Department of Otolaryngology, Head and Neck Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan.
School of Medicine, Tzu Chi University, Hualien, Taiwan.
Int Forum Allergy Rhinol. 2024 Aug;14(8):1327-1336. doi: 10.1002/alr.23341. Epub 2024 Mar 11.
To elucidate the role of balloon Eustachian tuboplasty (BET) in the management of chronic rhinosinusitis with obstructive Eustachian tube dysfunction (ETD), we evaluated the results of endoscopic sinus surgery (ESS) with and without BET in patients with chronic rhinosinusitis with obstructive ETD.
This randomized controlled trial conducted in a single-institution tertiary care center setting included 50 patients diagnosed with primary chronic rhinosinusitis and obstructive ETD between July 2018 and June 2022. Twenty-five patients were prospectively enrolled for combined ESS/BET. The control group (25 patients) underwent ESS alone. Outcome measurements of the Sinonasal Outcome Test 22, modified Lund-Kennedy score, Eustachian Tube Dysfunction Questionnaire-7 (ETDQ-7), and serial Eustachian tube function test results were analyzed 3 months postoperatively.
The improvement (12.60 ± 6.50) in the ETDQ-7 score in the BET group was significantly higher than that in the control group (6.60 ± 5.58). The ratio of improvement in the ETDQ-7 score was also significantly higher in the BET than in the control group (92% vs. 68%, p = 0.034). Logistic regression analysis showed that performing BET (odds ratio [OR]: 5.41, 95% confidence interval [CI]: 1.02-28.79, p = 0.048) and a low post-modified Lund-Kennedy score (OR: 0.15, 95% CI: 0.04-0.54, p = 0.004) were significantly associated with ETDQ-7 score improvement.
Combined BET/ESS could decrease otologic symptoms and improve Eustachian tube function. BET may be an appropriate adjunctive procedure for treating chronic rhinosinusitis with obstructive ETD.
为了阐明球囊咽鼓管成形术（BET）在伴有咽鼓管功能障碍（ETD）的慢性鼻窦炎患者中的作用，我们评估了伴有和不伴有 ETD 的慢性鼻窦炎患者接受内镜鼻窦手术（ESS）联合 BET 的结果。
这项在单中心三级医疗机构进行的随机对照试验纳入了 2018 年 7 月至 2022 年 6 月期间诊断为原发性慢性鼻窦炎和伴有 ETD 的 50 例患者。25 例患者前瞻性纳入接受 ESS/BET 联合治疗。对照组（25 例）仅接受 ESS。术后 3 个月，分析了鼻窦结局测试 22 项、改良 Lund-Kennedy 评分、咽鼓管功能障碍问卷-7（ETDQ-7）和连续咽鼓管功能测试结果。
BET 组 ETDQ-7 评分改善（12.60±6.50）明显高于对照组（6.60±5.58）。BET 组 ETDQ-7 评分改善率也明显高于对照组（92% vs. 68%，p=0.034）。Logistic 回归分析显示，行 BET（比值比 [OR]：5.41，95%置信区间 [CI]：1.02-28.79，p=0.048）和术后改良 Lund-Kennedy 评分较低（OR：0.15，95%CI：0.04-0.54，p=0.004）与 ETDQ-7 评分改善显著相关。
联合 BET/ESS 可减少耳科症状并改善咽鼓管功能。BET 可能是治疗伴有 ETD 的慢性鼻窦炎的一种合适的辅助治疗方法。
