中华耳鼻咽喉头颈外科杂志
中華耳鼻嚥喉頭頸外科雜誌
중화이비인후두경외과잡지
CHINESE JOURNAL OF OTORHINOLARYNGOLOGY HEAD AND NECK SURGERY
2012年
7期
591-593
,共3页
儿童,学龄前%鼓膜%声阻抗试验%鼻疾病%鼻咽疾病
兒童,學齡前%鼓膜%聲阻抗試驗%鼻疾病%鼻嚥疾病
인동,학령전%고막%성조항시험%비질병%비인질병
Child,preschool%Tympanic membrane%Acoustic impedance tests%Nose diseases%Nasopharyngeal diseases
目的 通过观察分析学龄前鼻及鼻咽部疾病患儿无症状性的鼓膜形态及声导抗异常,初步探讨相关疾病导致潜在性分泌性中耳炎的危险因素.方法 研究对象为81例(162耳)经纤维电子鼻明镜、过敏原皮肤点刺试验及鼻窦CT检查分别确诊为变应性鼻炎、慢性鼻-鼻窦炎及腺样体肥大的患儿,主诉均无耳部症状但体检发现鼓膜异常,进一步行声导抗检测判定是否合并潜在的分泌性中耳炎,同时分析治疗前后相关检查结果的变化.结果 81例(162耳)鼓膜形态异常的患儿中声导抗异常者15例(29耳),在各相关疾病中所占比例分别为:变应性鼻炎13.6％[ 6/44,耳数(下同)],慢性鼻-鼻窦炎18.2％ (12/66),腺样体肥大21.2％ (11/52)；组间比较差异具有统计学意义(x2=63.02,P＜0.05).治疗2周后29耳中有28耳由C型转为A型,治疗4周后1耳由B型转为C型,随访3个月,未见复发.结论 部分学龄前鼻及鼻咽部疾病患儿鼓膜形态及声导抗检查结果存在异常,有发展为分泌性中耳炎的潜在危险,其中腺样体肥大对中耳功能的影响较大.对相关疾病的早期干预可阻断分泌性中耳炎的发展趋势.
目的 通過觀察分析學齡前鼻及鼻嚥部疾病患兒無癥狀性的鼓膜形態及聲導抗異常,初步探討相關疾病導緻潛在性分泌性中耳炎的危險因素.方法 研究對象為81例(162耳)經纖維電子鼻明鏡、過敏原皮膚點刺試驗及鼻竇CT檢查分彆確診為變應性鼻炎、慢性鼻-鼻竇炎及腺樣體肥大的患兒,主訴均無耳部癥狀但體檢髮現鼓膜異常,進一步行聲導抗檢測判定是否閤併潛在的分泌性中耳炎,同時分析治療前後相關檢查結果的變化.結果 81例(162耳)鼓膜形態異常的患兒中聲導抗異常者15例(29耳),在各相關疾病中所佔比例分彆為:變應性鼻炎13.6％[ 6/44,耳數(下同)],慢性鼻-鼻竇炎18.2％ (12/66),腺樣體肥大21.2％ (11/52)；組間比較差異具有統計學意義(x2=63.02,P＜0.05).治療2週後29耳中有28耳由C型轉為A型,治療4週後1耳由B型轉為C型,隨訪3箇月,未見複髮.結論 部分學齡前鼻及鼻嚥部疾病患兒鼓膜形態及聲導抗檢查結果存在異常,有髮展為分泌性中耳炎的潛在危險,其中腺樣體肥大對中耳功能的影響較大.對相關疾病的早期榦預可阻斷分泌性中耳炎的髮展趨勢.
목적 통과관찰분석학령전비급비인부질병환인무증상성적고막형태급성도항이상,초보탐토상관질병도치잠재성분비성중이염적위험인소.방법 연구대상위81례(162이)경섬유전자비명경、과민원피부점자시험급비두CT검사분별학진위변응성비염、만성비-비두염급선양체비대적환인,주소균무이부증상단체검발현고막이상,진일보행성도항검측판정시부합병잠재적분비성중이염,동시분석치료전후상관검사결과적변화.결과 81례(162이)고막형태이상적환인중성도항이상자15례(29이),재각상관질병중소점비례분별위:변응성비염13.6％[ 6/44,이수(하동)],만성비-비두염18.2％ (12/66),선양체비대21.2％ (11/52)；조간비교차이구유통계학의의(x2=63.02,P＜0.05).치료2주후29이중유28이유C형전위A형,치료4주후1이유B형전위C형,수방3개월,미견복발.결론 부분학령전비급비인부질병환인고막형태급성도항검사결과존재이상,유발전위분비성중이염적잠재위험,기중선양체비대대중이공능적영향교대.대상관질병적조기간예가조단분비성중이염적발전추세.
Objective To investigate the risk factors of related disorders,which could lead to potential otitis media by observing the abnormal configuration of drum and abnormal acoustic immittance without symptoms in preschool children. Methods Eighty-one cases (162 ears) received flexible pharyngorhinoscopy,skin prick test,CT examination of sinus,and were diagnosed as allergic rhinitis,chronic sinusitis,adenoid hypertrophy.They had no complaints of ear related symptoms,but were observed to have abnormality in ear drum by physical examined.Acoustic immittance measurement were performed,so as to estimate whether they were accompany with potential otitis media.The changes of examination and tests were analyzed before and after the treatment.Results There were 15 cases(29 ears) with abnormal acoustic admittance among 81 cases( 162 ears) who had no ear related symptoms but had different degree abnormality in ear drum.The morbidity rate of these 15 patients was 13.6％ (6/44 ears) in allergic rhinitis patients,18.2％ (12/66 ears) in chronic sinusitis patients,and 21.2％ (11/52 ears) in adenoid hypertrophy patients,respectively.The differences among the three diseases had statistical significance ( x2 =63.02,P ＜ 0.05 ).Among 29 ears,28 ears whose type of tympanic pressure curve were transfered from type C to type A two weeks after treatment.One ear whose type of tympanic pressure curve transferred from type B to type C four weeks after treatment.All cases had been followed up with no recurrent cases.Conclusions Some preschool children with nasal and nasopharyngeal disorders had abnormal configuration of drum and abnormal acoustic immittance,and had potential risk for otitis media.Among the disorders,adenoid hypertrophy impact more on middle ear function.The early intervention of related diseases could prevent the developing trend of otitis media.
