目的:分析鼓室注射曲安奈德与鼻咽癌放疗后中耳压力(MEP)及并发放射性分泌性中耳炎(RSOM)的相关性。方法:将52例放疗前无中耳炎的鼻咽癌患者随机分为3组。治疗一组17例(34耳),放疗开始前1h每侧鼓室注射曲安奈德注射液,第1~7周每周1次;治疗二组17例(34耳),放疗开始前1h每侧鼓室注射曲安奈德注射液,第1~12周每周1次;对照组18例(36耳),不行鼓室注射。放疗开始及开始后第1、2、3个月末测104耳的MEP。结果:放疗开始时至开始后1、2、3个月末治疗一组、二组及对照组RSOM罹患率逐渐增高,MEP逐渐减小,其中治疗二组RSOM罹患率最低,MEP最大(P<0.01);治疗一组RSOM罹患率较低,MEP较大(P<0.05);对照组RSOM罹患率最高,MEP最小(P>0.05)。结论:鼓室注射曲安奈德可减轻中耳放射性损伤,用药时间与MEP呈正相关,与RSOM罹患率呈负相关,且疗程越长疗效越显著;放疗后3个月末RSOM、MEP变化趋势最明显,可能与放疗后3个月始中耳放射损伤较修复更为活跃有关,长期疗效仍须继续观察。 Objective: To analyze the relationship between tympanic injection of triamcinolone acetonide and middle ear pressure (MEP) and concurrent otitis media with radiosensitizing otitis media (RSOM) after radiotherapy of nasopharyngeal carcinoma. Methods: Fifty-two patients with nasopharyngeal carcinoma without otitis media before radiotherapy were randomly divided into three groups. A group of 17 patients (34 ears) were treated with triamcinolone acetonide injection in each tympanum 1h before the start of radiotherapy, once a week for the first 1-7 weeks, 17 cases (34 ears) for the second group, Tympanum injection of triamcinolone acetonide injection 1 to 12 weeks weekly; control group of 18 patients (36 ears), not intratympanic injection. 104 ears of MEP were measured at the beginning of radiotherapy and at the end of the first, second and third month. Results: The incidence of RSOM in both groups and control group increased gradually from the beginning of radiotherapy to the end of 1, 2, and 3 months after the start of therapy, while the MEP gradually decreased. The attack rate of RSOM was the lowest and the MEP was the highest in the two groups (P <0.01) ). The incidence of RSOM in the treatment group was lower and the MEP was larger (P <0.05). The control group had the highest attack rate and the lowest MEP (P> 0.05). CONCLUSION: Tympanic injection of triamcinolone acetonide can reduce the radioactive injury of the middle ear. The time of administration is positively correlated with MEP and negatively correlated with the attack rate of RSOM. The longer the course of treatment is, the more effective the treatment is. The trend of RSOM and MEP at the end of 3 months after radiotherapy is the most obvious, May be 3 months after radiotherapy and radiation injury in the middle ear more active than the repair, the long-term efficacy still need to be observed.