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鼓膜成形术联合或不联合球囊咽鼓管成形术治疗伴有咽鼓管功能障碍的慢性化脓性中耳炎。

Tympanoplasty With or Without Balloon Eustachian Tuboplasty for Chronic Suppurative Otitis Media With Obstructive Eustachian Tube Dysfunction.

机构信息

Department of Otolaryngology, Head and Neck Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung.

School of Medicine, Tzu Chi University, Hualien, Taiwan (R.O.C.).

出版信息

Otol Neurotol. 2020 Sep;41(8):1077-1083. doi: 10.1097/MAO.0000000000002730.

Abstract

OBJECTIVE

To further elucidate the role of balloon Eustachian tuboplasty (BET) in tympanoplasty, we conducted a study to compare the outcomes of tympanoplasty with and without BET for the treatment of chronic suppurative otitis media (CSOM) with obstructive Eustachian tube dysfunction (OETD).

STUDY DESIGN

Case control study.

SETTING

Tertiary referral center.

PATIENTS

A total of 70 ears diagnosed with CSOM (tubotympanic type) and OETD were included in this study. Thirty-five patients were prospectively enrolled for BET and tympanomastoidectomy between February 2018 and June 2019. Thirty-five control subjects were matched by sex and age and retrospectively enrolled for tympanomastoidectomy between July 2016 and January 2018.

INTERVENTIONS

BET, tympanomastoidectomy.

MAIN OUTCOME MEASURES

The graft take rate, hearing levels, and Eustachian tube function test results.

RESULTS

The graft take success rate was higher in the BET group (80.0%; 28/35) than in the control group (68.6%; 24/35). However, the difference was not statistically significant. The average air-bone gap (ABG) improvement was 10.93 ± 7.70 dB in the BET group and 7.11 ± 8.08 dB in the control group, with a statistically significant between-group difference (p = 0.033).

CONCLUSIONS

Our findings suggest that BET can objectively and subjectively improve the Eustachian tube function, with a slight but significant improvement in ABG despite the lack of a clinically significant improvement overall. However, it does not affect the graft take rate. In summary, BET could be used as an adjunctive procedure in the treatment of CSOM with OETD.

摘要

目的

为了进一步阐明球囊咽鼓管成形术(BET)在鼓室成形术中的作用,我们进行了一项研究,比较了 BET 联合和不联合鼓室成形术治疗伴有咽鼓管功能障碍(OETD)的慢性化脓性中耳炎(CSOM)的疗效。

研究设计

病例对照研究。

设置

三级转诊中心。

患者

本研究共纳入 70 耳诊断为 CSOM(鼓室-乳突型)和 OETD 的患者。35 例患者前瞻性纳入 BET 和鼓室成形乳突切除术组,于 2018 年 2 月至 2019 年 6 月接受治疗。35 例对照组患者按性别和年龄匹配,并回顾性纳入 2016 年 7 月至 2018 年 1 月接受鼓室成形乳突切除术的患者。

干预措施

BET、鼓室成形乳突切除术。

主要观察指标

移植物成活率、听力水平和咽鼓管功能测试结果。

结果

BET 组移植物成活率(80.0%;28/35)高于对照组(68.6%;24/35),但差异无统计学意义。BET 组平均气骨导差(ABG)改善值为 10.93±7.70dB,对照组为 7.11±8.08dB,两组间差异有统计学意义(p=0.033)。

结论

我们的研究结果表明,BET 可客观和主观地改善咽鼓管功能,ABG 有轻微但显著的改善,尽管总体上无临床显著改善。但 BET 不影响移植物成活率。总之,BET 可作为伴有 OETD 的 CSOM 的辅助治疗方法。

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