The effect of different degrees of Eustachian tube dysfunction on hearing threshold in patients with acquired primary middle ear cholesteatoma after balloon eustachian tuboplasty
-
摘要: 目的 探讨咽鼓管功能障碍程度不同的后天原发性中耳胆脂瘤患者行咽鼓管球囊扩张术后的听力变化情况。方法 回顾性分析2020年11月至2022年4月行开放式乳突切开+鼓室成形+咽鼓管球囊扩张术的后天原发性中耳胆脂瘤伴咽鼓管功能障碍患者40例，术前咽鼓管评分为0~2分者为低分组，3~5分者为高分组。分别于术前、术后1、3、6及12个月测量患者纯音听阈，计算250~4 000 Hz骨导听阈、气导听阈平均值，并计算气骨导差。通过SPSS 25.0进行统计学分析，以P < 0.05表示差异有统计学意义。结果 低分组术后3个月时的气导听阈和气骨导差较术前降低(P < 0.05)，术后6个月的气骨导差较术前降低(P < 0.05)。高分组术后3、6和12个月的气导听阈和气骨导差较术前降低(P < 0.05)。结论 后天原发性中耳胆脂瘤伴咽鼓管功能障碍患者行咽鼓管球囊扩张治疗后，气导听阈和气骨导差较术前明显改善，咽鼓管功能障碍程度较轻的患者听力改善维持时间更持久。Abstract: Objective To investigate the changes in hearing threshold of the acquired primary cholesteatoma of the middle ear with different degrees of eustachian tube dysfunction after balloon eustachian tuboplasty.Methods This retrospective study included forty cases with middle ear cholesteatoma and eustachian tube dysfunction who underwent open mastoidectomy + tympanoplasty + balloon eustachian tuboplasty were enrolled. All patients were admitted from November 2020 to April 2022. The preoperative eustachian tube score of 0-2 were defined as the lower group, and the scores of 3-5 were defined as the higher group. Pure tone audiometry was measured preoperatively and 1, 3, 6 and 12 months postoperatively. The average value of bone conduction threshold and air conduction threshold of 250-4 000 Hz were calculated, and the air-bone gap was calculated simultaneously. SPSS 25.0 was used for statistical analysis. P < 0.05 was considered statistically significant.Results In the lower group, the air conduction threshold and air-bone gap at 3 months postoperatively were significantly decreased in comparison with those preoperatively(P < 0.05), as was the air-bone gap at 6 months postoperatively(P < 0.05). In the higher group, the air conduction threshold and air-bone gap were significantly decreased at 3, 6 and 12 months postoperatively(P < 0.05).Conclusion The air conduction threshold and air-bone gap of patients with the acquired primary cholesteatoma of the middle ear and eustachian tube dysfunction were significantly decreased after eustachian tube balloon dilatation. Hearing improvement lasted longer in patients with slight eustachian tube dysfunction.
-
-
表 1 2组患者术前基本情况比较
项目 低分组(n=18) 高分组(n=22) t/χ2 P 年龄/岁 52.28±10.47 49.59±17.01 0.585 0.562 性别/例(男︰女) 8︰10 12︰10 0.404 0.525 侧别/例(右︰左) 9︰9 11︰11 < 0.001 1.000 骨导听阈 32.89±16.72 29.14±12.78 0.803 0.427 气导听阈 69.44±17.64 62.05±18.09 1.301 0.201 气骨导差 36.56±6.29 32.91±1.80 1.266 0.213 
下载: 导出CSV
表 2 2组患者术后不同时间纯音听阈结果
X±S 时间 低分组 高分组 骨导听阈 气导听阈 气骨导差 骨导听阈 气导听阈 气骨导差 术后1个月 37.31±12.66 69.46±17.81 32.15±8.89 25.10±13.18 52.80±21.22 27.70±12.44 术后3个月 29.44±15.02 52.33±20.91 22.89±9.28 26.75±12.25 49.08±16.26 22.33±9.98 术后6个月 29.40±13.73 58.30±22.11 28.90±10.97 22.01±14.72 44.27±21.15 22.27±10.36 术后12个月 27.43±17.28 61.43±24.93 34.00±11.46 20.00±8.03 41.80±14.55 21.80±13.27
下载: 导出CSV
-
[1] Ockermann T, Reineke U, Upile T, et al. Balloon dilatation eustachian tuboplasty: a clinical study[J]. Laryngoscope, 2010, 120(7): 1411-1416. doi: 10.1002/lary.20950
[2] Ockermann T, Reineke U, Upile T, et al. Balloon dilation eustachian tuboplasty: a feasibility study[J]. Otol Neurotol Off Publ Am Otol Soc Am Neurotol Soc Eur Acad Otol Neurotol, 2010, 31(7): 1100-1103. doi: 10.1097/MAO.0b013e3181e8cc6d
[3] 戴嵩, 李洪波, 侯乐. 一种咽鼓管功能障碍治疗新方法(附1例报告)[J]. 中华耳科学杂志, 2014, 12(2): 343-344. https://www.cnki.com.cn/Article/CJFDTOTAL-ZHER201402044.htm
[4] Choi SW, Oh SJ, Kim Y, et al. A multicenter, randomized, active-controlled, clinical trial study to evaluate the efficacy and safety of navigation guided balloon Eustachian tuboplasty[J]. Sci Rep, 2021, 11(1): 23296. doi: 10.1038/s41598-021-02848-1
[5] Oehlandt H, Laakso J, Lindfors O, et al. Efficacy of balloon tuboplasty for baro-challenge-induced eustachian tube dysfunction: a systematic review and a retrospective cohort study of 39 patients[J]. Otol Neurotol, 2022, 43(6): 611-618. doi: 10.1097/MAO.0000000000003558
[6] 李秋焕, 姜子刚, 田晓斌, 等. 成人慢性复发性分泌性中耳炎采用咽鼓管球囊扩张联合鼓膜切开置管术的疗效观察[J]. 临床耳鼻咽喉头颈外科杂志, 2021, 35(12): 1073-1077, 1084. https://lceh.whuhzzs.com/article/doi/10.13201/j.issn.2096-7993.2021.12.004
[7] 许政敏, 沈翎, 刘大波, 等. 咽鼓管球囊扩张术在儿童分泌性中耳炎治疗中的应用[J]. 临床耳鼻咽喉头颈外科杂志, 2022, 36(4): 243-246. https://lceh.whuhzzs.com/article/doi/10.13201/j.issn.2096-7993.2022.04.001
[8] Demir B, Batman C. Efficacy of balloon Eustachian tuboplasty as a first line treatment for otitis media with effusion in children[J]. J Laryngol Otol, 2020: 1-4.
