Huang Yan, Liang Liyang, Zhang Lina, Liu Wei, Guo Jia, Zhang Zhigang, Si Yu
Department of Otorhinolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
Institute of Hearing and Speech, Sun Yat-sen University, Guangzhou, China.
Laryngoscope. 2025 Jul;135(7):2538-2546. doi: 10.1002/lary.32086. Epub 2025 Feb 20.
Patients with Turner syndrome (TS) commonly experience acute otitis media and Eustachian tube dysfunction (ETD). Comparison of the anatomical features of the Eustachian tube (ET) between TS patients and age-matched controls may provide insights into the high prevalence of ETD in TS.
This study compared the ET angle, length, and diameters of the bone segment, bone-cartilage (BC) junction, and pharyngeal opening between TS patients and control children. A subgroup analysis was also conducted to explore potential risk factors for ETD in TS patients.
The ET angle in the TS group was significantly smaller (31.57°; 95% confidence interval [95% CI]: 30.05-33.09) compared with the control group (33.72°; 95% CI: 32.68-34.75; p = 0.019). No significant difference in ET length was observed between the two groups. However, the TS group exhibited significantly narrower diameters at the bony segment of the ET (0.30 cm; 95% CI: 0.29-0.32; p = 0.001), the BC junction (0.15 cm; 95% CI: 0.13-0.16; p = 0.001), and the pharyngeal orifice (0.14 cm; 95% CI: 0.13-0.16; p = 0.001) compared with the control group. Correlation analysis revealed a significant positive correlation between ET length and angle in the control group, whereas a non-significant negative correlation was observed in the TS group. In patients with TS, ET angles < 33.25°, bone segment diameters < 0.355 cm, and pharyngeal diameters < 0.15 cm were significantly associated with an increased risk of ETD.
A more horizontal ET angle, along with narrower diameters at various ET segments, may contribute to the development of ETD in patients with TS. Consequently, heightened vigilance in monitoring hearing and early intervention strategies is recommended for children with TS (https://www.chictr.org.cn/, ChiCTR2300068063).
特纳综合征(TS)患者常患急性中耳炎和咽鼓管功能障碍(ETD)。比较TS患者与年龄匹配的对照组咽鼓管(ET)的解剖特征,可能有助于深入了解TS中ETD的高患病率。
本研究比较了TS患者与对照儿童的ET角度、长度以及骨段、骨-软骨(BC)交界处和咽口的直径。还进行了亚组分析,以探索TS患者发生ETD的潜在危险因素。
与对照组(33.72°;95%置信区间[95%CI]:32.68 - 34.75;p = 0.019)相比,TS组的ET角度明显更小(31.57°;95%CI:30.05 - 33.09)。两组之间未观察到ET长度的显著差异。然而,与对照组相比,TS组在ET的骨段(0.30 cm;95%CI:0.29 - 0.32;p = 0.001)、BC交界处(0.15 cm;95%CI:0.13 - 0.16;p = 0.001)和咽口(0.14 cm;95%CI:0.13 - 0.16;p = 0.001)处的直径明显更窄。相关性分析显示,对照组中ET长度与角度之间存在显著正相关,而TS组中观察到的是不显著的负相关。在TS患者中,ET角度<33.25°、骨段直径<0.355 cm和咽直径<0.15 cm与ETD风险增加显著相关。
更水平的ET角度以及ET各段更窄的直径,可能导致TS患者发生ETD。因此,建议对TS儿童加强听力监测的警惕性并采取早期干预策略(https://www.chictr.org.cn/,ChiCTR2300068063)。