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儿童球囊咽鼓管成形术

Balloon Eustachian Tuboplasty in children.

作者信息

Leichtle A, Hollfelder D, Wollenberg B, Bruchhage K-L

机构信息

Department of Otolaryngology, University of Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany.

出版信息

Eur Arch Otorhinolaryngol. 2017 Jun;274(6):2411-2419. doi: 10.1007/s00405-017-4517-8. Epub 2017 Mar 10.

Abstract

Endonasal ballon dilatation of the Eustachian tube (BET) is a promising treatment for Eustachian tube dysfunction with encouraging results over the last years in adults. In addition, in children, single studies demonstrated promising results, but revealed the necessity for broader and additional studies. Our retrospective analysis presents outcomes with BET in children with chronic obstructive dysfunction of the Eustachian tube, showing resistance to the conventional therapy after adenotomy with paracentesis or grommets (ventilation tubes). The data of 52 children, having undergone BET from April 2011 to April 2016, were retrospectively evaluated. Most children in our study presented middle ear effusion (47%), adhesive (21%), chronic otitis media (13%), or recurrent acute otitis media (11%). In 24 (37%) children, we combined BET with a paracentesis, in 5 (8%) patients with a tympanoplasty type I and in 3 (5%) patients with a type III. All children were assessed using an audiogram, tympanometry, and tubomanometry (50 mbar) before and after BET. In addition, we evaluated the results of the Lübecker questionnaire, which we performed before and after BET. The childrens' ear-related and quality of life-related symptoms, such as pressure equalization, ear pressure, hearing loss, pain and limitation in daily life, and satisfaction pre- and postoperatively, were analyzed. In the majority of patients, we could see an improvement in the ear pressure, hearing loss, limitation in daily life, and satisfaction with recurrent inflammations, underlined by better outcomes in the tubomanometry and the tympanogram. BET in children is a safe, efficient, and promising method to treat chronic tube dysfunction, especially as a second line treatment, when adenotomy, paracentesis, or grommets failed before.

摘要

经鼻咽鼓管球囊扩张术(BET)是治疗咽鼓管功能障碍的一种有前景的方法,在过去几年中,该方法在成人治疗中取得了令人鼓舞的效果。此外,在儿童中,个别研究也显示出了有前景的结果,但也表明需要进行更广泛的补充研究。我们的回顾性分析展示了BET治疗慢性阻塞性咽鼓管功能障碍儿童的结果,这些儿童在腺样体切除联合穿刺或置管(通气管)后对传统治疗有抵抗性。我们回顾性评估了2011年4月至2016年4月期间接受BET治疗的52名儿童的数据。我们研究中的大多数儿童表现为中耳积液(47%)、粘连(21%)、慢性中耳炎(13%)或复发性急性中耳炎(11%)。在24名(37%)儿童中,我们将BET与穿刺术联合应用,5名(8%)患者接受了I型鼓室成形术,3名(5%)患者接受了III型鼓室成形术。所有儿童在BET前后均使用听力图、鼓室导抗图和咽鼓管测压(50毫巴)进行评估。此外,我们评估了BET前后进行的吕贝克问卷的结果。分析了儿童与耳朵相关的症状以及与生活质量相关的症状,如压力平衡、耳内压力、听力损失、疼痛和日常生活受限情况,以及术前和术后的满意度。在大多数患者中,我们可以看到耳内压力、听力损失、日常生活受限情况以及对复发性炎症的满意度有所改善,咽鼓管测压和鼓室图的更好结果也证实了这一点。BET对儿童来说是一种安全、有效且有前景的治疗慢性咽鼓管功能障碍的方法,特别是作为二线治疗方法,当腺样体切除、穿刺术或置管术之前失败时。

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