目的:目前尚无诊断咽鼓管(ET)功能障碍的金标准。为ET功能障碍的临床诊断提供客观依据。我们探索了超声管法的特点,阻抗tubo-tympano-aerography(TTAG),和健康ET志愿者的血管造影(TMM)。
方法:超声管法,阻抗TTAG,在55名志愿者的110只健康耳朵中进行了TMM测试,并对各项ET试验的特点进行了比较和讨论。
结果:比较超声管法与干吞咽法之间的ET开口率,Valsalva动作的阻抗,TTAG与瓦尔萨尔瓦演习,和鼻咽压力为50毫巴的TMM在100(90.9%),102(92.7%),99(90.0%),和104只(94.5%)耳朵,4种方法间差异无统计学意义(P=0.575)。在超声管法中,在检测ET开度方面,干吞咽和Valsalva动作均优于湿吞咽(P=0.000)。在TMM中,开口率和外耳道压力均与鼻咽部压力呈正相关。具体来说,随着鼻咽压力的增加,开口率和外耳道压力增加(r=0.271,P=0.000;r=0.315,P=0.000)。
结论:超声管法,阻抗TTAG,和TMM各有优缺点。在临床实践中,应根据患者的具体情况选择适当的ET功能测试。
OBJECTIVE: There is currently no gold standard for the diagnosis of eustachian tube (ET) dysfunction. To provide an objective basis for the clinical diagnosis of ET dysfunction, we explored the characteristics of sonotubometry, impedance, tubo-tympano-aerography (TTAG), and tubomanometry (TMM) in volunteers with healthy ETs.
METHODS: Sonotubometry, impedance, TTAG, and TMM tests were performed in 110 healthy ears of 55 volunteers, and the characteristics of each ET test were compared and discussed.
RESULTS: The ET opening rate was compared between sonotubometry with dry swallowing, impedance with the Valsalva maneuver, TTAG with the Valsalva maneuver, and TMM with a nasopharyngeal pressure of 50 mbar in 100 (90.9%), 102 (92.7%), 99 (90.0%), and 104 (94.5%) ears, respectively; there was no significant difference among the four methods (P = 0.575). In sonotubometry, both dry swallowing and the Valsalva maneuver were superior to wet swallowing in terms of detecting ET opening (P = 0.000). In TMM, both the opening rate and the external auditory canal pressure were positively correlated with the nasopharyngeal pressure. Specifically, the opening rate and external auditory canal pressure increased with an increase in the nasopharyngeal pressure (r = 0.271, P = 0.000; r = 0.315, P = 0.000, respectively).
CONCLUSIONS: Sonotubometry, impedance, TTAG, and TMM have their own advantages and disadvantages. In clinical practice, the appropriate ET function test should be chosen on the basis of the patient\'s specific condition.