共查询到19条相似文献，搜索用时 46 毫秒
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咽鼓管功能障碍(Eustachian Tube Dysfunction,ETD)是许多中耳疾病发病的重要因素,可以导致中耳通气不足,引起耳满胀感和耳鸣,此外,还可能引起分泌性中耳炎、鼓膜内陷和胆脂瘤等并发症,但是临床并没有针对ETD检测的金标准.目前对于咽鼓管功能的测量方法 包括:内镜检查、咽鼓管测压(Tubomano... 相似文献
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咽鼓管功能障碍是导致中耳疾病的重要因素之一,临床上对咽鼓管功能障碍的判断方法及治疗方法很多,球囊咽鼓管扩张技术治疗咽鼓管功能障碍是一项简便、微创、疗效好的新方法。 相似文献
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在正常情况下咽鼓管为连接鼓室和咽部的唯一通道,由骨部与软骨部两部分组成。一旦咽鼓管出现功能障碍,无法正常开放,会引起中耳负压。主要表现为耳闷胀感,并伴有不同程度的传导性聋或耳鸣。治疗包括非手术治疗和手术治疗,最常用的手术治疗为鼓膜穿刺及鼓膜置管。咽鼓管球囊扩张是一种新兴的治疗方法,具有简便、安全、微创、有效等优点。 相似文献
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目的探讨合并咽鼓管功能障碍的慢性化脓性中耳炎病例的适宜手术方案。方法收集咽鼓管功能障碍的慢性化脓性中耳炎病例68耳,分为观察组(28耳),同期行中耳乳突手术及咽鼓管球囊扩张术,对照组(40耳),仅行中耳乳突手术。术前,术后3个月、6个月、12个月分别以ETDQ-7评分、听阈、气骨导差进行对比。结果观察组术后6～12个月随访气导平均听力改善率为89%(25/28),干耳率93%(26/28)。对照组听力改善率为75%(30/40),干耳率95%(38/40)。观察组术后3～6个月EDDQ-7评分及听阈达到较明显缓解,但术后6～12个月上述指标有加重趋势。观察组及对照组术后听力均比术前听力提高,有统计学差异,两组的术后听力相对比,观察组优于对照组,有统计学意义。结论在咽鼓管功能障碍的慢性化脓性中耳炎患者中,中耳手术同期咽鼓管球囊扩张术较单纯中耳手术的听力改善率高,改善程度高,重新内陷率低,重新粘连率低,干耳率无明显差别。术后3～6个月患者咽鼓管相应症状达到较明显缓解,6～12个月症状有反复。 相似文献
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中耳变压疗法在咽鼓管功能障碍患者中的应用 总被引：5，自引：1，他引：5
咽鼓管最重要的功能就是保持鼓室内外两侧压力的平衡。咽鼓管功能失调是引起中耳炎症尤其是分泌性中耳炎的重要原因之一。２０００年３月～５月对３０例（３５耳）咽鼓管机能障碍患者应用了中耳变压疗法,取得较好疗效,报告如下。１ 材料与方法１．１ 临床资料 根据临床症状体征及声导抗测试临床诊断为咽鼓管功能障碍患者３０例３５耳,其中男１６例,女１４例;年龄２４～７９岁,平均４５岁;病程５天～２年。鼓室导抗图与临床表现的关系见附表。 按临床症状的程度不同分为以下三度：（１）轻度：有轻度的耳闷塞感,鼓膜轻度内陷,呈淡红… 相似文献
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《中华耳科学杂志》2016,(5)
目的探讨咽鼓管球囊扩张术(balloon eustachian tuboplasty,BET)临床治疗效果。方法对2015年1月至2015年7月间,收治的57例(84耳)诊断为顽固性分泌性中耳炎并行咽鼓管球囊扩张术的患者进行术前,术后1,3,6,9和12月时的咽鼓管功能评分(eustachian tube score,ETS)的对比分析及同期咽鼓管功能问卷(eustachian tube dysfunc-tion questionnaire-7,ETDQ-7)调查,对其术前,术后1,3,6和12月进行得分均值比较。结果 ETS评分术前和术后对比,有统计学意义(P<0.05),术后6个月,ETS评分从术前0.5提高到3.0,术后3月为4.5,术后1月和12月均为5.0,术后的有效率为83.9%;ETDQ-7评分术前和术后对比都显著降低(P<0.05),术后6个月时由术前的4.50±1.07降至2.65±1.24,术后12月时为2.71±1.39,术后1月和3月为2.30±0.92,其中患者的主观有效率为84.3%。结论 BET在顽固性分泌性中耳炎患者治疗中,操作简易,安全有效,有效率大于80%。术后6个月症状改善趋于稳定。ETS评分和ETDQ-7评分方法值得在临床中应用,对于降低咽鼓管功能障碍在中耳手术的术后效果的影响有积极的意义。 相似文献
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《中华耳科学杂志》2016,(5)
目的初步探讨咽鼓管球囊扩张技术(Balloon Eustachian Tuboplasty,BET)在儿童复发性分泌性中耳炎治疗中的效果及安全性。方法 2014年12月-2016年2月就诊于北京儿童医院耳鼻咽喉头颈外科的18例复发性分泌性中耳炎患儿。既往有腺样体切除及1次以上鼓膜置管手术史;经过常规保守治疗3月鼓室积液无法吸收或既往1年内急性中耳炎发作3次以上。术前评估内容包括鼓膜相、纯音听力及声导抗测试、咽鼓管功能评分、鼻咽镜检查、颞骨CT。手术采用经鼻同/对侧咽鼓管球囊置入和/或鼓膜置管术。术后随访6月-18月,随访内容包括听力及鼓膜情况;鼻咽镜及咽鼓管功能评分,数据进行统计分析。结果 16例(28耳)患儿全麻下完成BET,2例(2侧)未能置入咽鼓管球囊;13例同期行鼓膜置管手术。术后听力显著提高(31.04±10.03、20.95±12.80;P<0.001);术后短期(6月内)、长期(6月后)咽鼓管评分显著提高(2.04±2.65、5.33±3.90、6.71±3.45;P<0.05),其中主观症状的改善短期内(6月内)出现,而客观症状的改善术后6月出现,随时间延长更加明显;反复接受置管手术病人术前术后ETS评分分别为1.455±1.969和4.727±3.869。1例患儿鼓膜原置管区穿孔,无大出血、咽鼓管口粘连等严重并发症出现。结论儿童复发性分泌性中耳炎患者术前综合评价必不可少,咽鼓管球囊扩张可以作为儿童复发性分泌性中耳炎的一种治疗选择。 相似文献
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《European annals of otorhinolaryngology, head and neck diseases》2018,135(2):105-110
There is at present no consensus on the treatment of obstructive Eustachian tube dysfunction. In case of failure of well-conducted drug and pressure therapy, some authors recommend balloon dilation; the present study aimed to assess the efficacy and safety of Eustachian tube balloon dilation.Materials and methodsA single-center retrospective study assessed clinical and tubomanometric results of Eustachian tube balloon dilation, complications and satisfaction in a consecutive series managed between June 2012 and February 2015. Indications were based on clinical and paraclinical signs of obstructive tube dysfunction despite well-conducted medical treatment.ResultsForty-five procedures were performed in 38 patients. Improvement in clinical symptoms was assessed as 88%, 80% and 80% at respectively 2 months, 6 months, and > 1 year. Improved function on tubomanometry was observed in 81% of cases. The procedure was well tolerated, with a minor complications rate of only 4%.ConclusionsThe present findings for efficacy, tolerance and safety were comparable to those in the literature, despite first-line failure in all patients. Eustachian tube function normalized in about one-third of cases. Despite these encouraging results, true efficacy remains to be confirmed in prospective studies with higher levels of evidence. 相似文献
