咽鼓管球囊扩张术在难治性咽鼓管功能障碍的儿科患者中有作用吗？
Is there a role for Eustachian tube balloon dilation in pediatric patients with refractory Eustachian tube dysfunction?
机构信息
University of Arkansas for Medical Sciences, Little Rock, AR, USA.
University of California San Diego, San Diego, CA, USA; Rady Children's Hospital, San Diego, CA, USA.
出版信息
Am J Otolaryngol. 2023 Jul-Aug;44(4):103896. doi: 10.1016/j.amjoto.2023.103896. Epub 2023 Apr 12.
BACKGROUND
Eustachian tube dysfunction (ETD) is common in children. Over the past decade, eustachian tube balloon dilation (ETBD) has become a more widespread treatment for this condition. Data has been encouraging in the adult population, but data among the pediatric population has been sparser. This comprehensive review aims to assess current evidence for ETBD in pediatric patients.
REVIEW
Studies relevant to ETBD in the pediatric population were identified by utilizing the PubMed MEDLINE database. While multiple retrospective studies were found, this search yielded two systematic reviews focused on the pediatric population as the highest level of evidence assessing ETBD in children. There was overlap of included studies, but each review contained a unique set of studies. These reviews found that ETBD was safe in children.
BEST PRACTICE SUMMARY
Overall, ETBD appears safe and efficacious in children with refractory ETD. Future prospective trials confirming this conclusion are warranted. At this time, there appears to be a role for ETBD with or without ventilation tube placement in children with refractory ETD.
背景
咽鼓管功能障碍（Eustachian tube dysfunction，ETD）在儿童中较为常见。在过去十年中，咽鼓管球囊扩张术（Eustachian tube balloon dilation，ETBD）已成为治疗这种疾病的更为广泛的方法。在成人人群中的数据令人鼓舞，但在儿科人群中的数据则较为稀少。本综述旨在评估 ETBD 在儿科患者中的现有证据。
综述
通过利用 PubMed MEDLINE 数据库，确定了与儿科人群中 ETBD 相关的研究。虽然发现了多项回顾性研究，但此搜索仅产生了两项针对儿科人群的系统评价，作为评估儿童 ETBD 的最高证据级别。虽然纳入的研究存在重叠，但每篇综述都包含了一组独特的研究。这些综述发现，ETBD 在儿童中是安全的。
最佳实践总结
总体而言，ETBD 似乎在难治性 ETD 的儿童中是安全且有效的。未来需要前瞻性试验来证实这一结论。目前，在难治性 ETD 的儿童中，无论是单独使用还是与通气管放置联合使用，ETBD 似乎都有一定的作用。
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