Department of Otorhinolaryngology, Wenzhou Medical University Affiliated Yiwu Hospital, Yiwu City, Zhejiang Province, China.
Department of Otolaryngology-Head and Neck Surgery, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
J Otolaryngol Head Neck Surg. 2024 Jan-Dec;53:19160216241291822. doi: 10.1177/19160216241291822.
The objective of this study was to compare the outcomes of endoscopic cartilage myringoplasty (ECM) with or without plasma radiofrequency (RF) tuboplasty (PRT) for repairing chronic large perforation with Eustachian tube dysfunction (ETD).
Chronic large perforations with ETD were randomly divided into receiving ECM or ECM plus PRT. During the 24 months follow-up, the Eustachian tube score (ETS), Eustachian Tube Dysfunction Questionnaire-7 (ETDQ-7), ET inflammation scale, hearing results, and graft success rate of the patients were analyzed.
A total of 61 subjects were included in the study. Difference of ETS was significant before and after surgery in the ECM + PRT group ( < .05) but the ECM group was not ( > .05). Also, significant between-group difference was found regardless of post-24 months ETS and improvement value. Postoperative ETDQ-7 scores were significantly reduced compared with preoperative ETDQ-7 scores in both groups ( < .05), also, significant between-group difference was found regardless of post-24 months ETDQ-7 scores and improvement value. The graft success rate was 86.7% in the ECM group and 96.8% in the ECM + PRT group at postoperative 24 months ( > .05). In addition, although the ECM + PRT group showed a better air-bone gap improvement than the ECM group, the difference was not significant (13.01 ± 2.97 vs 10.92 ± 0.69 dB; > .05). No PRT procedure-related serious adverse events were reported during the follow-up process. No patients developed atelectasis or otitis media with effusion in either group.
ECM combined with low-temperature PRT did not affect the graft success rate but showed a better long-term improvement in ETS and ETDQ-7 than cartilage myringoplasty for the treatment of chronic perforation with ETD. In addition, although PRT showed a better hearing improvement, the difference was not significant between the 2 groups.
本研究旨在比较内镜下软骨鼓膜修补术（ECM）联合或不联合等离子射频（RF）管成形术（PRT）治疗伴有咽鼓管功能障碍（ETD）的慢性大穿孔的疗效。
将伴有 ETD 的慢性大穿孔患者随机分为 ECM 组或 ECM 联合 PRT 组。在 24 个月的随访期间，分析患者的咽鼓管评分（ETS）、咽鼓管功能障碍问卷-7（ETDQ-7）、ET 炎症评分、听力结果和移植物成功率。
共有 61 例患者纳入本研究。ECM+PRT 组患者手术前后 ETS 差异有统计学意义（ < .05），而 ECM 组患者手术前后 ETS 差异无统计学意义（ > .05）。此外，无论术后 24 个月 ETS 还是改善值，两组间均存在显著的组间差异。两组患者术后 ETDQ-7 评分均较术前显著降低（ < .05），且无论术后 24 个月 ETDQ-7 评分还是改善值，两组间均存在显著的组间差异。ECM 组患者术后 24 个月移植物成功率为 86.7%，ECM+PRT 组患者为 96.8%（ > .05）。此外，虽然 ECM+PRT 组患者的气骨导差改善优于 ECM 组，但差异无统计学意义（13.01 ± 2.97 vs 10.92 ± 0.69 dB； > .05）。在随访过程中，未报告任何与 PRT 相关的严重不良事件。两组患者均未发生肺不张或中耳炎。
ECM 联合低温 PRT 不影响移植物成功率，但在治疗伴有 ETD 的慢性穿孔方面，与单纯软骨鼓膜修补术相比，长期 ETS 和 ETDQ-7 改善效果更好。此外，虽然 PRT 显示出更好的听力改善，但两组间差异无统计学意义。
