内镜下鼓膜切开置管术治疗分泌性中耳炎的临床疗效及并发症观察

Observation on the Clinical Efficacy and Complications of Endoscopic Tympanostomy Tube Insertion in the Treatment of Secretory Otitis Media

目的研究内镜下鼓膜切开置管术(TBI)治疗分泌性中耳炎(SOM)的临床疗效及并发症情况。方法选取2020年1月-2023年6月上栗县人民医院眼耳鼻喉科收治的60例SOM患者,经随机数字表法分为对照组(31例)和观察组(29例)。对照组行常规保守治疗,观察组则应用内镜下TBI治疗,比较两组临床疗效、咽鼓管功能[捏鼻鼓气(Valsalva)法评分、咽鼓管功能障碍7项问卷(ETDQ-7)]、耳鸣症状[耳鸣评价量表(TEQ)评分、耳鸣消失时间]、听力水平(听力检测值、耳闭消失时间)、并发症。结果观察组治疗有效率为96.55%,高于对照组的77.42%(P<0.05)。两组术后4个月Valsalva、ETDQ-7评分低于术前,且观察组Valsalva、ETDQ-7评分低于对照组(P<0.05);两组TEQ评分低于术前,且观察组TEQ评分低于对照组,耳鸣消失时间短于对照组(P<0.05);两组听力检测值低于术前,且观察组听力检测值低于对照组,耳闭消失时间短于对照组(P<0.05)。观察组并发症发生率为20.69%,高于对照组的3.23%(P<0.05)。结论内镜下TBI治疗SOM效果肯定,可改善患者咽鼓管功能,加速耳鸣消退,减轻或消除耳闭症状以提高听力水平,但存在一定并发症风险。

Objective To study the clinical efficacy and complications of endoscopic tympanostomy tube insertion(TBI)in the treatment of secretory otitis media(SOM).Methods Sixty SOM patients admitted to the Department of Ophthalmology,Otorhinolaryngology,Shangli County People's Hospital from January 2020 to June 2023 were selected and divided into control group(31 patients)and observation group(29 patients)by random number table method.The control group was treated with routine conservative treatment,while the observation group was treated with endoscopic TBI.The clinical efficacy,eustachian tube function[Valsalva score,Eustachian tube dysfunction questionnaire(ETDQ-7)],tinnitus symptoms[Tinnitus Evaluation Questionnaire(TEQ)score,tinnitus disappearance time],hearing level(hearing test value,ear closure disappearance time)and complications were compared between the two groups.Results The effective rate of treatment in the observation group was 96.55%,which was higher than 77.42%in the control group(P<0.05).The scores of Valsalva and ETDQ-7 in the two groups at 4 months after operation were lower than those before operation,and the scores of Valsalva and ETDQ-7 in the observation group were lower than those in the control group(P<0.05).The TEQ score of the two groups were lower than those before operation,and the TEQ score of the observation group was lower than that of the control group,and the disappearance time of tinnitus was shorter than that of the control group(P<0.05).The hearing test values of the two groups were lower than those before operation,and the hearing test value of the observation group was lower than that of the control group,and the disappearance time of ear closure was shorter than that of the control group(P<0.05).The incidence of complications in the observation group was 20.69%,which was higher than 3.23%in the control group(P<0.05).Conclusion Endoscopic TBI is effective in the treatment of SOM,which can improve the function of eustachian tube,accelerate the regression of tinnitus,reduce or eliminate the symptoms of ear closure to improve the hearing level,but there is a certain risk of complications.