目的:咽鼓管球囊成形术(BET)是咽鼓管(ET)功能障碍的有希望的治疗选择。然而,缺乏关于BET在有慢性ET功能障碍症状但无病理贡献的成人中的作用的数据。这项研究调查了BET在仅有慢性ET功能障碍症状的成年患者中的作用。
方法:这项前瞻性临床试验包括患有充气生理中耳和ET功能障碍症状超过6个月的成年患者。随访依从性为93.3%。我们用鼓室法评估BET的效果,通过鼓室测量验证评估Valsalva或Toynbee的动作,咽鼓管功能障碍问卷(ETDQ-7),和纯音测听法。在手术前1天和BET后2、6和12个月记录数据。当患者表现出新获得的进行Valsalva或Toynbee动作的能力或ETDQ-7评分提高了20%或更多时,治疗被认为是成功的。
结果:我们在分析中纳入了14只耳朵。在2、6和12个月后,治疗成功了,根据ETDQ-7,在11/14(78.6%;95%CI:48.8-94.3),13/14(92.9%;95%CI:64.2-99.6),和12/14(85.7%;95%CI:56.2-97.5)耳朵,分别。这些结果具有统计学意义。ETDQ-7评分在BET后2、6和12个月也显著下降,当观察到任何变化时。所有患者都有改善。只有1例患者在2个月后报告暂时恶化。在没有鼻息肉或花粉症的患者中,治疗更为成功。
结论:仅有慢性ET功能障碍症状的成年人从BET中受益更多,持续时间更长,与由ET功能障碍引起的病理患者相比。这些患者可以推荐球囊咽鼓管成形术。
OBJECTIVE: Balloon eustachian tuboplasty (
BET) is a promising therapeutic option for eustachian tube (ET) dysfunction. However, data are lacking on the effect of
BET in adults with symptoms of chronic ET dysfunction but without a contributing pathology. This
study investigated the effect of
BET in adult patients with only symptoms of chronic ET dysfunction.
METHODS: This prospective clinical
trial included adult patients with aerated physiological middle ears and symptoms of ET dysfunction for more than 6 months. Compliance with follow-up was 93.3%. We evaluated the effects of BET with tympanometry, assessment of the Valsalva or Toynbee maneuver with tympanometry verification, a Eustachian Tube Dysfunction Questionnaire (ETDQ-7), and pure-tone audiometry. Data were recorded 1 day before surgery and 2, 6, and 12 months after
BET. Therapy was considered successful when the patient exhibited a newly acquired ability to perform the Valsalva or Toynbee maneuver or when the ETDQ-7 score improved by 20% or more.
RESULTS: We included 14 ears in the analysis. After 2, 6, and 12 months, therapy was successful, according to the ETDQ-7, in 11/14 (78.6%; 95% CI: 48.8-94.3), 13/14 (92.9%; 95% CI: 64.2-99.6), and 12/14 (85.7%; 95% CI: 56.2-97.5) ears, respectively. These results were statistically significant. The ETDQ-7 scores also significantly decreased at 2, 6, and 12 months after the BET, when any change was observed. All patients experienced improvement. Only 1 patient reported temporary deterioration after 2 months. Treatment was more frequently successful in patients without nasal polyps or pollinosis.
CONCLUSIONS: Adults with only symptoms of chronic ET dysfunction benefitted more and had longer lasting results from BET, compared to patients with pathologies caused by ET dysfunction. Balloon eustachian tuboplasty could be recommended for these patients.