咽鼓管球囊扩张联合鼓膜置管术在儿童复发性分泌性中耳炎中的疗效

Analysis of Balloon Eustachian Tuboplasty Combined with Tympanotomy Tube Insertion in the Treatment of Recurrent Otitis Media with Effusion in Children

目的分析咽鼓管球囊扩张术(balloon eustachiantuboplasty,BET)联合鼓膜切开置管术在儿童复发性分泌性中耳炎的应用效果。方法将21例复发性分泌性中耳炎患儿随机分为两组,观察组10例患儿(20耳),采用咽鼓管球囊扩张联合鼓膜切开置管术;对照组11例患儿(21耳),仅采用鼓膜切开置管术。术后随访1月、3月、6月。随访内容包括纯音测听(PTA)、耳内镜、鼻咽镜及咽鼓管功能障碍问卷评分(ETDQ-7),数据进行统计分析。结果两组患儿术后1、3、6月PTA值均较术前改善(P<0.05),术后6月,观察组的PTA值(17.25±3.75),低于对照组(21.08±6.48),(P<0.05);两组患儿术后1、3、6月ETDQ-7评分均较术前降低,(P<0.05)。术后3月和6月,观察组ETDQ-7评分(3.43±0.36),(1.90±0.32)较对照组(3.75±0.45),(2.58±0.84)降低(P<0.05)。结论对于复发性分泌性中耳炎的患儿,采用咽鼓管球囊扩张联合鼓膜切开置管术能显著改善咽鼓管功能,提高纯音听阈值,临床疗效好。

Objective To evaluate the effcacy of balloon eustachian tuboplasty(BET) combined with tympanotomy tube insertion(TTI) in the treatment of recurrent otitis media with effusion in children.Me thods A prospective case control study data from 21 cases of recurrent otitis media with effusion in children were analyzed and divided into an experimental and a control group. Cases in the experimental group received balloon eustachian tuboplasty combined with tympanotomy tube insertion(n = 10, 20 ears), while those in the control group received tympanotomy tube insertion only(n = 11,21 ears).Follow ups were conducted at 1, 3 and 6 months following the surgery. The eustachian tube dysfunction questionnaire 7-item(ETDQ-7), pure-tone audiometry(PTA),otoscopy and endoscopy were completedand analyzed at each follow-up visit.Re s ults Postoperative PTA improved in both groups at 1,3 and 6 months after operation(P<0.05) In the experimental group PTA(17.25±3.75) was lower than that(21.08±6.48) in the control group(P<0.05). Eustachian tube function improved in both groups at 1, 3 and 6 months following the surgery(P<0.05). At 3 and 6 months following the surgery, ETDQ-7 scores(3.43±0.36),(1.90±0.32) of the experimental group were lower than those of the control group(3.75±0.45),(2.58±0.84),P<0.05. Conclusion For recurrent otitis media with effusion in children,BET combined with TTI can significantly improve eustachian tube dysfunction and hearing. It is an effective surgical intervention.