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摘要: 咽鼓管异常开放症(patulous Eustachian tube，PET)的患者因咽鼓管的过度开放常出现随呼吸一致的耳鸣、自听增强、耳胀满感等症状，严重影响生活质量，临床缺乏有效统一的治疗策略。本文将近年来PET的治疗方式、手术操作要点、术式优缺点等进展进行总结，建议在充分沟通评估下，明确合适期望值后，以保留正常的咽鼓管功能和实现良好的中耳通气为目标，开展包括保守治疗、鼓膜手术、咽鼓管咽口缩窄手术、咽鼓管鼓室口堵塞手术及咽鼓管肌肉手术“阶梯式”的治疗策略。Abstract: Patients with patulous Eustachian tubes(PET) usually suffer from annoying symptoms, such as tinnitus, autophony and aural fullness, due to the excessive opening of the Eustachian tube. There is no uniform standard of treatment, and conservative therapy combined with"Step-up"surgical intervention strategy is the main treatment. In this article, we reviewed various surgical treatments of patulous Eustachian tube in recent years, including key points of surgical operation, effectiveness, safety and complications. Full communication and evaluation are needed to establish appropriate patients' expectations preoperatively. A "Step-up" treatment strategy will be carried out, including conservative treatment, tympanic membrane surgery, Eustachian tube pharyngeal orifice constriction surgery, Eustachian tube tympanic orifice plug surgery and Eustachian tube muscle surgery, which aims to maintain normal Eustachian tube function and good middle ear ventilation.
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Key words:
- Eustachian tube /
- patulous Eustachian tube /
- surgical treatment
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