Low W K, Lim T A, Fan Y F, Balakrishnan A
Department of Otolaryngology, Singapore General Hospital, Republic of Singapore.
J Laryngol Otol. 1997 May;111(5):431-4. doi: 10.1017/s0022215100137557.
The theory that middle-ear effusion (MEE) associated with nasopharyngeal carcinoma (NPC) is merely the result of tensor veli palatinus destruction is deficient because recent studies have shown that many patients with NPC have MEE but no tensor veli palatinus dysfunction. The present study evaluates the relationship between MEE and Eustachian cartilage erosion by NPC and examines the pathogenesis of NPC-associated MEE from a new perspective. Thirty-five patients with NPC were studied by magnetic resonance scans taken along the lengths of the Eustachian tubes. Twenty-four patients had tumour involvement of both sides of the nasopharynx so that 59 ears were available for study. Eighteen ears had MEE of which 12 had Eustachian cartilage erosion (p < 0.00001), Fischer's Exact Test). In ears with MEE, Eustachian cartilage erosion was frequently but not necessarily associated with tensor veli palatinus destruction. We postulate that altered Eustachian tubal compliance as a result of cartilage erosion by tumour is an important reason why middle-ear effusions develop in patients with NPC.
认为与鼻咽癌（NPC）相关的中耳积液（MEE）仅仅是腭帆张肌破坏所致的理论是有缺陷的，因为最近的研究表明，许多鼻咽癌患者有中耳积液，但并无腭帆张肌功能障碍。本研究评估了鼻咽癌导致的中耳积液与咽鼓管软骨侵蚀之间的关系，并从一个新的角度探讨了鼻咽癌相关中耳积液的发病机制。通过沿咽鼓管长度进行磁共振扫描，对35例鼻咽癌患者进行了研究。24例患者双侧鼻咽部均有肿瘤累及，因此共有59只耳朵可供研究。18只耳朵有中耳积液，其中12只存在咽鼓管软骨侵蚀（p<0.00001，Fisher精确检验）。在有中耳积液的耳朵中，咽鼓管软骨侵蚀经常但不一定与腭帆张肌破坏相关。我们推测，肿瘤侵蚀软骨导致咽鼓管顺应性改变是鼻咽癌患者发生中耳积液的一个重要原因。
