Department of Otorhinolaryngology - Head and Neck Surgery, Head and Neck Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
Department of Otorhinolaryngology, Turku University Hospital and University of Turku, Turku.
Otol Neurotol. 2022 Jul 1;43(6):611-618. doi: 10.1097/MAO.0000000000003558.
Baro-challenge-induced Eustachian tube dysfunction (ETD) manifests due to inadequate Eustachian tube (ET) function during rapid ambient pressure changes, although ET function may be normal in normobaric situations. This systematic review and retrospective cohort study aimed to evaluate the effectiveness of balloon Eustachian tuboplasty (BET) for the treatment of baro-challenge-induced ETD.
PubMed, the Cochrane Library, Scopus, and Helsinki University Hospital cohort.
A systematic literature search was conducted in November 2020 and resulted in 174 articles. Eight articles fulfilled the inclusion criteria. Data was available altogether from 74 adult baro-challenge-induced ETD patients. In addition, we retrospectively evaluated 39 BET operations at Helsinki University Hospital from 2011 to 2020. Data from these 39 patients were collected from medical charts, and a questionnaire was sent to the patients. Meta-analysis was used to evaluate subjective symptom improvement, changes in ETD Questionnaire-7 (ETDQ-7) scores, and Valsalva maneuver performance.
In the systematic review, the outcome parameters varied between studies. Improvement was reported in subjective symptoms, Valsalva maneuver, ETDQ-7, tubomanometry, and pressure chamber test. Response rate for the Helsinki University Hospital cohort study was 72% (28/39). Mean follow-up time from the BET to the questionnaire was 4 years 8 months (SD 26months). Of those patients 93% (26/28) found the operation beneficial. Meta-analysis including up to 113 patients showed improvement in Valsalva maneuver, ETDQ-7, and improvement in subjective symptoms. Overall improvement in symptoms was noted in 81% of the patients.
BET seems to be effective in the majority of patients with baro-challenge-induced ETD.
气压挑战引起的咽鼓管功能障碍（ETD）是由于在快速环境压力变化期间咽鼓管（ET）功能不足引起的，尽管在常压情况下 ET 功能可能正常。本系统评价和回顾性队列研究旨在评估球囊咽鼓管成形术（BET）治疗气压挑战引起的 ETD 的有效性。
PubMed、Cochrane 图书馆、Scopus 和赫尔辛基大学医院队列。
我们于 2020 年 11 月进行了系统文献检索，共检索到 174 篇文章。8 篇文章符合纳入标准。共有 74 名成人气压挑战引起的 ETD 患者的数据可用。此外，我们还回顾性地评估了 2011 年至 2020 年在赫尔辛基大学医院进行的 39 例 BET 手术。从病历中收集了这 39 名患者的数据，并向患者发送了一份问卷。Meta 分析用于评估主观症状改善、ETDQ-7 评分变化和瓦尔萨尔瓦动作表现。
在系统评价中，研究之间的结局参数不同。主观症状、瓦尔萨尔瓦动作、ETDQ-7、管内压测量和压力室测试均有改善。赫尔辛基大学医院队列研究的回复率为 72%（28/39）。从 BET 到问卷调查的平均随访时间为 4 年 8 个月（SD 26 个月）。在这些患者中，93%（26/28）认为手术有益。包括多达 113 名患者的 Meta 分析显示，瓦尔萨尔瓦动作、ETDQ-7 和主观症状均有改善。81%的患者出现总体症状改善。
BET 似乎对大多数气压挑战引起的 ETD 患者有效。
