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咽鼓管功能障碍中球囊咽鼓管成形术联合或不联合鼓膜切开术

Balloon Eustachian Tuboplasty Combined or Not with Myringotomy in Eustachian Tube Dysfunction.

作者信息

Lin Wei-Chieh, Chang Yao-Wen, Kang Ting-Ya, Ye Ciou-Nan, Wu Hung-Pin, Lin Chung-Ching

机构信息

Department of Otolaryngology, Head and Neck Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung 427, Taiwan.

School of Medicine, Tzu Chi University, Hualien 970, Taiwan.

出版信息

J Pers Med. 2023 Oct 25;13(11):1527. doi: 10.3390/jpm13111527.

Abstract

BACKGROUND

Eustachian tube dysfunction (ETD) is a common disorder causing ear pressure, pain, and hearing loss. Balloon Eustachian tuboplasty (BET) is an emerging technique for dilating the Eustachian tube and treating ETD. Whether adding myringotomy improves BET efficacy is controversial.

METHODS

This retrospective study included 95 ETD patients undergoing BET alone ( = 44) or BET with myringotomy (BET + M; = 51) between June 2020 and August 2021 at a single medical center. The primary outcome was the change in ETDQ-7 symptom scores from baseline to 6 months after treatment. Secondary outcomes included audiometry, endoscopy, Valsalva maneuver, and complications.

RESULTS

The ETDQ-7 scores improved significantly after treatment in both groups ( < 0.001), without significant between-group differences ( = 0.417). No significant differences occurred in the audiometry, endoscopy, and Valsalva results or in most complications between groups. One BET + M patient had a persistent tympanic membrane perforation.

CONCLUSIONS

Both BET alone and BET + M effectively and safely improved the subjective and objective ETD outcomes. However, adding myringotomy did not further improve the outcomes over BET alone, while it incurred risks such as persistent perforation. BET alone may sufficiently treat ETD without requiring myringotomy in this cohort. Further randomized controlled trials should identify optimal candidates for BET alone versus combined approaches.

摘要

背景

咽鼓管功能障碍(ETD)是一种常见疾病,可导致耳内压力、疼痛和听力损失。球囊咽鼓管成形术(BET)是一种用于扩张咽鼓管和治疗ETD的新兴技术。鼓膜切开术是否能提高BET的疗效存在争议。

方法

这项回顾性研究纳入了2020年6月至2021年8月期间在单一医疗中心接受单纯BET(n = 44)或BET联合鼓膜切开术(BET + M;n = 51)的95例ETD患者。主要结局是从基线到治疗后6个月ETDQ-7症状评分的变化。次要结局包括听力测定、内窥镜检查、瓦尔萨尔瓦动作和并发症。

结果

两组治疗后ETDQ-7评分均显著改善(P < 0.001),组间无显著差异(P = 0.417)。两组在听力测定、内窥镜检查、瓦尔萨尔瓦动作结果或大多数并发症方面均无显著差异。一名BET + M患者出现持续性鼓膜穿孔。

结论

单纯BET和BET + M均有效且安全地改善了ETD的主观和客观结局。然而,联合鼓膜切开术并未比单纯BET进一步改善结局,同时还带来了如持续性穿孔等风险。在该队列中,单纯BET可能足以治疗ETD,无需鼓膜切开术。进一步的随机对照试验应确定单纯BET与联合治疗方法的最佳适用人群。

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