鼓膜置管注药联合咽鼓管球囊扩张治疗成人难治性分泌性中耳炎的回顾性分析

A retrospective analysis of 18 cases of refractory secretory otitis media treated with tympanic tube injection combined with Eustachian tube balloon dilation

目的难治性分泌性中耳炎临床治疗效果不佳,本文回顾性分析了鼓膜置管注药联合咽鼓管球囊扩张术对伴有咽鼓管功能障碍的难治性中耳炎患者的疗效。方法选择从2017年1月~2021年1月我院住院的18例难治性分泌性中耳炎患者,全麻下施行内镜下鼓膜切开置管术+咽鼓管球囊扩张术,术后按时复诊鼓室注射地塞米松,随访6个月以上,记录比较了术前、术后1月纯音测听阈值,鼓室图。术后6月的咽鼓管功能评分,满意度问卷调查。结果术前患者电测听显示传导聋及鼓室图B型曲线,患者有明显的耳闷不适感,TMM检测示咽鼓管功能障碍。手术过程顺利,术后当天耳闷感觉明显好转,听力改善,术后1月电测听有改善,术后6月部分病人复发11%(2/18),但有效率89%(16/18)仍较高。结论鼓膜置管注药联合咽鼓管球囊成形术对难治性分泌性中耳炎疗效明显,值得临床推广。

Objective The clinical treatment effect of refractory secretory otitis media is not good.This paper retrospectively analyzed the effect of tympanic tube injection combined with eustachian tube balloon dilatation on refractory otitis media patients with eustachian tube dysfunction.Methods A total of 18 patients with refractory secretory otitis media hospitalized in our hospital from January 2017 to January 2021 were selected for endoscopic tympanic incision and catheterization plus pharyngotympanic balloon dilatation under general anesthesia.The patients were regularly returned to the tympanic cavity for injection of dexamethasone after surgery,and were followed up for more than 6 months.The pure tone audiometry threshold and tympanic chart were recorded and compared before and 1 month after surgery.Eustachian tube function score and satisfaction questionnaire were conducted 6 months after operation.Results Conduction deafness and tympanogram B-type curve were shown by electro audiometry before operation.The patient had obvious ear discomfort.TMM test showed dysfunction of eustachian tube.The operation process was smooth,the ear stuffy feeling was significantly improved on the day after the operation,the hearing was improved 1 month after the operation,and the recurrence of some patients in 6 months after the operation was 11%(2/18),but the effective rate of 89%(16/18)was still high.Conclusion Tympanic tube injection combined with pharyngotympanic tube balloon plasty is effective for refractory secretory otitis media and worthy of clinical promotion.