Huisman Jolien Marieke Lieselot, Verdam Froukje Jantina, Stegeman Inge, de Ru Jacob Alexander
Department of Otorhinolaryngology, University Medical Centre Utrecht, Utrecht, The Netherlands.
Department of Otorhinolaryngology, Central Military Hospital Utrecht, Utrecht, The Netherlands.
Laryngoscope. 2018 Jan;128(1):237-247. doi: 10.1002/lary.26800. Epub 2017 Aug 11.
Balloon dilation is a new entity in the therapeutic approach of Eustachian tube dysfunction. The aim of this systematic review is to evaluate the success of balloon dilation of the tuba auditiva in reducing symptoms in adult patients with Eustachian tube dysfunction.
Embase, PubMed, and Cochrane Library.
The systematic literature search was conducted independently by two authors based on title and abstracts, and resulted in 36 articles. These articles were screened as full text, 15 of them were eligible for critical appraisal. Data were extracted from selected studies and presented in this article. A meta-analysis was conducted for four subgroups. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement was used as a writing guideline for this systematic review.
All 15 included studies were case series. A total of 1,155 patients were treated with balloon dilation of the tuba auditiva. Outcome parameters were relief of symptoms, otoscopy, Valsalva maneuver or Toynbee test, audiometry, tympanometry, Eustachian tube dysfunction classification, and Eustachian tube score. All articles showed short-term improvement of original symptoms; some showed further improvement over time. Follow-up ranged from just after therapy to 50 months. Relatively mild and self-limiting complications were described in 36 patients.
All current studies suggest that balloon dilation of the Eustachian tube can be a helpful treatment in patients with Eustachian tube dysfunction. However, placebo controlled trials are still warranted. Laryngoscope, 128:237-247, 2018.
球囊扩张术是咽鼓管功能障碍治疗方法中的一种新手段。本系统评价的目的是评估成人咽鼓管功能障碍患者经咽鼓管球囊扩张术缓解症状的成功率。
Embase、PubMed和Cochrane图书馆。
由两位作者独立根据标题和摘要进行系统文献检索，共检索到36篇文章。这些文章经全文筛选，其中15篇符合严格评价标准。从入选研究中提取数据并在本文中呈现。对四个亚组进行了荟萃分析。本系统评价采用系统评价和荟萃分析的首选报告项目声明作为写作指南。
纳入的15项研究均为病例系列研究。共有1155例患者接受了咽鼓管球囊扩张术治疗。观察指标包括症状缓解情况、耳镜检查、瓦尔萨尔瓦动作或唐比试验、听力测定、鼓室导抗图、咽鼓管功能障碍分类以及咽鼓管评分。所有文章均显示原有症状有短期改善；部分文章显示随着时间推移症状进一步改善。随访时间从治疗后即刻至50个月不等。36例患者出现相对轻微且自限性的并发症。
目前所有研究均表明，咽鼓管球囊扩张术对咽鼓管功能障碍患者可能是一种有效的治疗方法。然而，仍需要进行安慰剂对照试验。《喉镜》，2018年，第128卷，第237 - 247页。
