Otitis Media With Effusion After Radiotherapy Of Nasopharyngeal Carcinoma Study On Bacteriology And The Immune Response

Objective: To study the characteristics of bacteriology and immuneresponse of secretory otitis media in patients with nasopharyngeal carcinomaafter radiotherapy and the understanding of radiation therapy of endotoxin andcytokine expression with secretory otitis media after radiotherapy, and comparedwith common secretory otitis media in bacteriology and immunologicalcharacteristics. In the perspective of bacteriology and immune response toexplore the pathogenesis and the impact on outcome of the disease and providesthe reference basis for clinical treatment.Methods：Thirty cases(30ears)with secretory otitis media after radiotherapywhich conformed to the standard and30cases (30ears) with secretory otitismedia, both group had tympanic membrane puncture therapy and collected themiddle ear effusion to culture aerobic and facultative anaerobic bacteria and testdrug sensitivty, at the same time using enzyme-linked immunosorbent（enzyme-linked immunosorbent assay，ELISA） reaction technology and thedynamic turbidimetric limulus test method to detect the expression HumanTNF-α and the Human IL-1β and endotoxin in the middle ear effusion andserum cytokines for each patient.Results:(1)The bacteria culture: normal group,1case of germiculture positive for acinetobacter baumannii, radiation group,2cases were positive, bothfor staphylococcus aureus;(2)The endotoxin: Normal group of middle eareffusion endotoxin detection rate was86.67%, the radiotherapy group was90%,were higher than that of their serum (normal group P=0.01<0.05, radiotherapygroup P=0.015<0.05), quantitative comparison, normal group of the middle eareffusion endotoxin value of356.36±163.06pg/ml,387.47±197.00pg/mlradiotherapy group were higher than that of their serum (normal groupP=0.007<0.05, radiotherapy group P=0.009<0.05), and the middle ear effusionbacterial endotoxin in the radiotherapy group was higher than normal group(P=0.003<0.05);(3)Immune response: Normal group of middle ear effusionHuman IL-1β detection rate was100%, the radiotherapy group was100%, werehigher than that of their serum (two group P<0.05), quantitative comparison,normal group of the middle ear effusion of the Human IL-1β to express a valueof289.98±215.68pg/ml, the radiotherapy group was276.74±261.86pg/ml, werehigher than their serum (normal group P=0.035<0.05, radiotherapy groupP=0.001<0.05); Normal group of middle ear effusion Human TNF-α detectionrate was100%, the radiotherapy group was100%, With no difference werefound than that of their serum(normal group P=0.246>0.05,radiotherapy groupP=0.500>0.05), quantitative comparison, normal group of middle ear effusionHuman expression of TNF-α value is1041.62±742.10pg/ml, the radiotherapygroup was1140.63±727.49pg/ml, were higher than their serum (two groupP<0.05);Human IL-1β、Human TNF-α in middle ear effusion of radiotherapygroup and ordinary group had no statistical difference (P>0.05).Conclusion: Bacteriology and immune response in nasopharyngealcarcinoma after radiotherapy with secretory otitis media and normal secretoryotitis media patients showed the same characteristics, namely low germiculture positive rate and local middle ear cavity effusion and high expression rate ofendotoxin, cytokines, and radiation therapy may increases the expression ofendotoxin in middle ear effusion.