耳内镜下鼓膜置管术对慢性分泌性中耳炎患者咽鼓管功能和气导听阈的影响

Impacts of otoscopic tympanic membrane catheterization on eustachian tube function and air conduction hearing threshold in patients with chronic secretory otitis media

摘要:

目的 探讨耳内镜下鼓膜置管术对慢性分泌性中耳炎（CSOM）患者咽鼓管功能和气导听阈的影响。方法 回顾性分析2021年6月－2023年6月该院收治的98例CSOM患者的临床资料，按手术方法的不同，分为：鼓膜穿刺组（n = 48，行耳内镜下鼓膜穿刺术）和鼓膜置管组（n = 50，行耳内镜下鼓膜置管术）。于术前和术后6个月，采用七项咽鼓管功能障碍症状评分量表（ETDQ-7）评价患者咽鼓管功能；测定不同频率下气导听阈水平，以评价患者听力情况；观察临床疗效、术后并发症和复发情况。结果 术后6个月，两组患者ETDQ-7评分和3个频率下气导听阈水平明显低于术前，且鼓膜置管组明显低于鼓膜穿刺组，差异均有统计学意义（P < 0.05）；鼓膜置管组总有效率为93.94%，明显高于鼓膜穿刺组的81.54%，差异有统计学意义（P < 0.05）；鼓膜置管组术后并发症总发生率为4.55%，明显低于鼓膜穿刺组的16.92%，差异有统计学意义（P < 0.05）；鼓膜置管组复发率为6.06%，和鼓膜穿刺组的10.77%比较，差异无统计学意义（P > 0.05）。结论 应用耳内镜下鼓膜置管术治疗CSOM，效果较佳，可有效改善患者咽鼓管功能和气导听阈水平，减少术后并发症的发生。值得临床推广应用。

Abstract:

Objective To explore the impacts of otoscopic tympanic membrane catheterization on eustachian tube function and air conduction hearing threshold in patients with chronic secretory otitis media (CSOM).Methods A retrospective analysis was conducted on the data of 98 CSOM patients from June 2021 to June 2023. They were divided into two groups based on different surgical procedures: the tympanic membrane puncture group (n = 48, using otoscopic tympanic membrane puncture) and the tympanic membrane catheterization group (n = 50, using otoscopic tympanic membrane catheterization). The seven-item eustachian tube dysfunction questionnaire (ETDQ-7) was used to evaluate the eustachian tube function before and 6 months after surgery. The level of air conduction hearing threshold was measured at different frequencies and used to evaluate the hearing of each group. The clinical efficacy, the postoperative complications, and recurrence were observed.Results 6 months after surgery, the ETDQ-7 score, and the air conduction hearing threshold level at three frequencies in both groups were lower than those before surgery, and the tympanic membrane catheterization group were lower than the tympanic membrane puncture group, the differences were statistically significant (P < 0.05). The total effective rate of the tympanic membrane catheterization group was higher than that of the tympanic membrane puncture group (93.94% vs 81.54%), the difference was statistically significant (P < 0.05); The incidence of postoperative complications in the tympanic membrane catheterization group was lower than that of the tympanic membrane puncture group (4.55% vs 16.92%), the difference was statistically significant (P < 0.05); There was no significant difference between the recurrence rate of 6.06% in the tympanic membrane catheterization group and 10.77% in the tympanic membrane puncture group (P > 0.05).Conclusion The application of otoscopic tympanic membrane catheterization in CSOM patients has a better effect, which can effectively improve the eustachian tube function and the level of air conduction hearing threshold, and help reduce the occurrence of postoperative complications. It is worthy clinical application.