儿童鼻窦炎对咽鼓管与中耳传音功能的影响.docxVIP

儿童鼻卖炎对咽鼓管与中耳传首功 能的影响 【摘要】探讨儿童鼻窦炎对咽鼓管与 中耳传音功能的影响及程度， 观察治疗鼻窦 炎后，中耳传音功能障碍的恢复情况。 方法: 对儿童鼻窦炎100例和正常儿童50例行耳 科检查、咽鼓管咽口观察、声阻抗检查、纯 音测听，对比结果；对鼻窦炎合并耳病变的 68例患者行有针对性的治疗。 结果：鼻窦炎 患者中鼓膜异常率为 64%咽鼓管咽口异常 率为62%咽鼓管功能异常率为 ％鼓室导抗 图异常率为％听力减退％，与正常儿童组相 比，差异有统计学意义。急性鼻窦炎、亚急 性鼻窦炎与慢性鼻窦炎中耳病变的发生率 和程度相比，差异有统计学意义。治疗鼻窦 炎后，中耳传音功能障碍有明显改善。 结论: 儿童鼻窦炎引起咽鼓管功能的改变， 中耳病 变发生率较正常儿童显着增高；随病程的延 长，发病率增高且程度加重。 【关键词】鼻窦炎声阻抗试验纯音测听 咽鼓管儿童 [ABSTRACT Objective: To investigate injury of the eustachian tube and middle ear by sinusitis in children and observe the recovery of the acoustic dysfunction after treatment for sinusitis. Methods: Examination of the ear, observation of the pharyngeal ostium of the eustachian tube , acoustic impedance tests, and pure tone audiometry were performed on 100 children with chronic sinusitis and 50 normal children. Of them, in 128 ears of 68 children sinusitis was found combined with ear diseases and then treated. Results: In children with sinusitis, the abnormal rate of the eardrum, the pharyngeal ostium of the eustachian tube , the function of the eustachian tube and the acoustic impedance tests was 64%, 62%, %, and %,respectively, and the rate of hearing loss was %. Compared with the normal children, the differences were statistically significant(P ). The differences of the incidence of middle ear disease and acute sinusitis, sub acute sinusitis and chronic sinusitis were statistically significant between the two groups (P ).The acoustic dysfunction had a significant improvement after the treatment for sinusitis. Conclusion: The changes of the eustachian tube function caused sinusitis lead to a significantly high incidence of middle ear disease. :KEY WORDS Sinusitis ; Acoustic impedance tests ; Pure tone audiometry ; Eustachian tube ; Middle ear; Children 由于鼻腔后部与咽鼓管咽口解剖上毗邻， 黏 膜延续，儿童鼻窦炎可通过直接或间接波及 的双重途径影响咽鼓管功能， 从而引起中耳 传音功能障碍，若不及时治疗，除影响听力 外，还可引起语言障碍。我们对儿童鼻窦炎 患者100例(200耳)及正常儿童50例行耳科 检查、咽鼓管咽口观察、声阻抗、纯音测听 检查，探讨儿童鼻窦炎对咽鼓管和中耳传音 功能的影响及其程度，为临床防治儿童鼻窦 炎引起听力障碍提供依据。 1资料与方法 临床资料 鼻窦炎组：选择2006年1月至 2006年10月在我科