耳内镜下经鼓室口行咽鼓管球囊扩张治疗伴有慢性化脓性中耳炎的延迟开放型咽鼓管功能障碍的临床研究

Clinical study of eustachian tube balloon dilatation through tympanic orifice under otoscope in the treatment of delayed open eustachian tube dysfunction with chronic suppurative otitis media

摘要:

目的 对伴有慢性化脓性中耳炎的延迟开放型咽鼓管功能障碍（ETD）患者，在实施中耳乳突手术的基础上联合行耳内镜下咽鼓管鼓室口球囊扩张术，以探讨耳内镜下治疗的有效性。方法 选取2016年2月－2021年2月来该院就诊的伴有慢性化脓性中耳炎的延迟开放型ETD患者50例，按随机分配原则分为观察组和对照组，各25例。观察组采用中耳乳突手术联合耳内镜下咽鼓管鼓室口球囊扩张术，对照组采用中耳乳突手术联合鼻内镜下咽鼓管咽口球囊扩张术。比较两组患者术前及术后1年咽鼓管功能障碍评分（ETDQ-7）及术后复发率。结果 两组患者组内术前与术后1年ETDQ-7评分比较，差异有统计学意义（P < 0.05）。观察组术后乳突腔引流通畅，未出现脓性渗出液。观察组术后1年复发率明显低于对照组，两组患者比较，差异有统计学意义（P < 0.05）。结论 对伴有慢性化脓性中耳炎的延迟开放型ETD患者，在实施中耳乳突手术的基础上，行耳内镜下咽鼓管鼓室口球囊扩张术，较行鼻内镜下咽鼓管咽口球囊扩张术更加安全，且术后复发率低，效果更好。故在可能的情况下，对伴有慢性化脓性中耳炎的延迟开放型ETD患者行中耳乳突手术联合耳内镜下咽鼓管鼓室口球囊扩张术，临床效果好，值得推广应用。

Abstract:

Objective For patients with delayed open eustachian tube dysfunction (ETD) with chronic suppurative otitis media, on the basis of middle ear mastoid surgery, combined with otoendoscopic eustachian tube tympanic orifice balloon dilatation, to explore the effectiveness of otoendoscopic treatment.Methods 50 patients with delayed open ETD with chronic suppurative otitis media who came to the hospital from February 2016 to February 2021 were randomly divided into observation group and control group, with 25 cases in each group. The observation group was treated with middle ear mastoid surgery combined with endoscopic eustachian tube tympanic balloon dilatation; The control group was treated with middle ear mastoid surgery combined with nasal endoscopic eustachian tube pharyngeal balloon dilatation. The scores of the seven-item eustachian tube dysfunction questionnaire (ETDQ-7) were compared between the two groups before operation and one year after operation; The recurrence rates of chronic suppurative otitis media and delayed open ETD were compared.Results The ETDQ-7 score was statistically significantly in the two groups before and 1 year after surgery (P < 0.05); The drainage of mastoid cavity was unobstructed and there was no purulent exudate after operation in the observation group; One year after operation, the recurrence rates in the observation group were significantly lower than those in the control group (P < 0.05).Conclusion For patients with delayed open ETD with chronic suppurative otitis media, on the basis of middle ear mastoid surgery, combined with otoendoscopic eustachian tube tympanic balloon dilatation can increase safety factor, have lower postoperative recurrence rate and better postoperative effect than nasal endoscopic eustachian tube tympanic balloon dilatation. Therefore, if possible, middle ear mastoid surgery combined with otoendoscopic eustachian tube tympanic balloon dilatation in patients with delayed open ETD with chronic suppurative otitis media is a treatment method, which is worthy of popularization.