Kepchar J, Acevedo J, Schroeder J, Littlefield P
Department of Surgery, Walter Reed National Military Medical Center, Bethesda, MD, USA.
J Laryngol Otol. 2012 Nov;126(11):1102-7. doi: 10.1017/S0022215112001983. Epub 2012 Sep 11.
To determine the feasibility and safety of transtympanic balloon dilatation of the eustachian tube.
Transtympanic eustachian tube dilatation was performed on six cadaver heads using balloon catheters. Catheters were placed in each eustachian tube and the head scanned by computed tomography. Randomised, blinded dilatation of one balloon in each head was performed, followed again by a second computed tomography scan. The scans were reviewed by a neurotologist and neuroradiologist who were blinded to previous treatment, and measurable dilatation and incidental damage noted.
There was adequate placement of the balloon catheter beyond the bony isthmus in 6 of 10 eustachian tubes. There was one insufficient catheter placement and three adverse placements (one into the petrous carotid canal and two into the vidian canal). Only one dilated tube showed a measurable increase in diameter.
This experiment revealed serious safety issues with transtympanic eustachian tube dilatation. Therefore, this approach should not be considered feasible at this time.
确定经鼓膜咽鼓管球囊扩张术的可行性和安全性。
使用球囊导管对六个尸头进行经鼓膜咽鼓管扩张术。将导管置于每个咽鼓管内，然后对头部进行计算机断层扫描。对每个尸头中的一个球囊进行随机、盲法扩张，之后再次进行计算机断层扫描。由一名对先前治疗不知情的耳神经科医生和一名神经放射科医生对扫描结果进行评估，并记录可测量的扩张情况和意外损伤。
10个咽鼓管中有6个的球囊导管在骨性峡部以外放置合适。有1次导管放置不足，3次放置不当（1次进入岩部颈动脉管，2次进入翼管）。只有1个扩张后的咽鼓管直径有可测量的增加。
该实验揭示了经鼓膜咽鼓管扩张术存在严重的安全问题。因此，目前不应认为这种方法可行。
