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球囊扩张咽鼓管成形术治疗伴有和不伴有渗出的扩张功能障碍:综合结局分析。

Balloon Dilation Eustachian Tuboplasty for Dilatory Dysfunction With and Without Effusion: A Comprehensive Outcome Analysis.

机构信息

Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan City, Taiwan.

Department of Otolaryngology, Kuo General Hospital, Tainan City, Taiwan.

出版信息

Otolaryngol Head Neck Surg. 2023 Nov;169(5):1179-1186. doi: 10.1002/ohn.383. Epub 2023 Jun 2.

Abstract

OBJECTIVE

This study aimed (1) to demonstrate the efficacy of balloon dilation Eustachian tuboplasty (BDET) for dilatory Eustachian tube dysfunction (ETD) and (2) to determine whether adjunctive ventilation tube insertion (VTI) is superior to myringotomy in relieving symptoms for patients with ETD and concurrent middle ear effusion (MEE) treated with BDET.

STUDY DESIGN

A retrospective cohort study.

SETTING

Tertiary care academic center.

METHODS

Patients with dilatory ETD undergoing BDET with a ≥6-month follow-up period were enrolled and evaluated mainly using Eustachian tube function (ETF) tests and Eustachian Tube Dysfunction Questionnaire-7 (ETDQ-7). Participants with concurrent MEE were further classified into 2 subgroups, BDET with VTI and BDET with myringotomy. An intergroup comparison and comprehensive outcome evaluation were performed.

RESULTS

In total, 35 patients with 50 symptomatic ears were enrolled. According to ETF test results, the normalized ETF rate was 94% on the last visit. The mean ETDQ-7 scores decreased significantly from 3.7 ± 1.4 to 2.0 ± 0.9 after interventions, with the most improvement in symptoms occurring for "ear fullness" and "muffled hearing." For the final visit, strong correlations among ETF tests, tympanometry, and Valsalva results were noted. The aforementioned assessment results did not significantly differ between (1) the patients with MEE and patients without MEE and (2) "BDET with VTI" subgroup and "BDET with myringotomy" subgroup.

CONCLUSION

BDET was effective for dilatory ETD, even in cases with concurrent MEE. For patients with ETD and MEE, further research is required to evaluate the benefits of adjunctive myringotomy with or without VTI.

摘要

目的

本研究旨在(1)证明球囊扩张咽鼓管成形术(BDET)治疗扩张性咽鼓管功能障碍(ETD)的疗效,以及(2)确定对于接受 BDET 治疗的 ETD 伴发中耳积液(MEE)患者,辅助鼓膜切开术(VTI)与鼓室置管(VTI)相比,哪种方法在缓解症状方面更具优势。

研究设计

回顾性队列研究。

设置

三级学术医疗中心。

方法

对接受 BDET 治疗且随访时间超过 6 个月的扩张性 ETD 患者进行了入组和评估,主要采用咽鼓管功能(ETF)测试和咽鼓管功能障碍问卷-7(ETDQ-7)进行评估。伴有 MEE 的患者进一步分为 BDET 联合 VTI 组和 BDET 联合鼓膜切开术组。对各组间进行了比较和综合结果评估。

结果

共纳入 35 例患者(50 侧患耳)。根据 ETF 测试结果,末次随访时的咽鼓管功能正常化率为 94%。干预后 ETDQ-7 评分均值从 3.7±1.4 显著降低至 2.0±0.9,其中“耳闷感”和“听力减退”的症状改善最为明显。末次随访时,ETF 测试、鼓室压图和瓦尔萨尔瓦动作测试结果之间存在显著相关性。在(1)伴有 MEE 的患者与不伴 MEE 的患者之间,以及(2)“BDET 联合 VTI”组与“BDET 联合鼓膜切开术”组之间,上述评估结果均无显著差异。

结论

BDET 对扩张性 ETD 有效,即使是合并 MEE 的患者。对于 ETD 伴 MEE 的患者,还需要进一步研究评估鼓膜切开术联合或不联合 VTI 的获益。

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