Young Y H, Sheen T S
Department of Otolaryngology, National Taiwan University, Taipei.
Acta Otolaryngol. 1998 Mar;118(2):280-3. doi: 10.1080/00016489850155026.
Nineteen nasopharyngeal carcinoma (NPC) patients were subjected to eustachian tube function testing before and 5 years after irradiation. Tubal patency and clearance function of the eustachian tube showed deterioration if maximum irradiation dosage was more than 70 Gy, whereas dynamic function of the eustachian tube was preserved. Development of middle ear complications in NPC patients post-irradiation was caused by both tubal and inflammatory factors. To preserve tubal function, maximum irradiation dosage to NPC should be limited to 70 Gy. To decrease the inflammatory reaction, firstly, middle ear effusion should be drained by repeated myringotomies instead of grommet insertion, and secondly, sinusitis should be evaluated and treated, because sinusitis can aggravate otitis media with effusion.
19例鼻咽癌患者在放疗前及放疗后5年接受了咽鼓管功能测试。如果最大照射剂量超过70 Gy，咽鼓管的通畅性和清除功能会恶化，而咽鼓管的动态功能得以保留。鼻咽癌患者放疗后中耳并发症的发生是由咽鼓管因素和炎症因素共同引起的。为保留咽鼓管功能，鼻咽癌的最大照射剂量应限制在70 Gy以内。为减少炎症反应，首先，应通过反复鼓膜切开术而非鼓膜置管术引流中耳积液，其次，应评估并治疗鼻窦炎，因为鼻窦炎会加重分泌性中耳炎。
