Silvola Juha, Kivekäs Ilkka, Poe Dennis S
Department of Otorhinolaryngology, Päijät-Häme Central Hospital, Lahti, Finland Department of Otolaryngology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
Department of Otolaryngology and Communication Enhancement Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts, USA Department of Otorhinolaryngology, Tampere University Hospital and the University of Tampere, Tampere, Finland.
Otolaryngol Head Neck Surg. 2014 Jul;151(1):125-30. doi: 10.1177/0194599814529538. Epub 2014 Apr 4.
Studies of balloon Eustachian tuboplasty (BET) have shown encouraging results in small series with short follow-ups. Our pilot study suggested that patients with protracted otitis media with effusion (OME) or atelectasis of the tympanic membrane (TM) could benefit from BET.
A prospective study where subjects act as their own controls. Patients from the pilot study and additional cases were enrolled in this cohort with long-term follow-up.
Regional Academic Center.
Out of 80 patients who underwent BET, 41 consecutive Eustachian tube (ET) operations were included. Subjects' inclusion criteria were OME and/or TM atelectasis, type B or C tympanograms, and inability to inflate their middle ears by Valsalva maneuver. All patients had longstanding ET dysfunction relieved only by repeated tympanostomies. Outcomes included ability to perform a Valsalva maneuver, audiometry, tympanometry, videoendoscopy of the ET with mucosal inflammation rating scores, and otomicroscopy.
All cases were dilated successfully, without significant complications. Mean follow-up was 2.5 years (range, 1.5-4.2 years). Eighty percent (33/41) could do a Valsalva maneuver postoperatively; none of these ears required new tympanostomy tubes and subjective symptoms were relieved. Tympanometry results showed overall improvement. Nine patients had persistent perforations and 3 declined removal of the tube. Subjective symptoms were not relieved for 10% (4/41).
The results show that BET can effectively improve ET function in ears with OME or atelectasis. The procedure is well tolerated and without significant complications. The follow-up continues and we are investigating possible reasons for failures.
球囊咽鼓管成形术（BET）的研究在小样本且随访时间短的情况下已显示出令人鼓舞的结果。我们的初步研究表明，患有迁延性中耳积液（OME）或鼓膜（TM）萎缩的患者可能从BET中获益。
一项前瞻性研究，受试者自身作为对照。将初步研究中的患者和其他病例纳入该队列进行长期随访。
地区学术中心。
在80例行BET的患者中，纳入41例连续的咽鼓管（ET）手术。受试者的纳入标准为OME和/或TM萎缩、B型或C型鼓室图，以及通过瓦尔萨尔瓦动作无法使中耳充气。所有患者均有长期的ET功能障碍，仅通过反复鼓膜切开术才能缓解。结果包括进行瓦尔萨尔瓦动作的能力、听力测定、鼓室导抗图、ET的视频内镜检查及黏膜炎症评分，以及耳显微镜检查。
所有病例均成功扩张，无明显并发症。平均随访时间为2.5年（范围1.5 - 4.2年）。80%（33/41）的患者术后能够进行瓦尔萨尔瓦动作；这些耳朵均无需新的鼓膜造孔管，主观症状得到缓解。鼓室导抗图结果总体有所改善。9例患者存在持续性穿孔，3例拒绝取出导管。10%（4/41）的患者主观症状未缓解。
结果表明，BET可有效改善患有OME或萎缩的耳朵的ET功能。该手术耐受性良好，无明显并发症。随访仍在继续，我们正在研究失败的可能原因。
