术后双侧鼻腔填塞对咽鼓管功能的影响

发布时间：2018-04-24 04:11

本文选题：前鼻孔填塞 + 声导抗　；参考：《听力学及言语疾病杂志》2014年01期

【摘要】：目的评估鼻腔、鼻窦术后双侧前鼻孔填塞对咽鼓管功能的影响。方法因鼻腔、鼻窦疾病入院手术患者40例(80耳)按病种不同分为三组:慢性鼻-鼻窦炎组(A组)30耳,鼻中隔偏曲伴鼻甲代偿性肥大组(B组)25耳,慢性肥厚性鼻炎组(C组)25耳,三组对象鼻腔手术后均以膨胀海绵和凡士林纱条经前鼻孔行双侧鼻腔填塞48小时,采用丹麦q0-I型声导抗仪分别测试三组手术前及术后1、2、5d的鼓室压、声顺值、坡度等,观察其变化。结果三组术后1d鼓室负压均增大,与术前比较差异有显著统计学意义(P0.01);术后2d(撤除鼻腔填塞物)三组鼓室负压均减小,与术前及术后1天比较差异有显著统计学意义(P0.01);术后1d三组鼓室峰压点明显左移,术后5d恢复至术前水平;手术前、后三组声顺值、坡度无明显变化(P0.05)。结论鼻腔、鼻窦术后双侧前鼻孔填塞可导致咽鼓管功能障碍,及时撤除鼻腔填塞物,定期清理术腔可减轻对咽鼓管功能的影响。
[Abstract]:Objective to evaluate the effect of bilateral anterior nostril tamponade on eustachian tube function after nasal cavity and sinus surgery. Methods 40 patients (80 ears) with nasal cavity and sinus diseases were divided into three groups: group A (30 ears) with chronic rhinosinusitis, group B (25 ears) with nasal septum deviation and compensatory hypertrophy of turbinate, and group C (25 ears) with chronic hypertrophic rhinitis. The nasal cavity of the three groups were filled with bulging sponge and vaseline gauze through the anterior nostril for 48 hours. The tympanic pressure, sonoconnormal value and slope of the three groups were measured by Danish Q0-I acoustic impedance meter before operation and 1 / 2 day after operation respectively. Observe its changes. Results on the 1st day after operation, the negative pressure of tympanic chamber increased in all the three groups, and the difference was statistically significant compared with that before operation, and the negative pressure of tympanic chamber in the three groups decreased at 2 days after operation. There was significant difference between before operation and 1 day after operation (P 0.01), the peak pressure point of tympanic chamber in the three groups shifted to the left obviously on the 1st day after operation and recovered to the preoperative level on the 5th day after operation, and before the operation, there was no significant change in the score and slope of the latter three groups (P 0.05). Conclusion bilateral anterior nostril tamponade after nasal cavity and sinus surgery can lead to the dysfunction of eustachian tube. Removing the nasal packing in time and clearing the cavity regularly can reduce the influence on eustachian tube function.
【作者单位】：南京医科大学附属淮安第一医院耳鼻咽喉科;
【分类号】：R764

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