耳闷患者咽鼓管球囊扩张治疗的中长期疗效分析

Evaluation of medium to long term efficacy of balloon dilation in the treatment of aural fullness as chief complaint

目的随访评估耳闷患者咽鼓管球囊扩张的中长期疗效,并探讨不同症状的改善情况以及与术后恢复时间的关系。方法连续收集2015年10月至2017年4月因耳闷塞感、耳鸣及听物矇眬感等咽鼓管功能不良症状在中山大学孙逸仙纪念医院行咽鼓管球囊扩张治疗且术前行咽鼓管功能障碍评分量表(the Seven-item Eustachian Tube Dysfunction Questionnaire,ETDQ-7)评估的患者,共29例,其中男16例、女13例;年龄20~62岁。术后追踪随访12~30个月并再次行ETDQ-7评估。利用SPSS 17.0软件分析ETDQ-7的总体评分及各个单项症状评分的改善情况,并观察术后恢复时间与评分之间是否存在线性相关。结果患者咽鼓管球囊扩张术后中长期ETDQ-7总体评分较术前明显下降[术前(27.0±7.9)分,术后(14.1±7.5)分],差异有统计学意义(P<0.05)。"耳闷塞感"、"耳内堵塞感或如同置身水下感觉,压迫感"、"感冒或鼻窦炎时出现耳部不适症状"、"耳内有嗡鸣声"以及"听声闷胀或含糊不清,有朦胧感"5项症状评分较术前明显下降,差异有统计学意义(P值均<0.05)。术后评估时间与ETDQ-7评分之间无线性相关(Spearman检验,ρ=-0.264,P=0.167)。结论以耳闷症状为主诉的咽鼓管功能不良患者咽鼓管球囊扩张术后中长期随访主观症状有明显改善,其改善程度与术后时间无线性相关。

Objective To discuss the characteristics of symptoms improvement based on the follow-up evaluation of Eustachian tube balloon dilation medium to long-term efficacy in patients with symptomatic Eustachian tube dysfunction(SETD).Methods Patients from 2015 to 2017 were followed up after Eustachian tube balloon dilation(with the sense of aural fullness,or tinnitus and hearing ambiguity).All participants had been done ETDQ-7 before surgery and were re-evaluated with ETDQ-7 in follow-up.The improvement of overall and individual symptoms scores in ETDQ-7,the effects of gender and the difference of scores at different stages(12-18 months,18-24 months and 24-30 months)after the operation were analyzed.Results There were 29 patients,including 16 males and 13 females,whose age ranged from 20 to 62 years old.The medium to long-term score of ETDQ-7 significantly declined after surgery(27.0±7.9 vs.14.1±7.5,P<0.05).Among all symptoms,symptoms like"blockage feeling in ear or being like under the water,constriction feeling","sound of blisters or explosions in the ear"decreased obviously(P<0.05).Comparing different stages after surgery,the scores of ETDQ-7 existed no difference(P>0.05).And the difference of gender showed no significant influence on surgery effects.Conclusion The subjective symptoms of patients with Eustachian tube dysfunction diagnosed with SETD can be significantly improved in the medium to long-term follow-up after Eustachian tube balloon dilation,and the degree of improvement is not linearly related to the postoperative time.