中国耳鼻咽喉头颈外科2025，Vol.32Issue(3)：158-163,6.DOI:10.16066/j.1672-7002.2025.03.005
反流性咽喉炎与中耳炎Ⅰ型鼓室成形术成功率的关系
Relationship between reflux laryngitis and the success rate of type Ⅰ tympanoplasty for otitis media
摘要
Abstract
OBJECTIVE Aimed at investigating whether reflux pharyngitis is an independent risk factor for the failure of type Ⅰ tympanoplasty for chronic otitis media.This is achieved by analyzing the relationship between the postoperative tympanic membrane healing in patients who underwent type Ⅰ tympanoplasty and pharyngolaryngeal reflux finding score(RFS).METHODS Patients who underwent type Ⅰ tympanoplasty in the Department of Otolaryngology Head and Neck Surgery,Nanshan People's Hospital,Shenzhen,China,from January 2023 to July 2024 were retrospectively included.All the patients received preoperative perfect nasal endoscopy,laryngoscopy,evaluation by the RFS questionnaire,preoperative otoscopy for tympanoplasty,pure tone hearing threshold,and temporal bone thin-layer CT examination.Postoperative otoscopic examination was performed to observe tympanic membrane healing and followed up for 3 months.The patients were divided into surgery success group and failure group based on the criterion of whether a complete tympanic membrane was formed by endoscopic examination within 3 months.The RFS scores of the two groups were statistically analyzed.RESULTS A total of 135 patients with an average age of 44.78 years(±12.22 years)took part in this study,with 60 males and 75 females included,and 68 left ears and 67 right ears involved.There were 120 patients in the surgery success group,and 15 patients in the failure group.Statistical analysis revealed that the RFS score of the patients in the tympanoplasty failure group was remarkably higher than that of the patients in the tympanoplasty success group.Moreover,there were significantly more cases with suspected reflux pharyngitis in the surgery failure group(P=0.007).Reflux-induced tympanic membrane lesion and reperforation mostly occurred in the central part of the tympanic membrane graft.CONCLUSION Reflux pharyngitis has been implicated with tympanoplasty failure,and thus may be a causative factor.Additionally,the RFS can be used to screen patients with chronic suppurative otitis media for suspected reflux pharyngitis.Findings from this work indicate that perioperative anti-reflux therapy,combined with dietary and lifestyle counselling for the patients who suffer from reflux pharyngitis and are about to undergo the tympanoplasty surgery may improve surgical success rate.关键词
反流性咽喉炎/胃食管反流/鼓室成形术/鼓膜穿孔/质子泵抑制剂/咽喉反流/反流体征评分量表Key words
Reflux Laryngitis/Gastroesophageal Reflux/Tympanoplasty/Tympanic Membrane Perforation/Proton Pump Inhibitors/Laryngopharyngeal Reflux/Reflux Finding Score引用本文复制引用
吴洁,杨琼,彭令仪,汤明星,曾楠,张略,张全明,胡璟,郭淑月,左向斌..反流性咽喉炎与中耳炎Ⅰ型鼓室成形术成功率的关系[J].中国耳鼻咽喉头颈外科,2025,32(3):158-163,6.基金项目
深圳市南山区科技计划区属事业单位研发项目(NS2022074) （NS2022074）
