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同期球囊咽鼓管成形术治疗扁桃体及腺样体肥大儿童分泌性中耳炎的疗效

Efficacy of concurrent balloon eustachian tuboplasty in the treatment of chronic otitis media with effusion in children with tonsil and adenoid hypertrophy.

作者信息

Ma Jianli, Kang Zhaopeng, Xu Lian, Ai Ping, Zhang Qun, Wang Lixin

机构信息

Department of Otorhinolaryngology Head and Neck Surgery, General Hospital of Ningxia Medical University, Yinchuan, China.

Department of Andrology, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, 442000, China.

出版信息

Eur Arch Otorhinolaryngol. 2025 May;282(5):2373-2379. doi: 10.1007/s00405-024-09158-y. Epub 2025 Jan 17.

Abstract

OBJECTIVE

This study aims to explore the clinical effects of simultaneous balloon eustachian tuboplasty (BET) in treating chronic secretory otitis media (COME) in children with bilateral tonsil and adenoid hypertrophy (TAH), providing a theoretical basis for the clinical application of BET.

METHODS

From January 2023 to January 2024, 30 children diagnosed with COME and bilateral TAH were included in this retrospective study at our hospital. The cohort comprised a total of 55 affected ears. Sixteen patients (28 affected ears) were assigned to the study group, which underwent bilateral ablation of tonsils and adenoids (ATA) combined with tympanostomy tube insertion (TTI) and BET. Fourteen patients (27 affected ears) were assigned to the control group, which received bilateral ATA and TTI only. The observation indicators included otolaryngology specialist examinations, imaging assessments, endoscopic evaluations, hearing examinations, and efficacy assessments.

RESULTS

All surgeries were performed successfully without significant complications. Within 48 h post-surgery, none of the patients experienced noticeable dizziness, vomiting, earache, or other discomforts. The proportion of symptom improvement in the study group was significantly higher than in the control group (P < 0.001). Additionally, the proportion of tympanogram type A in the study group was significantly greater than that in the control group (P = 0.004). Six months post-operation, the air conduction (AC), bone conduction (BC), and air-bone gap (ABG) values in the study group were significantly lower than those in the control group (all P < 0.05). Furthermore, the effective rate in the study group six months after the operation was significantly higher than that in the control group (P < 0.001).

CONCLUSION

This study confirms the near-term efficacy and safety of the combined approach of ATA, TTI, and BET in treating children with COME. It provides valuable clinical experience and a theoretical foundation for the application of BET in this patient population.

摘要

目的

本研究旨在探讨同期球囊咽鼓管成形术(BET)治疗双侧扁桃体及腺样体肥大(TAH)患儿慢性分泌性中耳炎(COME)的临床效果,为BET的临床应用提供理论依据。

方法

2023年1月至2024年1月,我院对30例诊断为COME且双侧TAH的患儿进行了这项回顾性研究。该队列共有55只患耳。16例患者(28只患耳)被分配到研究组,接受双侧扁桃体及腺样体切除术(ATA)联合鼓膜置管术(TTI)和BET。14例患者(27只患耳)被分配到对照组,仅接受双侧ATA和TTI。观察指标包括耳鼻喉科专科检查、影像学评估、内镜评估、听力检查和疗效评估。

结果

所有手术均成功完成,无明显并发症。术后48小时内,所有患者均未出现明显头晕、呕吐、耳痛或其他不适。研究组症状改善比例显著高于对照组(P < 0.001)。此外,研究组A型鼓室图比例显著高于对照组(P = 0.004)。术后6个月,研究组的气导(AC)、骨导(BC)和气骨导间距(ABG)值显著低于对照组(均P < 0.05)。此外,术后6个月研究组的有效率显著高于对照组(P < 0.001)。

结论

本研究证实了ATA、TTI和BET联合治疗COME患儿的近期疗效和安全性。它为BET在该患者群体中的应用提供了宝贵的临床经验和理论基础。

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