Xie Hua, Sun Wenzhong, Que Ying, Dai Shanjun, Zhen Qingping
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2014 Nov;28(22):1785-8.
To analyze the correlation of the tympanic injection of triamcinolone acetonide, middle ear pressure (MEP) and radioactive secretory otitis media (RSOM) with nasopharyngeal carcinoma (NPC) after radiotherapy.
Fifty-two patients suffering NPC without otitis media before radiotherapy were randomly divided into three groups. 17 cases with 34 ears were distributed into treatment group I, and radiotherapy 1 hour before the start of each side of the tympanic cavity injection of triamcinolone acetonide injection, 1-7 weeks 1 times a week. Treatment group I had 17 cases with 34 ears,and radiotherapy 1 hour before the start of each side of the tympanic cavity injection of triamcinolone acetonide injection, 1-12 weeks 1 times a week. And control group consisted of 18 cases with 36 ears who didn't accept such treatment. In all 104 ears, MEP was tested at the begin of radiotherapy and the end of 1st, 2nd, 3rd month after radiotherapy.
From the beginning of radiotherapy to the end of th 1st, 2nd, 3rd month after radiotherapy, the morbidity of RSOM gradually increased and MEP decreased in the treatment group I , II and the control group, in which treatment group II showed the lowest morbidity of RSOM and MEP was maximum (P < 0.01), and the treatment group I showed the lower morbidity of RSOM and MEP was greater (P < 0. 05), while the control group showed the highest morbidity of RSOM and MEP was minimum (P > 0.05).
Tympanic injection of triamcinolone acetonide could reduce radiation injury, and medication time was positively correlated with the MEP, and a negative correlation with RSOM morbidity, and the longer treatment, the more significant the effect is. The difference is most obvious at the end of 3rd month after radiotherapy. It may be due to the more active repairation after radiation damage in middle ears, but long-term efficacy must continue to observe.
分析鼻咽癌放疗后鼓室内注射曲安奈德、中耳压力（MEP）与放射性分泌性中耳炎（RSOM）的相关性。
将52例放疗前无中耳炎的鼻咽癌患者随机分为三组。治疗组Ⅰ有17例34耳，在放疗开始前1小时于每侧鼓室注射曲安奈德注射液，1 - 7周每周1次。治疗组Ⅱ有17例34耳，在放疗开始前1小时于每侧鼓室注射曲安奈德注射液，1 - 12周每周1次。对照组有18例36耳，未接受该治疗。104耳均在放疗开始时及放疗后第1、2、3个月结束时检测MEP。
从放疗开始至放疗后第1、2、3个月结束，治疗组Ⅰ、Ⅱ及对照组RSOM发病率逐渐升高，MEP降低，其中治疗组Ⅱ的RSOM发病率最低，MEP最高（P < 0.01），治疗组Ⅰ的RSOM发病率较低，MEP较大（P < 0.05），而对照组RSOM发病率最高，MEP最低（P > 0.05）。
鼓室内注射曲安奈德可减轻放射损伤，用药时间与MEP呈正相关，与RSOM发病率呈负相关，治疗时间越长，效果越显著。在放疗后第3个月结束时差异最明显。可能是由于中耳放射损伤后修复更活跃，但长期疗效仍需继续观察。