[9] Kivekäs I, Chao WC, Faquin W, et al. Histopathology of balloon-dilation Eustachian tuboplasty[J]. Laryngoscope, 2015, 125(2): 436-441. doi: 10.1002/lary.24894
[10] Tisch M, Maier H, Sudhoff H. Balloon dilation of the Eustachian tube: clinical experience in the management of 126 children[J]. Acta Otorhinolaryngol Ital, 2017, 37(6): 509-512. doi: 10.14639/0392-100X-1690
[11] Smith ME, Weir AE, Prior DCC, et al. The mechanism of balloon Eustachian tuboplasty: a biomechanical study[J]. Med Biol Eng Comput, 2020, 58(4): 689-699. doi: 10.1007/s11517-020-02121-z
[12] 龚辉成, 于锋, 焦粤龙, 等. 中耳胆脂瘤手术同期行咽鼓管球囊扩张的临床观察[J]. 中国耳鼻咽喉颅底外科杂志, 2019, 25(3): 285-288, 292. https://www.cnki.com.cn/Article/CJFDTOTAL-ZEBY201903014.htm
[13] 陈金灿, 徐继峰, 李巍. 改良乳突根治术联合咽鼓管球囊扩张术在中耳胆脂瘤并咽鼓管功能障碍患者中的应用[J]. 局解手术学杂志, 2021, 30(2): 156-160. https://www.cnki.com.cn/Article/CJFDTOTAL-JJXZ202102014.htm
[14] Hsieh CY, Chang CJ, Sun CH, et al. Tympanoplasty with or without balloon eustachian tuboplasty for chronic suppurative otitis media with obstructive eustachian tube dysfunction[J]. Otol Neurotol, 2020, 41(8): 1077-1083. doi: 10.1097/MAO.0000000000002730
[15] 曾镇罡, 高一铭, 孙佳玉, 等. I型鼓室成形术中咽鼓管功能的评估及其对疗效的影响[J]. 中华耳科学杂志, 2021, 19(1): 61-65. https://www.cnki.com.cn/Article/CJFDTOTAL-ZHER202101012.htm
[16] Kaderbay A, Karkas A, Schmitt D, et al. Balloon dilation for persistent unilateral chronic obstructive Eustachian tube dysfunction is effective: a prospective multicentre study[J]. Eur Arch Otorhinolaryngol, 2023, 280(3): 1101-1109. doi: 10.1007/s00405-022-07578-2
[17] 方玲, 刘泓毅, 苏晓磊, 等. 分泌性中耳炎伴有咽鼓管功能障碍行球囊扩张治疗的中长期疗效分析[J]. 中华耳科学杂志, 2023, 21(1): 41-46. https://www.cnki.com.cn/Article/CJFDTOTAL-ZHER202301008.htm
[18] 中华耳鼻咽喉头颈外科杂志编辑委员会, 中华医学会耳鼻咽喉头颈外科学分会. 咽鼓管功能障碍专家共识[J]. 中华耳鼻咽喉头颈外科杂志, 2018, 53(6): 406-409.
[19] 杨亚利, 王士杰, 韩曙光, 等. 声导抗及咽鼓管评分在咽鼓管功能测试中的相关性研究[J]. 临床耳鼻咽喉头颈外科杂志, 2022, 36(8): 587-591. https://lceh.whuhzzs.com/article/doi/10.13201/j.issn.2096-7993.2022.08.004
[20] 邱泽恒, 王培, 黄秋红, 等. 咽鼓管测压对儿童分泌性中耳炎疗效评估的价值[J]. 听力学及言语疾病杂志, 2017, 25(6): 600-602. https://www.cnki.com.cn/Article/CJFDTOTAL-TLXJ201706014.htm
[21] Smith ME, Zou CC, Baker C, et al. The repeatability of tests of eustachian tube function in healthy ears[J]. Laryngoscope, 2017, 127(11): 2619-2626. doi: 10.1002/lary.26534
[22] Oehlandt H, Lindfors O, Sinkkonen ST. Tubomanometry correlations with patient characteristics and other diagnostic tests of Eustachian tube dysfunction: a cohort study of 432 ears[J]. Eur Arch Otorhinolaryngol, 2022, 279(11): 5153-5160. doi: 10.1007/s00405-022-07358-y
-
计量
- 文章访问数: 306
- 施引文献: 0