Department of Otolaryngology-Head and Neck Surgery, Weill Cornell Medical College, New York, NY 10021, USA.
Int Forum Allergy Rhinol. 2012 May-Jun;2(3):191-8. doi: 10.1002/alr.21007. Epub 2012 Jan 17.
Eustachian tube dysfunction (ETD) is a common condition without an effective, accepted treatment. Balloon dilation Eustachian tuboplasty (BDET) has been recently proposed for the management of ETD. Previous studies of Eustachian tube function and treatment have not included a validated assessment of patient symptoms. We report for the first time the outcomes of BDET using a validated disease-specific symptom score, the 7-item Eustachian Tube Dysfunction Questionnaire (ETDQ-7).
Consecutive patients undergoing BDET were prospectively enrolled from an otolaryngology practice at a tertiary care medical center. Inclusion criteria were adults with a diagnosis of ETD based on symptoms and abnormal tympanogram. Patients with craniofacial abnormalities or active infection were excluded from study. Primary outcome measures included the ETDQ-7 score, tympanometry, and otoscopic appearance. Secondary measures included the 22-item Sinonasal Outcome Test (SNOT-22) score.
Twenty-two consecutive patients underwent 35 BDET procedures. Significant postoperative improvement was seen in tympanometry and otoscopic appearance (p < 0.001). ETDQ-7 scores at 3 weeks, 6 weeks, 12 weeks, and 6 months postoperatively were significantly improved over baseline (p < 0.001). ETDQ-7 scores showed fair correlation with SNOT-22 scores (r > 0.65). ETDQ-7 change scores demonstrated good responsiveness and sensitivity to clinical change following BDET.
BDET is an effective surgical intervention for the treatment of ETD in adults. Postoperative improvements were observed using objective and subjective measures. The ETDQ-7 is a valid, disease-specific instrument for the assessment of treatment outcomes and may be applied for clinical use in patients with ETD. Further study is necessary to determine long-term effectiveness.
咽鼓管功能障碍（Eustachian tube dysfunction，ETD）是一种常见病症，目前尚无有效的治疗方法。球囊扩张咽鼓管成形术（balloon dilation Eustachian tuboplasty，BDET）最近被提出用于 ETD 的治疗。既往有关咽鼓管功能和治疗的研究并未包括对患者症状的有效评估。我们首次报道了使用经过验证的疾病特异性症状评分，即 7 项咽鼓管功能障碍问卷（Eustachian Tube Dysfunction Questionnaire，ETDQ-7），对 BDET 进行评估的结果。
我们连续纳入了在一家三级医疗中心的耳鼻喉科门诊接受 BDET 的患者。纳入标准为根据症状和异常鼓室图诊断为 ETD 的成年人。患有颅面畸形或活动性感染的患者被排除在研究之外。主要观察指标包括 ETDQ-7 评分、鼓室图和耳镜检查外观。次要观察指标包括 22 项鼻-鼻窦结局测试（SNOT-22）评分。
连续 22 例患者共接受了 35 次 BDET 手术。术后鼓室图和耳镜检查外观明显改善（p < 0.001）。术后 3 周、6 周、12 周和 6 个月的 ETDQ-7 评分均较基线显著提高（p < 0.001）。ETDQ-7 评分与 SNOT-22 评分呈高度相关（r > 0.65）。ETDQ-7 评分变化在 BDET 治疗后具有良好的反应性和对临床变化的敏感性。
BDET 是成人 ETD 的有效手术治疗方法。使用客观和主观测量均观察到术后改善。ETDQ-7 是一种有效的、针对疾病的评估治疗结果的工具，可能适用于 ETD 患者的临床应用。还需要进一步的研究来确定长期疗效。
