咽鼓管异常开放症  

Patulous Eustachian tube

作　　者：孙宇[1] 谢乐 SUN Yu;XIE Le(Department of Otolaryngology Head and Neck Surgery,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430056,China)

机构地区：[1]华中科技大学同济医学院附属协和医院,耳鼻咽喉头颈外科,湖北武汉430056

出　　处：《中国耳鼻咽喉颅底外科杂志》2023年第4期1-6,共6页Chinese Journal of Otorhinolaryngology-skull Base Surgery

基　　金：科技部国家重点研发课题(2021YFF0702303)。

摘　　要：咽鼓管是连接鼻咽部和中耳鼓室腔的管道结构,当由于各种原因导致咽鼓管失去静息时关闭功能而处于持续开放状态时,称为咽鼓管异常开放症(PET)。PET是一种常见的耳鼻咽喉科疾病,其典型症状为自听增强、闻及自身呼吸音、主观性耳鸣及耳闷胀感等。PET患者症状由于与咽鼓管开放不良的功能障碍症状相似,常容易被漏诊或误诊,本文围绕PET的诊断和治疗方面,对最新的研究进展进行了综述。诊断上,症状、体征和实验室检查是诊断PET的核心,然而尚没有单一的咽鼓管功能检查可以在没有其他临床观察和检查的情况下准确评估咽鼓管功能。治疗上,常见的治疗方法包括保守治疗及手术治疗,针对PET患者,可进行“阶梯式”治疗策略:即先增重、冲洗鼻腔、滴酸等保守治疗,若保守治疗效果不佳,症状严重且患者有强烈治疗需求者,可采用如鼓膜手术、堵塞咽鼓管、缩窄咽鼓管口创伤性的手术治疗。The Eustachian tube is a duct structure that connects the nasopharynx and the middle ear cavity.When the Eustachian tube loses its resting closure function and remains continuously open for various reasons,it is called a patulous Eustachian tube(PET).PET is a common otolaryngological disorder and its typical symptoms include autophony,hearing one’s own breathing sounds,subjective tinnitus,and ear pressure.PET patients’symptoms are similar to those of Eustachian tube dysfunction,which can easily be missed or misdiagnosed.This article presents a review of the latest research progress on the diagnosis and treatment of PET.Regarding diagnosis,symptoms,signs,and laboratory tests are essential for PET diagnosis,but there is no single Eustachian tube function test that can accurately evaluate function without other clinical observations and examinations.In terms of treatment,common methods include conservative treatment and surgical treatment.For PET patients,a"stepwise"treatment strategy can be employed,such as weight gain,nasal irrigation,and acid drops as conservative treatments.If the conservative treatment is ineffective,the symptoms are severe and the patient expresses a strong need for treatment,then invasive surgical treatments like tympanic membrane surgery,plug surgery,or tuboplasty can be performed.

关 键 词：咽鼓管异常开放症 诊断 治疗 

分 类 号：R764.2[医药卫生—耳鼻咽喉科]