05咽鼓管球囊扩张术的在咽鼓管相关疾病的应用.doc

咽鼓管球囊扩张术在咽鼓管相关疾病的应用 梁茂金，郑亿庆，张志钢，许耀东，区永康，陈穗俊，杨海弟，司瑜，陈玲，邱泽恒 通讯作者：郑亿庆，email：yiqingzheng@ [摘要]目的：探讨咽鼓管球囊扩张术在咽鼓管相关疾病中的治疗效果及其适应症。方法：连续收集咽鼓管相关疾病患者46例（74耳），男25例，女21例，年龄18岁~70岁；其中症状性咽鼓管功能不良22例，分泌性中耳炎15例，鼓膜膨胀不全4例，上鼓室内陷袋2例，梅尼埃病3例。所有患者术前咽鼓管测压均证实咽鼓管阻塞性功能不良，并行咽鼓管球囊扩张术。用视觉评分量表（VAS评分）对耳闷塞感、听物朦胧感、耳内水泡声、耳鸣等进行主观症状评估，记录术前，术后1周、1个月及3个月评分情况。结果：术前、术后1周耳闷塞感、听物朦胧感VAS评分：8.2±1.4 vs. 2.0±1.2，6.2±1.2 vs.3.1±0.8,耳闷塞感、听物朦胧感评分显著降低（P0.05）；术后1月，症状耳闷塞感、听物朦胧感症状持续消失，术后3个月，症状无反复。结论：咽鼓管球囊扩张术对阻塞性咽鼓管不良及咽鼓管相关的中耳疾病短期治疗效果良好，长期治疗效果有待观察，可能为解决咽鼓管相关疾病提供一个新的途径。 关键词：咽鼓管球囊扩张术，咽鼓管功能不良，分泌性中耳炎，膨胀不全，内陷袋 Eustachian tube balloon dilation(balloon dilation eustachian tuboplasty) in eustachian tube related diseases [Abstract] Objective: to examine the effect of Eustachian tube balloon dilation (ETBD) in treatment of eustachian tube related diseases and investigate the indications for ETBD. Methods: forty six patients (74 ears) of Eustachian tube dysfunction were recruited, 25 male and 21 female, age from 18 to 70 years old. Of which, 22 were diagnose of symptomatic Eustachian tube dysfunction，15 for otitis media with effusion, 4 for tympanic atelectasis, 2 for attic retraction pocket, and another 3 were Menieres disease. Technique of tubomanometry (TMM) showed obstructive Eustachian tube dysfunction in all patients. All the patients were received ETBD and followed up with VAS evaluation of ear fullness, muffled hearing, poping sound in the ear and tinnitus. Results: ear fullness, muffled hearing released with one week (ear fullness：8.2±1.4 vs. 2.0±1.2，P0.05, muffled hearing：6.2±1.2 vs.3.1±0.8, P0.05）. No recurrence was seemed within one month. Poping sound in the ear and tinnitus were slight increase within one week, but released in one month post the operation. On one month post the operation, effusion disappeared in all 15 otitis media with effusion, 3 tympanic atelectasis recovered and 1 turned better. TMM retest showed all the Eustachian tube can be opened with swallow. Conclusions: ETBD have good short-term effect