咽鼓管球囊扩张+鼓膜切开置管联合咽鼓管冲洗治疗难治性分泌性中耳炎  

Balloon Eustachian tuboplasty plus tympanostomy tube placement combined with Eustachian tube irrigation for the treatment of refractory otitis media with effusion

作　　者：唐江凤 张光辉 张锋 刘永胜 TANG Jiang-feng;ZHANG Guang-hui;ZHANG Feng;LIU Yong-sheng(Department of Otolaryngology,the First People′s Hospital of Hangzhou Lin′an District,311300 Hangzhou,Zhejiang,China)

机构地区：[1]杭州市临安区第一人民医院耳鼻咽喉科,浙江杭州311300

出　　处：《广东医学》2023年第9期1150-1154,共5页Guangdong Medical Journal

基　　金：杭州市医药卫生科技项目(B20210215)。

摘　　要：目的研究咽鼓管球囊扩张术(BET)、鼓膜切开置管(TTI)联合咽鼓管冲洗治疗难治性分泌性中耳炎的临床疗效。方法选择2020年1月至2022年1月,在杭州市临安区第一人民医院就诊的30例难治性分泌性中耳炎患者(共48只患耳),在局部麻醉或全身麻醉下行BET+TTI联合生理盐水及地塞米松咽鼓管冲洗治疗,收集并分析患者术前和术后1、3、6、12个月的纯音测听、主观症状及治疗前与术后12个月的气骨导差、鼓室压、七项咽鼓管功能障碍症状评分(ETDQ-7)评分等数据,对治疗前后患耳功能情况进行对比分析,评价治疗效果。结果经治疗12个月后,总有效率达到了91.66%,纯音测听、气骨导差、鼓室压、ETDQ-7评分较治疗前均有明显好转(P<0.05),乳突CT图像、主观症状较治疗前明显改善。结论咽鼓管球囊扩张术+鼓膜切开置管联合咽鼓管冲洗是治疗分泌性中耳炎的有效方法,提高了患者远期生活质量。Objective To investigate the clinical efficacy of Balloon Eustachian tuboplasty(BET)combined with tympanostomy tube placement(TTI)and Eustachian tube irrigation in the treatment of refractory otitis media with effusion.Methods Thirty patients(48 affected ears)with refractory otitis media with effusion who visited the First People′s Hospital of Hangzhou Lin′an District from January 2020 to January 2022 were selected.The patients underwent BET plus TTI combined with physiologic saline and dexamethasone Eustachian tube irrigation under local or general anesthesia.Preoperative and postoperative(at 1,3,6,and 12 months)pure-tone audiometry,subjective symptoms,and data on air-bone gap,middle ear pressure,and Eustachian tube dysfunction questionnaire-7(ETDQ-7)score were collected and analyzed.The functional status of the affected ears before and after treatment was compared and the treatment effect was evaluated.Results After 12 months of treatment,the total effective rate reached 91.66%.There was significant improvement in pure-tone audiometry,air-bone gap,middle ear pressure,and ETDQ-7 score compared to before treatment(P<0.05).Mastoid CT images and subjective symptoms were significantly improved compared to before treatment.Conclusion Pharyngotympanic tube balloon dilation combined with tympanostomy tube placement and Eustachian tube irrigation is an effective method for treating otitis media with effusion,which improves the long-term quality of life for patients.

关 键 词：分泌性中耳炎 咽鼓管球囊扩张术 鼓膜置管 咽鼓管功能障碍 

分 类 号：R762[医药卫生—耳鼻咽喉科] R764.21[医药卫生—临床医学]