Justine Litta, Tuli Isha Preet
Department of Otorhinolaryngology and Head &Neck Surgery, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India.
Indian J Otolaryngol Head Neck Surg. 2024 Oct;76(5):4417-4425. doi: 10.1007/s12070-024-04879-2. Epub 2024 Jul 13.
To evaluate the association between mucociliary function of the Eustachian tube using the Saccharin test preoperatively and its correlation with dynamic slow-motion video endoscopy on the outcome of Type-I Tympanoplasty in patients with inactive mucosal chronic otitis media.
Eighty patients diagnosed with inactive mucosal chronic otitis media who underwent Type-I Tympanoplasty were included in the study. Preoperative assessment of Eustachian tube function was conducted using the Saccharin test. Results of this test were categorized as normal, partial, or gross dysfunction. Dynamic slow-motion video endoscopy was performed to assess motion and pathological factors of the Eustachian tube. Results were evaluated based on a previously validated Visual Analogue Score (VAS). Patients were followed up postoperatively for 3 months.
The proportion of patients with surgical failure at the end of the 1st and 3rd month postoperatively was significantly higher in cases of gross Eustachian tube dysfunction compared to those with normal and partial dysfunction (-value < 0.0001 and -value = 0.0001, respectively). Preoperative VAS scores in normal Eustachian tubes were significantly higher compared to those with partial dysfunction and gross dysfunction.
The Saccharin test is a valuable tool for preoperative evaluation of mucociliary clearance of the Eustachian tube, and dynamic slow-motion video endoscopy serves as a useful adjunct in predicting the outcome of Type-I Tympanoplasty. Routine evaluation of mucociliary clearance function of the Eustachian tube should be included in the preoperative workup for patients undergoing Tympanoplasty to achieve optimal surgical outcomes.
评估术前使用糖精试验评估咽鼓管黏液纤毛功能及其与动态慢动作视频内镜检查在静止期黏膜慢性中耳炎患者Ⅰ型鼓室成形术预后的相关性。
纳入80例诊断为静止期黏膜慢性中耳炎并接受Ⅰ型鼓室成形术的患者。使用糖精试验对咽鼓管功能进行术前评估。该试验结果分为正常、部分或严重功能障碍。进行动态慢动作视频内镜检查以评估咽鼓管的运动和病理因素。结果根据先前验证的视觉模拟评分（VAS）进行评估。患者术后随访3个月。
与正常和部分功能障碍的患者相比，咽鼓管严重功能障碍的患者术后第1个月和第3个月末手术失败的比例显著更高（p值分别<0.0001和p值=0.0001）。正常咽鼓管的术前VAS评分显著高于部分功能障碍和严重功能障碍的患者。
糖精试验是术前评估咽鼓管黏液纤毛清除功能的有价值工具，动态慢动作视频内镜检查是预测Ⅰ型鼓室成形术预后的有用辅助手段。对于接受鼓室成形术的患者，术前检查应包括咽鼓管黏液纤毛清除功能的常规评估，以实现最佳手术效果。
