咽鼓管功能障碍的慢性化脓性中耳炎治疗分析

doi:10.6040/j.issn.1673-3770.0.2018.094

摘要/Abstract

摘要： 目的探讨合并咽鼓管功能障碍的慢性化脓性中耳炎病例的适宜手术方案。方法收集咽鼓管功能障碍的慢性化脓性中耳炎病例68耳,分为观察组(28耳),同期行中耳乳突手术及咽鼓管球囊扩张术,对照组(40耳),仅行中耳乳突手术。术前,术后3个月、6个月、12个月分别以ETDQ-7评分、听阈、气骨导差进行对比。结果观察组术后6~12个月随访气导平均听力改善率为89%(25/28),干耳率93%(26/28)。对照组听力改善率为75%(30/40),干耳率95%(38/40)。观察组术后3~6个月EDDQ-7评分及听阈达到较明显缓解,但术后6~12个月上述指标有加重趋势。观察组及对照组术后听力均比术前听力提高,有统计学差异,两组的术后听力相对比,观察组优于对照组,有统计学意义。结论在咽鼓管功能障碍的慢性化脓性中耳炎患者中,中耳手术同期咽鼓管球囊扩张术较单纯中耳手术的听力改善率高,改善程度高,重新内陷率低,重新粘连率低,干耳率无明显差别。术后3~6个月患者咽鼓管相应症状达到较明显缓解,6~12个月症状有反复。

关键词: 咽鼓管球囊扩张术, 慢性化脓性中耳炎, 咽鼓管功能障碍

Abstract: Objective To investigate the improved techniques for middle ear surgery in patients with chronic suppurative otitis media and eustachian tube dysfunction. Methods A total of 68 ears with chronic suppurative otitis media and eustachian tube dysfunction were analyzed. The observation group included 28 ears and underwent balloon eustachian tuboplasty and middle ear surgery at the same time. The control group included 40 ears and underwent middle ear surgery only. The Eustachian Tube Dysfunction Questionnaire-7(ETDQ-7)scores, auditory thresholds, and air-bone gap before and 3, 6, and 12 months after treatment were compared between the groups. Results The rate of improvement in auditory threshold in the observation group was 89%(25/28)and the frequency of dry ear was 93%(26/28). The rate of improvement in auditory threshold in the control group was 75%(30/40)and the frequency of dry ear was 95%(38/40). From 3 to 6 months after the operation, the observation group was satisfied with the treatment; however, symptoms of eustachian tube dysfunction recurred partially 6 to 12 months after the operation. Conclusion Results from this small sample indicate that middle ear surgery combined with balloon eustachian tuboplasty may be more effective in improving auditory thresholds than middle ear surgery alone. The frequency of dry ear was similar in both groups. Two simultaneous operations may yield good treatment effects in patients with chronic suppurative otitis media 3 to 6 months postoperatively, but symptoms are likely to recur partially 6 to 12 months after the operation.

Key words: Balloon eustachian tuboplasty, Chronic otitis media, Eustachian tube dysfunction

中图分类号:

R764.2

张浩亮,于锋,吴云文. 咽鼓管功能障碍的慢性化脓性中耳炎治疗分析[J]. 山东大学耳鼻喉眼学报, 2019, 33(2): 72-75.

ZHANG Haoliang, YU Feng, WU Yunwen. Analysis of treatment approaches for chronic suppurative otitis media with eustachian tube dysfunction[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(2): 72-75.

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