The Relationship Between The Change In Cross Section Area Of Tensor Veli Palatini And Secretory Otitis Media In Patients With Nasopharyngeal Carcinoma After Radiotherapy

Objective:To explore the occurrence mechanism of secretory otitis media (SOM) in patients with nasopharyngeal carcinoma(NPC) after radiotherapy through analyzing the relationship between SOM after radiotherapy and radiation-induced TVP injury.Methods:Magnetic resonance image manifestations of 32 patients with NPC were analyzed.Measuring the CSA of TVP and Medial Pterygoid(MP) to understand the change of their CSA in pre- and post-irradiation;Meanwhile surveying the incidence of SOM after radiotherapy and analyzing the relationship between the change of TVP and the incidence of SOM after radiotherapy.Result:(1) Before radiotherapy,the average value of CSA of the left TVP in 32 NPC patients(64 ears) is 45.33±9.96 mm~2,and the right is 45.72±10.76 mm~2;while after radiotherapy,the average value of the CSA for the left was 31.68±12.52 mm~2,and the right was 31.81±13.22 mm~2.There is statistical significance in the differential value of the CSA in two side TVP before and after radiotherapy(P＜0.001); (2) Before radiotherapy,the average value of CSA of the left MP in 32 NPC patients(64ears) is 94.98±6.19 mm~2,and the right is 95.00±7.07mm~2; while after radiotherapy,the average value of the CSA for the left was 82.67±8.11 mm~2,and the right was 82.30±9.18mm~2.There is statistical significance in the differential value of the CSA in two side MP before and after radiotherapy (P＜0.001);(3) The change in the CSA of TVP after radiotherapy has a positive correlation with the time after radiotherapy,but no relationship with T stage of NPC;(4) Post-irradiation SOM has nothing to do with the patient's T stage of NPC;(5) Before radiotherapy,there are 48 ears without SOM,in which 27 ears developed post-irradiation SOM including 24 ears with TVP atrophy and 3 ears without TVP atrophy,and 21 ears without post-irradiation SOM including 8 ears with TVP atrophy and 13 ears without TVP atrophy,there are statistically significant difference by X~2 Test(p＜0.01) showing post-irradiation SOM have correlation with TVP atrophy.Conclusion:(1) TVP in patients with NPC have the trend of obvious atrophy 6 months after radiotherapy,and post-irradiation SOM have certain correlation with TVP atrophy,so radiation-induced TVP injury maybe one of the factors of post-irradiation SOM;(2) MP have the trend of atrophy after radiotherapy,which indicate the muscles of pharyngonasal wall are likely to develop radiation-induced muscle injury after radiotherapy;(3) The relationship between post-irradiation SOM and radiation-induced TVP injury remains to be further studied in function,so as to explore the occurrence mechanism of post-irradiation SOM.