Morgan N J, Soo G, Frain I, Nunez D A
ENT Department, Leicester Royal Infirmary, UK.
Clin Otolaryngol Allied Sci. 1995 Oct;20(5):411-2. doi: 10.1111/j.1365-2273.1995.tb00072.x.
Nasal packing is associated with post-operative Eustachian tube dysfunction in patients undergoing nasal surgical procedures. The effect of cannulated nasal packs which may improve nasopharyngeal ventilation was investigated in a prospective randomized controlled trial. Adult elective patients without tympanometric evidence of pre-operative Eustachian tube dysfunction were recruited. All subjects underwent single or combined intranasal surgical procedures and were randomized to receive either bilateral cannulated or non-cannulated Merocel nasal packs. Middle ear pressures (MEP) were recorded pre-operatively and post-operatively before nasal pack removal. Left and right ear results were amalgamated for analysis and 40 adults, 20 in each group were analysed. There was no difference in pre-operative MEP, -15 dPa (median value) in both groups. Post-operatively the MEP changed in both groups P < 0.0001. There was no significant inter group difference in the post-operative median MEP, -85 dPa in the cannulated and -70 dPa in the control groups, (95% c.i. for the difference in the medians -25-55 dPa). Nasal surgery with post-operative packing leads to an objective reduction in MEP which is not altered by venting the packs.
鼻填塞与接受鼻腔手术的患者术后咽鼓管功能障碍有关。在一项前瞻性随机对照试验中，研究了可改善鼻咽通气的带管鼻填塞的效果。招募了无术前咽鼓管功能障碍鼓室图证据的成年择期患者。所有受试者均接受了单次或联合鼻内手术，并随机分为接受双侧带管或不带管的美罗海绵鼻填塞。在取出鼻填塞物之前，于术前和术后记录中耳压力（MEP）。将左右耳的结果合并进行分析，共分析了40名成年人，每组20名。两组术前MEP无差异，均为-15 dPa（中位数）。术后两组MEP均发生变化（P<0.0001）。术后两组MEP中位数无显著组间差异，带管组为-85 dPa，对照组为-70 dPa（中位数差异的95%置信区间为-25至55 dPa）。术后填塞的鼻腔手术导致MEP客观降低，而通过使填塞物通气并不能改变这一情况。
