咽鼓管球囊扩张术治疗难治性分泌性中耳炎的策略和疗效分析.pdfVIP

Chinese Journal of Otology Vo1.14,No.5 , 2016 ·591 · ·咽 鼓 管 专 辑 · 咽鼓管球囊扩张术治疗难治性分泌性 中耳炎的策略和疗效分析 刘月红 庄惠文 吴旋 熊观霞 中山大学附属第一医院耳鼻咽喉科医院//耳鼻咽喉科研究所（广州 510080 ） 【摘要】目的探讨咽鼓管球囊扩张术（balloon eustachian tuboplasty ，BET）在难治性分泌性中耳炎中的治疗效果以 及其围手术期的处理策略。方法收集难治性分泌性中耳炎患者20 例（25 耳）。同期行BET 并鼓膜切开置管术（2 例前 期行鼓膜穿刺术）。随访3 个月以上。记录手术前后咽鼓管功能问卷评分（ETDQ-7 ）、鼻内镜、纯音测听、鼓室图及Val⁃ salva 动作下颞骨CT 检查情况。结果2 耳前期行BET 并鼓膜穿刺者，术后4 周内均复发；23 耳同期行BET 并鼓膜切开 置管术者，术后3 个月ETDQ-7 评分、纯音测听（4PTA ）阈值均较术前明显降低（P0.05 ）；颞骨CT 提示乳突及鼓室内软 组织影均消失或不到术前的5%。12耳在BET 术后3 个月拔管，其中6 耳恢复正常，另6 耳在拔管后8 周内复发，予重新 切开置管。结论BET 联合鼓膜切开置管治疗难治性分泌性中耳炎能获得良好的短期疗效。坚持规律的Valsalva 锻炼 以及3 个月以上时间的鼓膜置管才能保证长期效果。 【关键词】咽鼓管球囊扩张术；难治性分泌性中耳炎；咽鼓管功能障碍；鼓膜切开置管 【中图分类号】R764.29 【文献标识码】A 【文章编号】1672-2922 （2016 ）05-591-5 Balloon eustachian tuboplasty for refractory secretory otitis media LIUYuehong,ZHUANGHuiwen,WUXuan,XIONGGuanxia 1OtorhinolaryngologyHospitalandInstituteoftheFirstAffiliatedHospitalofSunYat-senUniversity, Guangzhou510080,China Correspondingauthor：XIONGGuanxia Email:xgx001@163.com 【Abstract 】Objective To study the efficacy of balloon eustachian tuboplasty (BET) in treating refractory secretory oti- tis media as well as treatment strategies. Method Twenty cases (25 ears) of refractory secretory otitis media were included. All cases underwent myringotomy and grommet insertion combined with BET (early auripuncture were performed in 2 cas- es). All cases were followed for 3 months or more. The eustachian tube dysfunction questionnaire (ETDQ-7), endoscopy, pure-tone audiometry (PTA), tympanograms and temporal CT data were collected before and after treatment. Res