Clinical Study On The Treatment Of Recurrent Secretory Otitis Media By Retrograde Catheterization Via Eustachian Tube And Bromhexine Hydrochloride Injection Under Nasal Endoscope

Objective: To explore the clinical effect of the treatment of recurrent secretory otitis media by retrograde catheterization via eustachian tube and bromhexine hydrochloride injection under nasal endoscope,and to provide new ideas for the treatment of recurrent secretory otitis media.Methods: 120 cases with secretory otitis media patients treated at Traditional Chinese Medical Hospital of Changshu City from March 2015 to June 2017 were selected as research subjects,all were diagnosed by medical history,clinical symptoms,otoscopy and acoustic impedance examination.The patients were randomly divided into the control group(n = 60)and the observation group(n = 60).The control group was treated with glucocorticoid and cephalosporin routine drug therapy,and the observation group was treated with retrograde catheterization via eustachian tube and bromhexine hydrochloride injection under nasal endoscope.Otoscopy,tympanum examination,and speech frequency air conduction hearing threshold were recorded before and after therapy.The expression level of platelet activation factor(PAF),interleukin-6(IL-6)and endothelin-1(ET-1)were detected by double antibody sandwich enzyme-linked immunosorbent assay(ELISA).Flow cytometer was used to count the peripheral blood T-cell lymphocyte subsets before and after treatment.The clinical curative effect,inflammatory factors and immune levels of two groups were compared,and the data were processed by computer with SPSS 18.0.Results: The observation group efficiency was 96.67% and 88.33% of the control group were statistically significant(P < 0.05).There was no statistically significant difference between the two groups in the pretreatment of the tympanic pressure(P > 0.05).The tympanic pressure after three months treatment was higher than that in the control group(P< 0.05).There was no statistically significant difference between the two groups in the pretreatment of the hearing threshold level(P > 0.05).The hearing threshold level after three months treatment was lower than that in the control group,the air conduction hearing threshold of 0.5 KHz,1KHz and 2KHz was significantly lower than that in the control group(P < 0.05).There was no significant difference in the levels of platelet activation factor,interleukin-6 and endothelin-1 levels in 2 groups(P > 0.05).The platelet activation factor,interleukin-6 and endothelin-1 level were lower than those in the control group(P < 0.05).There was no statistically significant difference between the two groups(P > 0.05).The ratio of CD4 +,CD8 + and CD4 + / CD8 + in the three months after treatment was higher than that in the control group(P < 0.05).There was no statistically significant difference in recurrence rate(P > 0.05)after 2 groups of treatment.The recurrence rate of the observation group after 2 months and 3 months was lower than the control group(P < 0.05).Conclusion: Retrograde catheterization via eustachian tube and bromhexine hydrochloride injection under nasal endoscope has set up a new drug therapy for recurrent secretory otitis media,can improve the effect of clinical treatment,could help decrease the level of inflammatory cytokines and the recurrence rate and improve the body's immune,promote patients hearing restored,which is worthy of popularization and application.