Department of Otorhinolaryngology, Affiliated Yiwu Hospital of Wenzhou Medical University (Yiwu Central Hospital), Yiwu City 322000, Zhejiang Province, China.
Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China.
Am J Otolaryngol. 2021 May-Jun;42(3):102926. doi: 10.1016/j.amjoto.2021.102926. Epub 2021 Jan 15.
To investigate the Effect of concurrent nasal surgery on the eustachian tube function (ETF) and myringoplasty outcomes for the chronic perforations with coexistent nasal pathology.
We retrospectively reviewed the records of 93 patients with perforations who underwent same-day myringoplasty and nasal-septal surgery. Group A exhibited septal deviations (n = 34) and Group B inflammatory sinus disease (n = 59). Groups were compared with respect to pre- and postoperative air-bone gaps (ABGs), graft success rates and ETF (Eustachian tube score [ETS] and seven-item Eustachian Tube Dysfunction Questionnaire [ETDQ-7]) at 6 and 24 months.
Graft success rates were 100.0% in Group A and 98.3% in Group B at 6 months postoperatively (P = 0.445). Graft success rates were 85.3% in Group A and 96.6% in Group B at 24 months postoperatively (P = 0.046), the re-perforation rate was significantly higher in Group A than in Group B (P = 0.015). Although the preoperative ETS was similar between two groups, the postoperative ETS in the Group B was significantly higher compared with Group A regardless of at postoperative 6th and 24th months. In addition, difference was significant for the patients with positive Valsalva maneuver among two groups at postoperative 24th months. Also, the improvement in the ETDQ-7 score in the B group was significantly higher than that in the A group at postoperative 6th and 24th months.
Concurrent nasal surgery and myringoplasty is feasible. In addition, ESS improves ETF and thus long-term outcomes of myringoplasty for the chronic perforations with inflammatory sinus disease.
探讨同期鼻手术对伴有鼻腔病变的慢性穿孔患者咽鼓管功能(ETF)和鼓膜成形术效果的影响。
我们回顾性分析了 93 例同期行鼓膜成形术和鼻-鼻中隔手术的穿孔患者的记录。A 组表现为鼻中隔偏曲(n=34),B 组为炎症性鼻窦疾病(n=59)。比较两组患者术前和术后空气骨导差(ABG)、移植物成功率和 ETF(咽鼓管评分[ETS]和七项咽鼓管功能障碍问卷[ETDQ-7]),分别在术后 6 个月和 24 个月进行评估。
术后 6 个月,A 组和 B 组的移植物成功率分别为 100.0%和 98.3%(P=0.445)。术后 24 个月,A 组和 B 组的移植物成功率分别为 85.3%和 96.6%(P=0.046),A 组的再穿孔率明显高于 B 组(P=0.015)。尽管两组患者术前 ETS 相似,但术后 B 组的 ETS 明显高于 A 组,无论在术后第 6 个月还是第 24 个月。此外,在术后 24 个月,两组中 Valsalva 动作阳性的患者之间差异显著。此外,B 组在术后第 6 个月和第 24 个月时 ETDQ-7 评分的改善明显高于 A 组。
同期行鼻手术和鼓膜成形术是可行的。此外,ESS 可改善 ETF,从而改善伴有炎症性鼻窦疾病的慢性穿孔患者的鼓膜成形术的长期效果。