Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts.
Department of Otorhinolaryngology-Head and Neck Surgery, Turku University Hospital, University of Turku, Turku, Finland.
Otol Neurotol. 2021 Apr 1;42(4):566-572. doi: 10.1097/MAO.0000000000003009.
Determine the safety and efficacy of balloon dilation of the Eustachian tube (ET) in pediatric patients.
Retrospective matched cohort study.
Tertiary medical center.
Pediatric patients (<18 yr) with persistent (>1.5 yr) chronic Eustachian tube dysfunction (ETD) with previous tympanostomy tube (TT) insertion versus matched controls.
Balloon dilation of the cartilaginous ET (BDET) was performed using concomitant myringotomy with/without tube placement and adjunctive procedures if indicated versus controls (TT).
Otitis media with effusion (OME)/retraction with need for additional tube, tympanogram, audiogram, otomicroscopy, ET mucosal inflammation/opening score, and Valsalva maneuver.
Forty six ETs (26 patients), ages 7 to 17 years (mean 12.5) underwent BDET. Mean follow-up was 2.3 years (standard deviation [SD], 1.1; range, 6 mo-5 yr). Significant improvements were observed for all measures. Tympanic membranes were healthy in 9% preoperatively, 38% at 6 months, 55% at 12 months, and 93% at 36 months postoperatively. Tympanograms improved to type A in 50% at 6 months, 59% at 12 months, and 85% at 36 months. Mean scores of mucosal inflammation declined from 3.2 (±0.6) preoperatively to 2.5 (±0.7) at 6 months and 1.7 (±0.6) at 36 months postoperatively. BDET had lower risk of failure versus TT insertion (adjusted hazard ratio [HR] 0.26; 95% confidence interval [CI]: 0.10, 0.70; p = 0.007). Probability of being failure free at 2 years was 87% (95% CI: 70, 94%) after BDET and 56% (95% CI: 40, 70%) after TT insertions.
BDET is a safe and possibly effective procedure in selected pediatric patients with chronic ETD.
确定球囊扩张咽鼓管（ET）在儿科患者中的安全性和疗效。
回顾性匹配队列研究。
三级医疗中心。
患有持续性（> 1.5 年）慢性咽鼓管功能障碍（ETD）的小儿患者（< 18 岁），既往行鼓膜切开置管术（TT）与匹配对照组。
行软骨 ET 球囊扩张术（BDET），同时行鼓膜切开术/置管术，并根据需要进行附加手术，与对照组（TT）进行比较。
分泌性中耳炎（OME）/伴有需要再次置管的鼓膜内陷、鼓室图、听力图、耳镜检查、ET 黏膜炎症/开放评分和瓦尔萨尔瓦动作。
46 例 ET（26 例患者），年龄 7-17 岁（平均 12.5 岁）行 BDET。平均随访时间为 2.3 年（标准差 [SD]，1.1；范围，6 个月-5 年）。所有指标均有显著改善。术前鼓膜正常占 9%，6 个月时为 38%，12 个月时为 55%，36 个月时为 93%。鼓室图在 6 个月时改善为 A 型占 50%，12 个月时为 59%，36 个月时为 85%。黏膜炎症评分从术前的 3.2（±0.6）降至 6 个月时的 2.5（±0.7）和 36 个月时的 1.7（±0.6）。与 TT 插入相比，BDET 失败的风险较低（调整后的危险比 [HR] 0.26；95%置信区间 [CI]：0.10，0.70；p=0.007）。BDET 组 2 年时无失败率为 87%（95% CI：70%，94%），TT 组为 56%（95% CI：40%，70%）。
BDET 是一种安全且可能有效的治疗方法，适用于有慢性 ETD 的特定儿科患者。
