidal hypertrophy Secretory otitis media Nasal endoscopy |
| 基金项目:山东省博士基金（BS2011YY005） |
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| 中文摘要: |
| 目的：探讨儿童腺样体肥大程度与分泌性中耳炎发生及预后的相关性，指导临床医师对分泌性中耳炎作出早期诊断和治
疗。方法：239 例住院手术切除腺样体的儿童，常规行鼻咽侧位片、声导抗检查；部分伴耳部症状、声导抗显示C 型曲线或查体可
疑鼓室积液征者行颞骨CT 检查或术中行鼓室穿刺。经统计学分析，比较分泌性中耳炎与腺样体肥大程度及咽鼓管咽口情况的相
关性。结果：在239 例腺样体肥大儿童中，经鼓室穿刺证实合并分泌性中耳炎者34 例（63 耳，14.2%），其中鼓室曲线呈B 型者33
耳（52.4%），C型（<-200 dapa）者10 耳（15.9%），C 型（>-200 dapa）者20 耳（31.7%）。结果表明分泌性中耳炎的发生与腺样体肥大
程度及咽鼓管园枕受压迫的程度呈正相关。结论：声导抗检查不能作为分泌性中耳炎诊断的金标准，必要时可行颞骨CT 明确诊
断；对腺样体肥大伴分泌性中耳炎的儿童鼻内镜下腺样体切除为其主要疗法，配合鼓室穿刺多可治愈，对反复发作的分泌性中耳
炎行鼓室置管术，避免术后并发症的发生。 |
| 英文摘要: |
| Objective:The purpose of the study was to explore the relationship between adenoid hypertrophy and the occurrence
and prognosis of secretory otitis media in children and to guide the clinical doctors on the early diagnosis and treatment of secretory otitis
media. Methods: To obtain a collection of appropriate medical histories, nasopharyngeal lateral slice endoscopy, acoustic immittance and
pure tone hearing threshold tests were performed routinely on 239 hospitalized children whose adenoid bodies were resected prior to
surgery. Those who had ear symptoms or presented with a C type curve in acoustic immittance testing were suspected to have a middle
ear effusion, and underwent further exmaination through a temporal bone CT or a tympanic cavity puncture examination during the operation.
Through the use of statistical software we analyzed the relationship between secretory otitis media, the degree of adenoid hypertrophy
and the condition of Eustachian tube.Results:Among 239 children with adenoid hypertrophy, 34 children (14.2%) were complicated
with secretory otitis media confirmed by tympanic cavity puncture in which 33 ears (52.4%) were type B, 10 ears(15.9%) were type C (＜
- 200 dapa), 20 ears(31.7%) were C (＞- 200dapa). The results demonstrated that the occurrence of secretory otitis media was positively
associated with the degree of adenoid hypertrophy and compression of the Eustachian tube. Conclusion:Acoustic immittance cannot be
used as the gold standard of the diagnosis of secretory otitis media. Temporal bone CT is necessary for patients who have ear symptoms
or present with a C type curve in acoustic immittance or have a suspected middle ear effusion in order to ensure diagnosis. For children
with adenoid hypertrophy, endoscopic adenoidectomy is the main therapy with high rates of resolution given adjunctive tympanic cavity
puncture. In cases of recurrent secretory otitis media, tympanic cavity catheterisation can be used to reduce the risk of postoperative complications. |
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