咽鼓管冠脉球囊扩张联合鼓膜置管治疗复发性分泌性中耳炎

Coronary balloon dilation eustachian tuboplasty combined with the catheterization of tympanic tube membrane in the treatment of recurrent secretory otitis media

目的观察咽鼓管冠脉球囊扩张联合鼓膜置管治疗复发性分泌性中耳炎的疗效。方法将49例(65耳)复发性分泌性中耳炎患者随机分为A、B、C组,A组为试验组,接受咽鼓管球囊扩张联合鼓膜置管治疗,共16例(22耳),B和C组是对照组,B组单纯接受咽鼓管球囊扩张治疗,共16例(21耳),C组单纯接受鼓膜置管治疗,共17例(22耳)。所有球囊扩张器械使用冠状动脉球囊。患者术后1、3、6个月定期随访。术后通过咽鼓管功能障碍7项问卷评分(the seven-item eustachian tube dysfunction questionair,ETDQ-7)、咽鼓管评分量表(eustachian tube score,ETS)及声导抗进行疗效评价。结果3组患者术后1、3、6个月咽鼓管功能均有提高。鼓膜愈合后复查,A型鼓室图逐渐增多。A组术后3、6个月ETDQ-7评分均较B组和C组低,对照组C组较B组低。术后3、6个月ETS得分A组均高于B、C组,对照组之间C组较B组高。结论对于复发性分泌性中耳炎的患者咽鼓管球囊扩张联合鼓膜置管能显著改善患者咽鼓管功能,提高分泌性中耳炎的治疗效果。冠状动脉球囊价格较常规咽鼓管球囊便宜,用于治疗分泌性中耳炎取得了同样好的疗效。

Objective To observe the effect of coronary balloon dilation eustachian tuboplasty combined with the catheterization of tympanic tube membrane in the treatment of recurrent secretory otitis media.Methods Forty-nine patients(64 ears)with recurrent secretory otitis media were retrospectively analyzed and followed up regularly at 1 month,3 months and 6 months after surgery.The 49 cases were divided into three groups(group A,B and C).The patients of group A is a experimental group(n=16,22 ears),who were received eustachian tube balloon dilation combined with tympanotomy tube insertion.The B and C groups are control.The patients of group B were received only eustachian tube balloon dilation(n=16,21 ears),while the patients of group C received only the catheterization of tympanic tube membrane(n=17,22 ears).All eustachian tube dilatation were done by coronary artery balloon.The 7-item eustachian tube dysfunction questionair(ETDQ-7),acoustic immitance and eustachian tube score(ETS)were completed for evaluating the efficacy of the stated treatment.Results Eustachian tube function of the patients was improved in three groups at 1 month,3 months and 6 months after surgery.Type A tympanogram was gradually increasing after the tympanic membrane healing.At 6 months after surgery,ETDQ-7 scores were lower in the group A than in the control B,C groups,and ETDQ-7 scores of the control group C were lower compared to that of the group B.At 3,6 months after surgery,ETS scores were higher in the group A than in the control B,C groups,and ETS scores of the control group C were higher compared to that of the group B.Conclusion For recurrent secretory otitis media caused by eustachian tube dysfunction,eustachian tube balloon dilation combined with with the catheterization of tympanic tube membrane can significantly improve clinical symptoms.It is an effective surgical intervention for treatment of secretory otitis media.The coronary balloon is cheaper than the conventional eustachian tube balloon and has the same therapeutic effect in the treatment of secretory otitis media.