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Eustachian tube dysfuntion intends to describe a variety of signs, symptoms, and physical findings that result from the impairment of ET function. A large variety of methods have been employed to assess ET function in the literature. Due to the lack of high level evidence, it is difficult to draw conclusions on the effectiveness of medical and surgical treatments. There are various medical and surgical interventions available for chronic obstructive ET dysfunction including balloon Eustachian tuboplasty (BET) and laser or microdebrider tuboplasty. Consensus on diagnostic criteria for ETD is required to define inclusion criteria of future trials. There is however emerging work with reassuring, but preliminary, results that suggest evidence for safety in the surgical management of ETD. Like many newly introduced techniques the current data remains limited to non-controlled case-series, with heterogeneous data collection methods and lacking substantial long-term outcomes. Nevertheless, short-term data provide favorable results. Current treatment options comprising BET and patulous ET surgery may be offered as a treatment possibility to selected patients. 相似文献
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Juha T. Laakso;Heidi Oehlandt;Ilkka Kivekäs;Teemu Harju;Jussi Jero;Saku T. Sinkkonen; 《The Laryngoscope》2024,134(4):1874-1881
Balloon Eustachian tuboplasty (BET) is used to treat obstructive Eustachian tube dysfunction (OETD) and recurrent otitis media with effusion (OME). However, there are no indisputable evidence of its efficacy. Here, we present a multicenter, double-blinded, randomized, placebo-controlled trial (MDRCT) design to evaluate the efficacy of BET, and the results of a pilot trial with 3- and 12-months' follow-up. 相似文献
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ObjectivesMultiple treatments are described in the literature for the treatment of chronic Eustachian tube dysfunction but high-level quality evidence seems missing to support these treatments. This systematic review aimed to determine and compare the safety and efficacy of Laser Eustachian tuboplasty and Microdebrider Eustachian tuboplasty as a treatment for long-term Eustachian tube dysfunction.Data sourcesA total of 12 electronic databases were searched up to April 2018 for published and unpublished literature in the English language. References of included studies were checked.MethodsA systematic review was undertaken. Outcomes assessed were: primary outcomes-subjective improvement in symptoms (ETDQ-7), audiometric improvement of hearing, improvement of negative middle ear pressure noticed in tympanometry, objective improvement of tympanic membrane retraction. Secondary outcomes were-the ability to auto-insufflate Eustachian tube i.e. Valsalva manoeuvre, improved quality of life, passive tubal opening, tubomanometry, swallowing test, reduction in mucosal inflammation of Eustachian tube orifice in the nose, complications from the procedure, the need for further procedures. Results are reported in a narrative synthesis as a meta-analysis was not possible due to heterogeneous data.ResultsThree studies were included. All included studies were small-scale case series (13–38 participants). Studies were conducted outside the UK. Subjective and objective improvement of Eustachian tube function was reported in all studies. But all included studies were at high risk of bias and subject to multiple limitations. No major complications were reported in either study.ConclusionsBased on current evidence, it is not possible to recommend the clinical use of either of these two interventions i.e. Laser or Microdebrider Eustachian tuboplasty. Lack of controlled studies was identified as a gap in the evidence. Future research should be directed toward designing randomised controlled trials. These trials should use strict standard methodology and reporting criteria. Future trials should make use of consensus statement document about Eustachian tube dysfunction definition, diagnostic methods, and outcome assessment criteria to design clinical trials. 相似文献
