Department of Otorhinolaryngology and Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea.
Department of Radiology and Biomedical Research Institute, Busan, Pusan National University Hospital, Busan, Republic of Korea.
Am J Otolaryngol. 2020 Jul-Aug;41(4):102499. doi: 10.1016/j.amjoto.2020.102499. Epub 2020 Apr 19.
To determine the usefulness of 'computed tomography (CT) with Valsalva maneuver (VM)' (Valsalva CT) for localizing lesions of the eustachian tube (ET) and identifying characteristics of ET dysfunction (ETD).
In this case-control study, 12, 17, and 25 patients with obstructive ETD (OETD), patulous eustachian tube (PET), and conductive hearing loss (control), respectively, underwent Valsalva CT in the supine position. The visualized length to total length ratio of the cartilaginous ET (VTRET) with and without VM were compared in the three groups. In the OETD group, obstructed areas of the ET were identified on multiplanar reconstructed images.
VTRET without VM in the PET group was significantly higher than that in the control and OETD groups (p-values, 0.003 and 0.007, respectively). However, there was no significant difference between the control and OETD groups (p = 0.053). VTRET with VM in the PET group was significantly higher than that in the other two groups (p < 0.001), whereas that in the control group was significantly higher than that in the OETD group (p < 0.001). In the OETD group, the obstructed area was clearly identified, and there were one, one, six, and eight patients in the isthmus; bony portion and isthmus; bony portion, isthmus, and cartilaginous portion; and isthmus and cartilaginous portion subgroups, respectively.
Valsalva CT is particularly valuable as a visualization assessment tool for identifying obstructed areas in the OETD. It may help future research of disease-specific mechanical characteristics of the ET on controlling pressure variables.
确定瓦氏动作（VM）下计算机断层扫描（CT）（瓦氏 CT）用于定位咽鼓管（ET）病变和识别 ET 功能障碍（ETD）特征的作用。
在这项病例对照研究中，分别有 12、17 和 25 例阻塞性 ETD（OETD）、咽鼓管扩张（PET）和传导性听力损失（对照组）患者，分别在仰卧位下进行瓦氏 CT。比较三组患者在 VM 前后 CT 中观察到的软骨 ET 长度与总长度比值（VTRET）。在 OETD 组，通过多平面重建图像识别 ET 的阻塞区域。
PET 组 VM 前后的 VTRET 无 VM 明显高于对照组和 OETD 组（p 值分别为 0.003 和 0.007）。然而，两组间无显著差异（p=0.053）。PET 组 VM 前后的 VTRET 明显高于另外两组（p<0.001），而对照组明显高于 OETD 组（p<0.001）。在 OETD 组，阻塞区域清晰可见，在肌管、骨部和肌管、骨部、肌管和软骨部、肌管和软骨部亚组中，分别有 1、1、6 和 8 例患者。
瓦氏 CT 作为一种可视化评估工具，对识别 OETD 中的阻塞区域特别有价值。它可能有助于未来对 ET 特定疾病机械特征的研究，以控制压力变量。
