咽鼓管解剖和功能与慢性化脓性中耳炎发生发展的相关性研究

杨洁; 王艳琦; 孙家强; 孙敬武

doi:10.13201/j.issn.1001-1781.2019.12.002

咽鼓管解剖和功能与慢性化脓性中耳炎发生发展的相关性研究

- 中国科学技术大学附属第一医院(安徽省立医院)耳鼻咽喉头颈外科(合肥, 230001)
基金项目:
安徽省重点研究与开发计划项目(No:201904a7020084)

详细信息

通讯作者: 孙敬武,E-mail:sunjwent@163.com

中图分类号: R764.21

收稿日期: 2019-05-23

Anatomy and function of the Eustachian tube influence the development of chronic suppurative otitis media

- Department of Otolaryngology Head and Neck Surgery, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, China

More Information

Corresponding author: SUN Jingwu, E-mail: sunjwent@163.com

Received Date: 23 May 2019

摘要

摘要: 目的:探讨咽鼓管长度和角度与慢性化脓性中耳炎发生的相关性。方法:回顾性纳入92例(184耳)成年慢性化脓性中耳炎患者,其中慢性化脓性中耳炎118耳、鼓膜膨胀不全25耳、正常对照41耳。所有患者均接受耳内镜、声导抗、纯音听阈、颞骨薄层CT及咽鼓管功能检查。排除松弛部内陷及外耳或中耳胆脂瘤患者,排除存在机械性咽鼓管阻塞或颌面部畸形的患者。对比分析咽鼓管长度、角度和功能。结果:慢性化脓性中耳炎耳的咽鼓管角度为(23.1±2.4)°,鼓膜膨胀不全耳为(22.9±2.9)°,正常对照耳为(25.1±3.0)°,慢性化脓性中耳炎和鼓膜膨胀不全耳的咽鼓管走形较正常对照耳更为水平(P<0.01)。慢性化脓性中耳炎耳的咽鼓管长度为(39.2±4.3) mm,鼓膜膨胀不全耳为(41.7±5.8) mm,正常对照耳为(43.0±5.9) mm,慢性化脓性中耳炎耳的咽鼓管较正常对照耳更短(P<0.01),鼓膜膨胀不全耳与正常对照耳的咽鼓管长度比较差异无统计学意义(P>0.05)。慢性化脓性中耳炎耳咽鼓管功能不良的比例为62%,鼓膜膨胀不全耳为68%,均较正常对照耳(22%)显著升高(P<0.05)。结论:咽鼓管的解剖特点与功能变化与慢性化脓性中耳炎的发生发展有一定的相关性。对于咽鼓管更为短平且存在咽鼓管功能不良的鼓膜膨胀不全耳,可以考虑采用更为积极的治疗措施。
- 中耳炎 /
- 咽鼓管 /
- 鼓膜膨胀不全
Abstract: Objective: To explore the influence of anatomy and function of the Eustachian tube(ET) on the development of chronic suppurative otitis media. Method: We retrospectively enrolled 92 cases(184 ears) of adult patients with chronic suppurative otitis media(CSOM), in whom 118 CSOM ears, 25 atelectasis ears and 41 normal ears were included. All patients underwent endoscopy, tympanometry, pure tone average, temporal bone computerized tomography scans and ET function test. Patients with pars flaccida retraction, cholesteatoma, ET obstruction or maxillofacial deformity were excluded. The length, angle and function of ET were analyzed. Result: The ET angle was(23.1±2.4) ° in CSOM ears, was(22.9±2.9) ° in atelectasis ears and was(25.1±3.0) ° in normal ears. The ETs were more horizontal in ears with CSOM and atelectasis(P<0.01). The ET length was(39.2±4.3) mm in CSOM ears, was(41.7±5.8) mm in atelectasis ears and was(43.0±5.9) mm in normal ears. The ETs in CSOM ears were shorter compared to the ETs normal ears(P<0.01). No significant difference was detected between the length of ETs of atelectasis ears and normal ears(P>0.05). The ET dysfunction rate was 62% in CSOM ears, was 68% in atelectasis ears, which were both significantly higher than the dysfunction rate in normal ears(22%)(P<0.05).Conclusion: The anatomical and functional changes of ETs contribute to the development of CSOM. For patients with more horizontal and shorter ETs as well as ETs dysfunction, more progressive treatment should be considered.
- otitis media /
- Eustachian tube /
- atelectasis

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