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[咽鼓管功能障碍的诊断与治疗]

[Diagnosis and treatment of Eustachian tube dysfunction].

作者信息

Schröder S, Ebmeyer J

机构信息

Klinik und Poliklinik für Hals‑, Nasen‑, Ohrenheilkunde, Kopf- und Halschirurgie "Otto Körner", Universitätsmedizin Rostock, Rostock, Deutschland.

Klinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Klinikum Bremerhaven Reinkenheide, Postbrookstr. 103, 27574, Bremerhaven, Deutschland.

出版信息

HNO. 2018 Feb;66(2):155-166. doi: 10.1007/s00106-017-0465-2.

Abstract

The Eustachian tube protects against secretion, germs and sound pressure from the nasopharynx, it acts as a drain, and serves pressure equalization in both directions so that the ear drum and sound-conducting apparatus can vibrate optimally. The incidence of Eustachian tube dysfunction in adults is about 1%, in children almost 40%. Symptoms are often unspecific. For diagnosis, the Eustachian tube score (ETS-5) can be used in patients with a perforated ear drum, and the ETS-7 score in patients with intact ear drum. Adenoid hypertrophy is a frequent cause of obstructive tube dysfunction in children. Treatment of obstructive dysfunction includes steroid nasal sprays and regular performance of the Valsalva maneuver, as well as tube dilation with the Bielefelder balloon catheter. The patulous Eustachian tube is treated with saline nasal irrigation, estrogen-nasal ointment, and craniocervical manual therapy; causal treatments are evaluated.

摘要

咽鼓管可防止来自鼻咽部的分泌物、病菌和声压进入,它起到引流作用,并在两个方向上实现压力平衡,以使鼓膜和传音装置能够最佳振动。成人咽鼓管功能障碍的发生率约为1%,儿童几乎为40%。症状通常不具有特异性。对于诊断,鼓膜穿孔患者可使用咽鼓管评分(ETS-5),鼓膜完整患者可使用ETS-7评分。腺样体肥大是儿童阻塞性咽鼓管功能障碍的常见原因。阻塞性功能障碍的治疗包括使用类固醇鼻喷雾剂、定期进行瓦尔萨尔瓦动作,以及使用比勒费尔德球囊导管进行咽鼓管扩张。咽鼓管异常开放的治疗方法包括盐水鼻腔冲洗、雌激素鼻软膏和颅颈手法治疗;对病因治疗进行评估。

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