Department of Otolaryngology, Hospital Clínic Barcelona, Universitat de Barcelona (UB), C. Villarroel 170, 08036 , Barcelona, Spain.
Departament de Medicina i Especialitats Médicoquirúrgiques, Facultat de Medicina, Universitat de Barcelona (UB), C. Casanova 143, 08036, Barcelona, Spain.
Eur Arch Otorhinolaryngol. 2023 Sep;280(9):4045-4055. doi: 10.1007/s00405-023-07906-0. Epub 2023 Mar 28.
To present the results after balloon eustachian tuboplasty (BET) in patients with obstructive Eustachian tube dysfunction (OETD) grouped up into: baro-challenge, chronic serous otitis media and adhaesive otitis media.
A retrospective study was carried out on patients who underwent BET surgery. As outcome measures, otoscopy, tympanometry, Eustachian tube dysfunction questionnaire-7 (ETDQ-7) and ability to perform the Valsalva manoeuvre were recorded at baseline and at 3, 12 and 24 months after BET. A p value of 0.05 was used to indicate a statistically significant difference for all statistical tests.
Three hundred and nineteen ears (248 patients) were included with a 3-month follow-up, 272 ears had a 12-month follow-up, and 171 ears had 24-month follow-up. Globally, a statistical significance improvement in all groups in all outcome measures was found. According to BET indication, in the baro-challenge group, there was no improvement in otoscopy, but ETDQ-7, Valsalva manoeuvre and tympanogram improved significantly. In the chronic serous otitis media group, otoscopy, ETDQ-7 and Valsalva manoeuvre were significantly improved in all the three timelines, including the avoidance of a new transtympanic tube after the BET in over 80% of cases. In the adhaesive otitis media group, Valsalva manoeuvre improved significantly, ETDQ-7 decreased and tympanogram improved but not significantly. Few mild complications were reported.
BET is an effective method for the treatment of OETD in all etiologic groups. The greatest benefit was observed in patients with baro-challenge. A long-term follow-up is recommended since the benefit seems to increase over time.
介绍根据咽鼓管功能障碍(Eustachian tube dysfunction,ETD)的不同病因分组,行球囊咽鼓管扩张术(balloon eustachian tuboplasty,BET)后患者的结果。分组如下:气压伤、慢性浆液性中耳炎和粘连性中耳炎。
对行 BET 手术的患者进行回顾性研究。以耳镜检查、鼓室图、咽鼓管功能障碍问卷-7 (Eustachian tube dysfunction questionnaire-7,ETDQ-7)和施行瓦尔萨尔瓦动作(Valsalva manoeuvre)的能力为观察指标,分别于 BET 术前、术后 3、12 和 24 个月进行记录。所有统计检验均采用 p 值<0.05 表示具有统计学意义。
纳入 248 例患者的 319 耳,术后 3 个月随访 248 例患者的 319 耳,12 个月随访 272 例患者的 272 耳,24 个月随访 171 例患者的 171 耳。总体而言,所有组别的所有观察指标均有统计学意义的改善。根据 BET 的适应证,气压伤组耳镜检查无改善,但 ETDQ-7、瓦尔萨尔瓦动作和鼓室图显著改善。慢性浆液性中耳炎组中,所有三个时间点的耳镜检查、ETDQ-7 和瓦尔萨尔瓦动作均显著改善,超过 80%的患者在 BET 后避免了新的鼓室置管。粘连性中耳炎组中,瓦尔萨尔瓦动作显著改善,ETDQ-7 降低,鼓室图改善但不显著。仅报告了少数轻度并发症。
BET 是治疗所有病因咽鼓管功能障碍的有效方法。气压伤患者获益最大。建议进行长期随访,因为随着时间的推移,获益似乎会增加。