Antoniv V F, Shakhverdiev A K, Antoniv T V, Pushkar' I S
Vestn Otorinolaringol. 2010(2):11-3.
Otalgia and/or impairment of hearing is one of the earliest, if not the first, symptom of certain pharyngeal and laryngeal disorders. Underestimation of these conditions or incorrect interpretation of their origin frequently lead to erroneous diagnosis and the wrong choice of treatment strategy. A total of 1074 patients with pharyngeal and laryngeal problems were available for examination that revealed pathologies in which otalgia and/or impairment of hearing is the first or an earlier symptom of the disease. Otalgia proved to be an early manifestation of serious inflammatory diseases affecting the middle part of the pharynx or of metastasis of malignant pharyngeal and laryngeal tumours into deep cervical lymph nodes. Juvenile angiofibroma, hemangiouma, malignant nasopharyngeal tumour are known to disturb functional automatism of pharyngeal openings of Eustachian tubes and cause impairment of hearing long before clinical manifestations of neoplastic growth. Results of diagnostic studies are usually interpreted as middle ear pathology (tubootitis, exudative otitis, middle ear inflammation). Correct diagnosis is possible within 1-12 months (or more) after the appearance of the first symptoms. An error is possible to avoid by thorough examination of the pharynx using endoscopic optics. Target biopsy is indicated as soon as neoplastic microlesions are identified excepting cases of branched arterial-type hemangiomas.
耳痛和/或听力障碍是某些咽喉疾病最早出现的症状之一，即便不是首个症状。对这些病症的低估或对其病因的错误解读常常导致误诊以及治疗策略的错误选择。共有1074例咽喉问题患者可供检查，检查发现其中一些病症以耳痛和/或听力障碍作为疾病的首个或较早症状。事实证明，耳痛是影响咽中部的严重炎症性疾病或咽喉恶性肿瘤转移至颈深部淋巴结的早期表现。众所周知，青少年血管纤维瘤、血管瘤、鼻咽恶性肿瘤早在肿瘤生长的临床表现出现之前，就会干扰咽鼓管咽口的功能自主性并导致听力障碍。诊断研究结果通常被解释为中耳病变（咽鼓管炎、渗出性中耳炎、中耳炎症）。在首个症状出现后的1至12个月（或更长时间）内有可能做出正确诊断。通过使用内镜光学设备对咽部进行全面检查可以避免误诊。一旦发现肿瘤微病变，除分支动脉型血管瘤病例外，均需进行靶向活检。
