鼻内镜咽鼓管吹张术治疗慢性分泌性中耳炎的临床效果

刘海龙

（辛集复明医院耳鼻喉科，河北 辛集，052360）

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摘要：

目的 观察鼻内镜下导管法咽鼓管吹张及鼓室给药治疗慢性分泌性中耳炎的疗效。方法 50例慢性分泌性中耳炎患者在鼻内镜引导下行导管法咽鼓管吹张，并经导管吹入曲安奈德注射液2 mL，1 次/周，共3~4 次，检查咽鼓管功能及鼓膜形态，检测听力，评估耳鸣及耳闭塞感变化。结果 所有患者耳闭塞感、耳鸣、自声增强症状明显改善，鼓膜内陷及咽鼓管功能状态明显缓解。纯音听阈下降10~30 dB 37例，下降10~15 dB 10例，无变化3例；耳闭塞感消失33例，减轻14例，无效3例；耳鸣消失28例，明显减轻19例，无效3例。结论 在鼻内镜引导下，直接导管法咽鼓管吹张，并经咽鼓管途径鼓室给药治疗慢性分泌性中耳炎，能明显改善患者症状，疗效好，值得临床推广。

关键词：分泌性中耳炎；鼻内镜；曲安奈德；鼓室给药

中图分类号：R764.2文献标志码：A文章编号：2096-1413(2017)08-0049-02

The clinical effect of endoscopic eustachian tube in the treatment of chronic secretory otitis media
LIU Hai-long
(Department of ENT, Xinji Fuming Hospital, Xinji 052360, China)

ABSTRACT: Objective To observe the therapeutic effect of endoscopic eustachian catheterization and intratympanic administration for the treatment of chronic secretory otitis media. Methods Fifty cases of patients with chronic secretory otitis media were treated with nasal endoscopy guided eustachian catheterization, and 2 mL of triamcinolone acetonide were injected into the catheter, with 1 time per week, a total of 3-4. The function of eustachian tube and tympanic membrane morphology, detection of hearing, evaluation of tinnitus and ear fullness changes were checked. Results All the patients with ear fullness, tinnitus, autophony symptoms were improved, and otopiesis and the function of eustachian tube were relieved. Pure tone audiometry which decreased 10-30 dB were 37 cases, decreased 10-15 dB were 10 cases, and 3 cases had no change. There were 33 cases of ear occlusion feeling disappeared, which were alleviated in 14 cases and ineffective in 3 cases. There were 28 cases of tinnitus disappeared, which were significantly reduced in 19 cases and ineffective in 3 cases. Conclusion In the endoscopic eustachian tube catheter with direct blowing, and via eustachian tube intratympanic treatment of chronic secretory otitis media, can significantly improve the clinical symptoms of patients, which has the curative effect. It is worthy of promotion.
KEYWORDS: secretory otitis media; nasal endoscope; triamcinolone acetonide; intratympanic administration

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