Cohen Atsmoni Smadar, Brener Avivit, Roth Yehudah
Department of Otolaryngology-Head and Neck Surgery, The Edith Wolsfon Medical Center, Holon, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Pediatric Endocrinology & Diabetes Unit, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Diabetes Metab Syndr. 2019 Mar-Apr;13(2):1141-1150. doi: 10.1016/j.dsx.2019.01.006. Epub 2019 Jan 17.
Diabetes mellitus is the most common endocrine disease, characterized by chronic hyperglycemia. The hyperglycemic milieu leads to endothelial injury in blood vessels of variant size, which results in microangiopathy and macroangiopathy (atherosclerosis). Consequential ischemia of nerves and hyperglycemia by itself lead to nerve degeneration and generalized neuropathy, affecting most often the sensory peripheral nerves and the autonomic nervous system. Auditory, vestibular and olfactory sensorium may be compromised by DM. People with DM have an increased susceptibility to infection, as a result of neutrophil dysfunction and impaired humoral immunity. Therefore DM predisposes to certain infectious diseases, such as fungal sinusitis or malignant otitis externa, which are rare in general population. Recovery from infections or from injuries may be compromised by coexisting DM. In this review we discuss complications of DM in the head and neck region. Otolaryngologists and general practitioners should be alert to specific conditions related to DM and be minded of the relevant complications and consequences.
糖尿病是最常见的内分泌疾病，其特征为慢性高血糖。高血糖环境会导致不同大小血管的内皮损伤，进而引发微血管病变和大血管病变（动脉粥样硬化）。随之而来的神经缺血以及高血糖本身会导致神经变性和全身性神经病变，最常影响感觉外周神经和自主神经系统。糖尿病可能会损害听觉、前庭和嗅觉感受器。由于中性粒细胞功能障碍和体液免疫受损，糖尿病患者更容易感染。因此，糖尿病易引发某些传染病，如真菌性鼻窦炎或恶性外耳道炎，这些疾病在普通人群中较为罕见。并存的糖尿病可能会影响感染或损伤后的恢复。在本综述中，我们将讨论糖尿病在头颈部区域的并发症。耳鼻喉科医生和全科医生应警惕与糖尿病相关的特定情况，并留意相关并发症及后果。
