| Background:Under normal circumstances,the balance of middle ear pressure and external pressure is achieved through the periodic opening of eustachian tube.The damage of middle ear ventilation caused by Eustachian tube dysfunction will lead to middle ear negative pressure,and long-term negative pressure may lead to middle ear effusion.One of the earliest uses of tympanic pressure curve is to indirectly detect eustachian tube function by measuring middle ear pressure.Therefore,the peak pressure of tympanic pressure curve can be used to monitor the development of otitis media.Abnormal peak pressure can provide early warning for the development of otitis media.Type B tympanum pressure curve and type C tympanuum pressure curve both indicate that there is abnormal peak pressure,but type B tympanum pressure curve is often closely related to tympanum effusion.When type B tympanum pressure curve appears,there is often middle ear effusion,while type C tympanum pressure curve indicates that eustachian tube function is impaired,which can be seen in the early stage of secretory otitis media.Adenoid hypertrophy,rhinosinusitis,allergic rhinitis and other nasal and/or pharyngeal diseases can lead to eustachian tube dysfunction,and may further cause secretory otitis media.F or children with nose and/or pharyngeal diseases that lead to eustachian tube dysfunction,the treatment of the primary pathogenesis of eustachian tube dysfunction can improve the status of middle ear function,so as to play an early intervention role in secretory otitis media.After many years of clinical practice,SST external treatment has a definite effect on adenoid hypertrophy,rhinosinusitis,allergic rhinitis and other nose and/or pharyngeal diseases.In this study,the children who complained of nasal and/or pharyngeal discomfort and showed C-tympanic pressure curve by acoustic immittance test were treated with SST external treatment.The changes of C-tympanic pressure curve during the treatment were observed and the improvement of middle ear function was discussed.At present,the research data of C-tympanum pressure curve at home and abroad are still limited.Foreign studies have shown that secretory otitis media in developed countries has a high self-healing ability,and the treatment and intervention for preschoolers with asymptomatic secretory otitis media do not show any benefit to their language development.Therefore,there are few studies on early intervention of secretory otitis media.However,it is also believed that the diagnosis and treatment measures for the disease should be formulated according to the living environment of the country,and the early treatment and intervention of secretory otitis media is more clinically significant than observation and waiting.According to the theory of prevention and treatment of diseases in traditional Chinese medicine,the management of diseases should be based on prevention before disease.Active treatment of nose and/or pharyngeal diseases which are easy to lead to eustachian tube dysfunction and improvement of middle ear function can prevent the disease from continuing to develop and play an early intervention role.Purpose:1.To observe the main complaint of nasal and/or pharyngeal discomfort and no obvious ear discomfort.The results of acoustic immittance test were the gender,age,clinical diagnosis and the distribution characteristics of deficiency and excess syndrome type of type C tympanum pressure curve.To observe the tympanum shape characteristics of type C tympanum pressure curve ear.2.The primary disease of nose and/or pharynx was treated by SST,and the effect of SST on middle ear function of children with eustachian tube dysfunction was analyzed by observing the change of tympanum pressure curve of type C.Method:Acoustic immittance test was carried out for the children who complained of the discomfort of nose and/or pharynx at the first time.The ventricular pressure curve of single or double tympanies was recorded as the clinical diagnosis of type C children.Tongue and pulse were collected.Otoendoscopy was carried out for some children to determine the tympanic membrane state.The tympanic pressure curve was reviewed regularly every two weeks for the children who received SST treatment.The patients who received SST treatment within four weeks were observed Changes of tympanic pressure curve in type C infants.Result:1.In terms of gender distribution,there were 53 males and 16 females in 69 children with c-tympanic pressure curve.2.In terms of age distribution,69 children are in the age group of 2-6 years old,59 cases in total,accounting for 85.51%of the total number of cases,including 35 cases of 2-4 years old and 24 cases of 5-6 years old.3.In clinical diagnosis,adenoid hypertrophy accounted for the largest proportion(51.46%),followed by tonsil hypertrophy,allergic rhinitis,rhinitis and rhinosinusitis(17.48%,16.50%,9.71%and 4.85%,respectively).4.In terms of the distribution of deficiency and excess syndrome types,the number of children with deficiency and excess syndrome is the largest among 69 children,50 in total,accounting for 72.46%of the total number of children.The number of children with excess and deficiency syndrome is 11 and 8 respectively,accounting for 15.94%and 11.59%of the total number of children.5.44 ears of 32 children were examined by otoendoscopy,of which 15 were normal in tympanic membrane sign,29 were abnormal in tympanic membrane sign,3,17 and 9 were positive in hyperemia,invagination and hydrops sign.6.51 ears of 34 cases were treated with SST.After 4 weeks of treatment,42 tympanic pressure curves changed from type C to type A,accounting for 82.35%of the total ears.Nine ears whose tympanum pressure curve was not converted to a type were analyzed.It was found that the peak pressure of nine ears improved in different degrees before and after treatment,and the difference was statistically significant.7.Type C tympanum pressure curve was divided into type C1 and type C2.It was found that 93.10%of type C1 tympanum pressure curve turned to type A after treatment,while the proportion of type C2 tympanum pressure curve was 68.18%.There was statistical significance between them.Conclusion:1.Boys and preschool children with nose and/or pharyngeal diseases have more eustachian tube dysfunction.2.Adenoid hypertrophy,tonsillar hypertrophy,allergic rhinitis,rhinitis and rhinosinusitis can lead to eustachian tube dysfunction,of which adenoid hypertrophy accounts for the largest proportion.3.Children who suffer from nose and/or pharyngeal diseases that are easy to cause eustachian tube dysfunction are mostly mixed with deficiency and excess.4.Tympanic signs of c-tympanic pressure curve ears may be normal,hyperemia,invagination,effusion and other different manifestations,most of which have occurred invagination,effusion and other abnormalities.5.SST external treatment can effectively improve the eustachian tube dysfunction and middle ear dysfunction caused by these diseases at the same time of treating the primary diseases of nose and/or pharynx.6.Type C1 tympanum pressure curve may change into type A in a short period of time after the intervention of SST,while type C2 tympanum pressure curve may change into type a relatively slowly.7.We should pay attention to the function of eustachian tube and middle ear in children with nose and/or pharyngeal diseases.Although there is no ear symptom,we should evaluate the function of eustachian tube and middle ear.We should treat the primary disease which is easy to cause eustachian tube dysfunction as soon as possible,so as to prevent the occurrence of secretory otitis media or intervene the secretory otitis media in the early stage. |
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