Formánek Martin, Formánková Debora, Školoudík Lukáš, Zeleník Karol, Chrobok Viktor, Komínek Pavel
Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Ostrava, Ostrava, Czech Republic.
Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Hradec Kralove, Charles University, Faculty of Medicine in Hradec Kralove, Hradec Kralove, Czech Republic.
Ear Nose Throat J. 2020 Dec 10:145561320980199. doi: 10.1177/0145561320980199.
Balloon eustachian tuboplasty (BET) is a promising therapeutic option for eustachian tube (ET) dysfunction. However, data are lacking on the effect of BET in adults with symptoms of chronic ET dysfunction but without a contributing pathology. This study investigated the effect of BET in adult patients with only symptoms of chronic ET dysfunction.
This prospective clinical trial included adult patients with aerated physiological middle ears and symptoms of ET dysfunction for more than 6 months. Compliance with follow-up was 93.3%. We evaluated the effects of BET with tympanometry, assessment of the Valsalva or Toynbee maneuver with tympanometry verification, a Eustachian Tube Dysfunction Questionnaire (ETDQ-7), and pure-tone audiometry. Data were recorded 1 day before surgery and 2, 6, and 12 months after BET. Therapy was considered successful when the patient exhibited a newly acquired ability to perform the Valsalva or Toynbee maneuver or when the ETDQ-7 score improved by 20% or more.
We included 14 ears in the analysis. After 2, 6, and 12 months, therapy was successful, according to the ETDQ-7, in 11/14 (78.6%; 95% CI: 48.8-94.3), 13/14 (92.9%; 95% CI: 64.2-99.6), and 12/14 (85.7%; 95% CI: 56.2-97.5) ears, respectively. These results were statistically significant. The ETDQ-7 scores also significantly decreased at 2, 6, and 12 months after the BET, when any change was observed. All patients experienced improvement. Only 1 patient reported temporary deterioration after 2 months. Treatment was more frequently successful in patients without nasal polyps or pollinosis.
Adults with only symptoms of chronic ET dysfunction benefitted more and had longer lasting results from BET, compared to patients with pathologies caused by ET dysfunction. Balloon eustachian tuboplasty could be recommended for these patients.
球囊咽鼓管成形术(BET)是治疗咽鼓管(ET)功能障碍的一种很有前景的治疗方法。然而,对于患有慢性ET功能障碍症状但无相关病理因素的成年人,BET的疗效尚缺乏数据。本研究调查了BET对仅患有慢性ET功能障碍症状的成年患者的疗效。
这项前瞻性临床试验纳入了中耳充气良好且有ET功能障碍症状超过6个月的成年患者。随访依从率为93.3%。我们通过鼓室图、通过鼓室图验证评估瓦尔萨尔瓦动作或托因比动作、咽鼓管功能障碍问卷(ETDQ-7)以及纯音听力测定来评估BET的效果。在手术前1天以及BET术后2、6和12个月记录数据。当患者表现出新获得的进行瓦尔萨尔瓦动作或托因比动作的能力,或者ETDQ-7评分提高20%或更多时,治疗被认为是成功的。
我们纳入了14只耳朵进行分析。根据ETDQ-7,在术后2、6和12个月时,治疗成功的耳朵分别为11/14(78.6%;95%置信区间:48.8-94.3)、13/14(92.9%;95%置信区间:64.2-99.6)和12/14(85.7%;95%置信区间:56.2-97.5)。这些结果具有统计学意义。在BET术后2、6和12个月,当观察到任何变化时,ETDQ-7评分也显著降低。所有患者均有改善。只有1例患者在2个月后报告有短暂恶化。在没有鼻息肉或花粉症的患者中,治疗更常成功。
与由ET功能障碍引起的病理状况患者相比,仅患有慢性ET功能障碍症状的成年人从BET中获益更多,且效果持续时间更长。对于这些患者可推荐球囊咽鼓管成形术。