Yang J, Wang Y Q, Sun J Q, Sun J W
Department of Otolaryngology Head and Neck Surgery,the First Affiliated Hospital of USTC,Division of Life Sciences and Medicine,University of Science and Technology of China,Hefei,230001,China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2019 Dec;33(12):1121-1124. doi: 10.13201/j.issn.1001-1781.2019.12.002.
To explore the influence of anatomy and function of the Eustachian tube(ET) on the development of chronic suppurative otitis media. We retrospectively enrolled 92 cases(184 ears) of adult patients with chronic suppurative otitis media(CSOM), in whom 118 CSOM ears, 25 atelectasis ears and 41 normal ears were included. All patients underwent endoscopy, tympanometry, pure tone average, temporal bone computerized tomography scans and ET function test. Patients with pars flaccida retraction, cholesteatoma, ET obstruction or maxillofacial deformity were excluded. The length, angle and function of ET were analyzed. The ET angle was (23.1±2.4) ° in CSOM ears, was (22.9±2.9) ° in atelectasis ears and was (25.1±3.0) ° in normal ears. The ETs were more horizontal in ears with CSOM and atelectasis(<0.01). The ET length was (39.2±4.3) mm in CSOM ears, was (41.7±5.8) mm in atelectasis ears and was (43.0±5.9) mm in normal ears. The ETs in CSOM ears were shorter compared to the ETs normal ears(<0.01). No significant difference was detected between the length of ETs of atelectasis ears and normal ears(>0.05). The ET dysfunction rate was 62% in CSOM ears, was 68% in atelectasis ears, which were both significantly higher than the dysfunction rate in normal ears(22%)(<0.05). The anatomical and functional changes of ETs contribute to the development of CSOM. For patients with more horizontal and shorter ETs as well as ETs dysfunction, more progressive treatment should be considered.
为探讨咽鼓管(ET)的解剖结构和功能对慢性化脓性中耳炎发生发展的影响。我们回顾性纳入了92例(184耳)成年慢性化脓性中耳炎(CSOM)患者,其中包括118耳CSOM、25耳中耳萎缩和41耳正常耳。所有患者均接受了内镜检查、鼓室导抗图检查、纯音平均听阈测试、颞骨计算机断层扫描及ET功能测试。排除松弛部内陷、胆脂瘤、ET阻塞或颌面畸形的患者。分析ET的长度、角度和功能。CSOM耳的ET角度为(23.1±2.4)°,中耳萎缩耳为(22.9±2.9)°,正常耳为(25.1±3.0)°。CSOM耳和中耳萎缩耳的ET更趋于水平(<0.01)。CSOM耳的ET长度为(39.2±4.3)mm,中耳萎缩耳为(41.7±5.8)mm,正常耳为(43.0±5.9)mm。CSOM耳的ET比正常耳短(<0.01)。中耳萎缩耳与正常耳的ET长度差异无统计学意义(>0.05)。CSOM耳的ET功能障碍率为62%,中耳萎缩耳为68%,均显著高于正常耳的功能障碍率(22%)(<0.05)。ET的解剖和功能改变促成了CSOM的发生发展。对于ET更趋于水平、较短且存在功能障碍的患者,应考虑更积极的治疗。