Giunta Antonio Am, Liberati Luca, Pellegrino Cristina, Ricci Giampietro, Rizzo Santino
ENT Department of Santa Maria Hospital of Terni, Viale Tristano di Joannuccio, Terni, Italy.
Corresponding author: Antonio Alberto Maria Giunta, ENT Department of Santa Maria Hospital of Terni, Viale Tristano di Joannuccio, Terni, Italy,
Diving Hyperb Med. 2019 Mar 31;49(1):9-15. doi: 10.28920/dhm49.1.9-15.
Eustachian tube balloon dilation is a minimally invasive surgical procedure used to treat Eustachian tube dysfunction which is not responsive to conventional therapies.
In this cohort intervention series we report the results of balloon dilation in treating refractory equalization problems in 20 freediving spearfishermen; in 19 cases the problem was unilateral and in one case bilateral. All the patients had already received medical and insufflation therapy and four patients had also had nasal surgery. None of these treatments or procedures had achieved improvement. We used a 20 mm x 3 mm disposable balloon catheter inserted through a 70-degree guide catheter and inflated up to 12 ATM three times at three different depths of insertion within the Eustachian tube. Every inflation lasted 120 seconds.
Fifteen out of 20 patients improved. Ten patients reported a complete resolution of equalization problems, five showed improvement with persistence of a slight equalization delay on the treated side. Five patients did not report any improvement. Two complications occurred: subcutaneous emphysema of the parotid region in one case; and a mild high frequency (4-8 KHz) sensorineural hearing loss in another patient.
Balloon dilation of the Eustachian tube is an effective therapy in the treatment of equalization problems with a good success rate.
咽鼓管球囊扩张术是一种微创手术,用于治疗对传统疗法无反应的咽鼓管功能障碍。
在这个队列干预系列中,我们报告了球囊扩张术治疗20名自由潜水渔民难治性中耳压力平衡问题的结果;其中19例为单侧问题,1例为双侧问题。所有患者均已接受药物和吹张治疗,4例患者还接受了鼻腔手术。这些治疗或手术均未取得改善。我们使用一根20毫米×3毫米的一次性球囊导管,通过一根70度的引导导管插入,在咽鼓管内三个不同深度处充气至12个大气压,每次充气持续120秒,共充气三次。
20例患者中有15例病情改善。10例患者报告中耳压力平衡问题完全解决,5例患者有所改善,但治疗侧仍有轻微的中耳压力平衡延迟。5例患者未报告任何改善。发生了2例并发症:1例为腮腺区皮下气肿;另1例患者出现轻度高频(4-8千赫)感音神经性听力损失。
咽鼓管球囊扩张术是治疗中耳压力平衡问题的有效疗法,成功率较高。