通氣管置入術治療成人中耳積液－臨床分析

Middle Ear Effusion in Adults Treated with Grommet Insertion - Clinical Analysis

王俊富(Chun-Fu Wang) ； 趙文元(Wen-Yuan Chao)

《中華民國耳鼻喉科醫學會雜誌》 32卷4期 (1997/08) Pp. 360-365

https://doi.org/10.6286/1997.32.4.360

摘要

本研究收集1988年7月至1996年6月8年間，在成大醫院初次診斷為性中耳炎並接受中耳通質管手術之16歲以上成年人，共198例(260耳)，根據病歷記載，分析各年齡層之鼓室圖、初發症狀、病因及復發率;並且統計通氣管置入至脫落的時間。結果顯示16-29歲及60歲以上者，病因以鼻竇炎較常見，而30-59歲之間則以鼻咽癌患者居多。初發症狀以耳塞感最常見，佔75.3%，其次是聽力障礙(74.2%)。追蹤2年以上的132例(175耳)中，171耳之通氣管均在2年內自行脫落，平均約為8.6個月。在2年內復發的情況，依其病因分別是患頭頸部腫瘤者78耳(78.8%)，鼻竇炎者12耳(27.3%)，上呼吸道感染者1耳(7.1%)，其他4耳(28.6%)。本研究顯示鼻咽癌及鼻竇炎為成人中耳積液的主要原因，故對於積液性中耳炎的成人患者，鼻咽部的詳細檢查是絕對必須的。(中耳醫誌 1997;32:360-365)

關鍵字

積液性中耳炎 ； 通氣管置入術

並列摘要

Otitis media with effusion (OME) commonly occurs at childhood, whereas adult-onset OME is less common. The latter is generally secondary to neoplastic diseases of the nasopharynx or other head and neck tumors. We retrospectively studied 198 patients (260 ears) with adultonset OME which needed grommet insertion at our department. Of 103 patients with head and neck cancers, 38.8% had OME before radiotherapy. Ear fullness and hearing impairment were wth most common symptoms in these patients. The mean extrusion time of the ventilation tube was 8.6 months. If the ventilation tube was extruded, the recurrence rate of OME was higher in the head and neck cancer patients than that of the others. We suggest that nasopharyngeal examination is mandatory in the adult-onset OME patients. Longterm flollow-up may be necessary to exclude the irreversible change of the Eustachian tube in the irradiated patients.

並列關鍵字

otitis media with effusion ； grommet insertion