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【目的】研究鼻咽癌 (NPC)患者接受放射治疗前后分泌性中耳炎 (SOM )的发生情况及其中耳压力和咽鼓管功能状况。【方法】追踪观察 2 18例 (4 36耳 )NPC患者放射治疗前后的耳部情况 ,检查耳部体征并测量中耳压力 (MEP)及咽鼓管功能 (ETF) ,另选择 12 0例鼻咽慢性炎症患者作对照组测量中耳压力及咽鼓管功能。【结果】NPC患者放疗前SOM发生率为2 2 4% (98/ 436 ) ,放疗后新发生SOM 72耳 ,占 2 1 3% (72 / 338) ;NPC患者放疗前后的平均MEP分别为 (- 5 4± 33)mmH2 O(1mmH2 O =9 80 6 6 5Pa)和 (- 6 9± 34)mmH2 O ,其负压远高于慢性鼻咽炎组的 (- 9± 14)mmH2 O ;NPC患者ETF障碍者较对照组多 ;放疗后新发生SOM的患耳 ,其放疗前有更高的中耳负压和ETF障碍发生率。【结论】SOM是NPC放疗的常见并发症 ,中耳压力和ETF的状况可能影响SOM的发生和转归。
【Objective】 To investigate the incidence of secretory otitis media (SOM) before and after radiotherapy in patients with nasopharyngeal carcinoma (NPC) and the effects of middle ear pressure and eustachian tube function. 【Methods】 The ears of 2 NPC patients (426 ears) before and after radiotherapy were followed up, the ear signs were measured and the middle ear pressure (MEP) and eustachian tube function (ETF) were measured. Another 120 cases were selected Pharyngeal chronic inflammation patients as control group to measure the middle ear pressure and eustachian tube function. 【Results】 The incidence of SOM in NPC was 224% (98/436) before radiotherapy and 72 cases (72/138) after radiotherapy. The average MEP before and after radiotherapy in NPC patients was ( --4 ± 33) mmH 2 O (1 mmH 2 O = 9 80 6 6 5Pa) and (-6 9 ± 34) mmH 2 O, and the negative pressure was much higher than that of the chronic nasopharyngitis group (-9 ± 14) mmH 2 O The patients with ETF were more disabled than the control group. The newly diagnosed ear with SOM after radiotherapy had higher negative pressure of middle ear and ETF before radiotherapy. 【Conclusion】 SOM is a common complication of NPC radiotherapy. The condition of middle ear pressure and ETF may affect the occurrence and prognosis of SOM.