咽鼓管球囊扩张术后不同诊断工具的临床评价

目的 评价常规工具在咽鼓管球囊扩张术(BET)术后效果的敏感度.方法 回顾性分析行单侧或双侧BET治疗的慢性分泌性中耳炎(CSOM)患者34例.分别在术前及术后2周、1个月、3个月随访时,进行常规体格检查、咽鼓管测压(TMM)测量R值、声导抗测试、咽鼓管评分(ETS)法和七项咽鼓管功能障碍症状评分量表(ETDQ-7),评价球囊扩张术的疗效.结果 在所有常规工具中,ETS和TMM测量R值变化最快.术前ETS为(3.65±1.60)分,术后2周的ETS为(4.38±1.60)分,差异有统计学意义(P<0.05).术后1个月、3个月的ETS分别为(7.00±1.39)分、(7.41±1.89)分,差异有统计学意义(P<0.05).术后1个月,ETDQ-7评分和声阻抗测试结果均有改善.术前ETDQ-7评分为(35.89±5.40)分,术后2周的ETDQ-7评分为(34.47±5.25)分,统计分析显示无改善(P>0.05).术后1个月、3个月的ETDQ-7评分分别降至(26.03±5.58)分、(14.85±6.32)分,差异有统计学意义(P<0.05).鼓室图显示,术后2周改善率为8.8%(3/34)差异无统计学意义(P>0.05);术后1个月、3个月的改善率分别为29.4%、67.6%,差异有统计学意义(P<0.05).结论 TMM是诊断ET功能障碍的一种客观、准确且可重复的检测方法.ETS是评价患者术后症状最敏感的指标,但不建议将其作为术后效果评估的唯一工具.

Objective To evaluate the sensitivity of conventional tools in the postoperative effect of balloon dilation eustachian tuboplasty(BET).Methods 34 patients with chronic secretory otitis media(CSOM)treated with unilateral or bilateral bet were analyzed retrospectively.Routine physical examination,R value measured by tubomanometry(TMM),acoustic immittance test,eustachian tube score(ETS)and the seven-item eustachian tube dysfunction questionnaire(ETDQ-7)were performed before operation and at the fllow-up of 2 weeks,I month and 3 months after operation to evaluate the efiacy of ballon dilatation.Results Among ll conventional tok,the R value measured by ETS and TMM changed the fastest.The scores of ETS before operation were(3.65±1.60)and 2 week afer operation were(4.38±1.60)(P<0.05).The ETS of 1 month and 3 months fer operation were(7.00±1.39)and(7.41±1.89)respectively,with significant diference(P<0.05).One month after operation,ETDQ-7 score and acoustic impedance test resuls were improved.The preoperative ETDQ-7 score was(35.89±5.40)and the ETDQ-7 score 2 weeks fter operation was(34.47±5.25),statistical analysis showed no improvement(P>0.05).The ETDQ-7 score at 1 month and 3 months after operation decreased to(26.03±5.58)and(14.85±6.32)respectively,and the difference was statisticall significant(P<0.05).Tympanogram showed that the improvement rate was 8.8%(3/34)2 weeks fter operation,and the dfference was not statistically significant(P>0.05).The improvement rates of 1 month and 3 months after operation were 29.4%and 67.6%respectively(P<0.05).Conclusion TMM is an objective,accurate and repeatable method to diagnose et dysfunction.ETS is the most sensitive index to evaluate patients postoperative symptoms,but itis not recommended to use it as the only tol for postoperative ffect evaluation.