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12 分钟会诊:转诊耳痛的循证管理。

12 minute consultation: an evidence-based management of referred otalgia.

机构信息

Department of ENT/Head and Neck Surgery, Southern General Hospital, Glasgow, UK.

出版信息

Clin Otolaryngol. 2010 Oct;35(5):409-14. doi: 10.1111/j.1749-4486.2010.02197.x.

Abstract

BACKGROUND

Otalgia is a common presenting symptom to the ENT clinic. The aetiology of otalgia can be divided into otological and referred depending on its underlying pathology. This article aims to provide a systematic and evidence-based method of managing a patient with referred otalgia.

METHODS

The data in this article are based on a literature review performed on MEDLINE and EMBASE in January 2010. The keywords used included otalgia in combination with diagnosis, management, investigations and treatment. Articles in the English language were selected and reviewed. Suitable references from these articles were also reviewed.

RESULTS

The majority of published literature on the management of diseases causing referred otalgia is level III/IV evidence.

CONCLUSIONS

An understanding of the different causes of referred otalgia is essential as it can be multifactorial in origin. The main concern in a patient with referred otalgia is overlooking a malignant lesion in the upper aerodigestive tract or base of skull/infratemporal fossae. A thorough history followed by a systematic examination usually helps to arrive at a diagnosis. Treatment should be directed towards the underlying pathology.

摘要

背景

耳痛是耳鼻喉科常见的就诊症状。耳痛的病因可根据其潜在的病理分为耳源性和牵涉性。本文旨在提供一种系统的、基于循证的方法来管理牵涉性耳痛患者。

方法

本文的数据基于 2010 年 1 月在 MEDLINE 和 EMBASE 上进行的文献回顾。使用的关键词包括耳痛与诊断、管理、检查和治疗相结合。选择并回顾了英语文献中的文章。还回顾了这些文章中的合适参考文献。

结果

关于引起牵涉性耳痛的疾病的管理,大多数已发表的文献都是 III/IV 级证据。

结论

理解牵涉性耳痛的不同原因是必要的,因为它可能是多因素起源的。牵涉性耳痛患者的主要关注点是忽略上呼吸道或颅底/颞下窝的恶性病变。详细的病史和系统的检查通常有助于做出诊断。治疗应针对潜在的病理。

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