1 Duke University Medical Center, Durham, North Carolina, USA.
2 Ochsner Clinic, New Orleans, Louisiana, USA.
Otolaryngol Head Neck Surg. 2019 Jul;161(1):6-17. doi: 10.1177/0194599819848423. Epub 2019 Jun 4.
To develop a clinical consensus statement on the use of balloon dilation of the eustachian tube (BDET).
An expert panel of otolaryngologists was assembled with nominated representatives of general otolaryngology and relevant subspecialty societies. The target population was adults 18 years or older who are candidates for BDET because of obstructive eustachian tube dysfunction (OETD) in 1 or both ears for 3 months or longer that significantly affects quality of life or functional health status. A modified Delphi method was used to distill expert opinion into clinical statements that met a standardized definition of consensus.
After 3 iterative Delphi method surveys, 28 statements met the predefined criteria for consensus, while 28 statements did not. The clinical statements were grouped into 3 categories for the purposes of presentation and discussion: (1) patient criteria, (2) perioperative considerations, and (3) outcomes.
This panel reached consensus on several statements that clarify diagnosis and perioperative management of OETD. Lack of consensus on other statements likely reflects knowledge gaps regarding the role of BDET in managing OETD. Expert panel consensus may provide helpful information for the otolaryngologist considering the use of BDET for the management of patients with OETD.
制定关于咽鼓管球囊扩张术(BDET)应用的临床共识声明。
召集了一组耳鼻喉科专家组成员,其中包括普通耳鼻喉科和相关亚专科协会的指定代表。目标人群为 18 岁或以上的成年人,其 1 或 2 侧耳朵因咽鼓管功能障碍(OETD)持续 3 个月或更长时间而导致阻塞,显著影响生活质量或功能健康状况,适合进行 BDET。采用改良 Delphi 法将专家意见提炼为符合共识标准化定义的临床陈述。
经过 3 次迭代 Delphi 法调查,28 条陈述符合共识的预设标准,而 28 条陈述不符合共识标准。为了便于呈现和讨论,临床陈述被分为 3 类:(1)患者标准,(2)围手术期考虑因素,(3)结局。
该专家组就明确 OETD 诊断和围手术期管理的若干陈述达成了共识。其他陈述缺乏共识可能反映了关于 BDET 在治疗 OETD 中的作用的知识空白。专家组共识可能为考虑使用 BDET 治疗 OETD 患者的耳鼻喉科医生提供有用信息。