Yu Haiyang, Sun Fenglin, Diao Xiuli, Xia Qian, Zhang Zeng
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 Nov;29(22):1988-91.
Through the application of eustachian tuboplasty assisted with hypothermy plasma ablation, we evaluate its efficacy in the threatment of adult refractory otitis media with effusion.
We retrospectively reviewed the charts of 48 cases (61 ears) suffering from adult refractory otitis media with effusion from January 2012 to December 2013. According to the admission date, the patients were divided into the control group (17 cases, 22 ears) and the treatment group (31 cases, 39 ears). In the control group, the patients were treated with drugs and physical therapy. In the treatment group, the hypothermy plasma ablation technology was used to ablates the hypertrophic tissues around the eustachian orifice besides the pharmaedogical interventions. The recurrence rate of the two groups were analyzed and compared in 1 year after treatment. Pure tone audiometry and acoustic immittance measurement were taken for the two groups in differernt periods (one week prior to operation, one months, three months, six months and one year after operation respectively) to evaluate their hearing change and the recurrence rate (within six months after treatment and one year respectively) objectively.
In the control group, 2 cases (2 ears) were lost to follow-up, and the recurrence rate was 65% (13/20) in 1 year. In the treatment group, four case were lost to follow-up,and the recurrence rate was 14.3% (5/35) in 1 year. The difference was statistically significant (P<0. 01). There were similar hearing improvement in the two groups after treatment in 1 month, but the hearing improvement in the treatment group increased with time. There were no complications occuring during the operation and post-operation. Within a month after operation, the majority of ears(28/35) obtained significant hearing improvement with the decreasing air-bone-gap comparision with the pre-operation (P < 0.01), and the preoperative tympanogram of 16 ears with type B or C turned to type A (P < 0.01). There were no both statistical significance in the variation of air-bone-gap and tympanogram of comparison with results between three months and six months, six months and one year postoperatively (P > 0.05).
This study confirmed the efficacy of eustachian tuboplasty assisted with hypothermy plasma ablation in the threatment of adult refractory otitis media with effusion caused by eustachian tube opening disorder was significant. It can reduce the recurrence rate significantly in one year and allow sustained hearing improvement within three months postoperatively.
通过应用低温等离子消融辅助咽鼓管成形术，评估其治疗成人难治性分泌性中耳炎的疗效。
回顾性分析2012年1月至2013年12月收治的48例（61耳）成人难治性分泌性中耳炎患者的病历资料。根据入院日期，将患者分为对照组（17例，22耳）和治疗组（31例，39耳）。对照组采用药物及物理治疗。治疗组在药物治疗的基础上，应用低温等离子消融技术消融咽鼓管咽口周围的肥厚组织。比较两组治疗后1年的复发率。分别于术前1周、术后1个月、3个月、6个月及1年对两组进行纯音听阈测试和声导抗测试，客观评估其听力变化及复发率（治疗后6个月内及1年）。
对照组失访2例（2耳），1年复发率为65%（13/20）。治疗组失访4例，1年复发率为14.3%（5/35）。两组复发率差异有统计学意义（P<0.01）。两组术后1个月听力均有改善，但治疗组听力改善随时间增加。手术及术后均无并发症发生。术后1个月内，多数耳（28/35）听力明显改善，气骨导差较术前减小（P<0.01），16例B型或C型鼓室导抗图术前转为A型（P<0.01）。术后3个月与6个月、6个月与1年气骨导差及鼓室导抗图变化比较差异均无统计学意义（P>0.05）。
本研究证实低温等离子消融辅助咽鼓管成形术治疗成人咽鼓管开放障碍所致难治性分泌性中耳炎疗效显著。可显著降低1年复发率，并使术后3个月内听力持续改善。