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OBJECTIVES/HYPOTHESIS: Surgical correction of eustachian tube dysfunction remains an elusive challenge. Repeat ventilation tube placement is often inadequate to prevent tympanic membrane and middle ear complications. Endoscopic analyses of eustachian tube dynamics have localized the site of primary pathophysiology to within the cartilaginous tube. The study investigated the feasibility, safety, and efficacy of a new endoluminal eustachian tube operation for the treatment of eustachian tube dysfunction. STUDY DESIGN: Prospective, institutional review board-approved surgical trial in a tertiary-care medical center. METHODS: Ten patients with more than 5 consecutive years of intractable otitis media with effusion recurring after two or more tympanostomy tube placements were treated with unilateral laser eustachian tuboplasty. Surgery was performed on an outpatient basis with the use of general anesthesia and combined both transnasal and transoral approaches. A 980-nm diode or argon laser was used to vaporize an appropriate amount of mucosa and cartilage on the posterior wall of the tubal lumen. Preoperative and postoperative dynamic video eustachian tube function analyses were compared. Outcome measures were presence or absence of middle ear effusion and impedance tympanograms. RESULTS: Five patients had at least 12 months of follow-up, and three of them had absence of any effusion (60%). Two patients had recurrence of their otitis media with effusion and required tympanostomy tubes again. Five patients had at least 6 months of follow-up, and four of them had absence of any effusion. The remaining patient had recurrence of otitis media with effusion and received a tympanostomy tube again. Overall results for all 10 patients after 6 months were 7 free of effusion (70%). There were no intraoperative complications. Postoperative complications were limited to minimal peritubal adhesions and one intranasal synechia. CONCLUSIONS: Preliminary results suggest that laser eustachian tuboplasty is safe and efficacious in the treatment of intractable eustachian tube dysfunction. Further study will be necessary to determine whether laser eustachian tuboplasty is a suitable alternative to repeated tympanostomy tube placement in selected patients. 相似文献
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AbstractBackground: Balloon Eustachian Tuboplasty (BET) is used as a second-line treatment in cases in which adenoidectomy, paracentesis, and VT have failed. However, studies have not investigated the efficacy of this procedure as a first-line treatment.Objectives: To evaluate the quality of life in children with chronic Eustachian tube dysfunction (ETD) after BET using the Otitis Media-6 (OM-6) questionnaire.Methods: We retrospectively evaluated the data of 62 children with chronic dysfunction ETD and divided patients into the following groups: 30 cases underwent BET (group 1), and 32 cases underwent ventilation tube (VT) insertion from July 2016 to April 2018. The children’s parents were instructed to complete the OM-6 questionnaire preoperatively and at 6?weeks and 1?year postoperatively.Results:. The average preoperative scores were higher than the postoperative scores, and the average 6-week postoperative scores were higher than the average 1-year postoperative scores for both groups 1 and 2. Further, the average 6-week postoperative scores from patients in group 2 were significantly higher than those in group 1.Conclusion and significance: Our results demonstrate that BET may be a safe, first-line intervention that positively effects the quality of life in children with chronic ETD. 相似文献
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目的评价改良完壁式乳突根治加鼓室成形术同期行咽鼓管球囊扩张治疗中耳胆脂瘤并咽鼓管功能障碍的临床疗效。方法选取中耳胆脂瘤并咽鼓管功能障碍患者共64例,所有患者术前通过正负压平衡试验、鼓室滴药、Valsalva动作难易程度评分均证实为咽鼓管功能障碍。将患者随机分为对照组和观察组,其中对照组36例,观察组28例,对照组改良完壁式乳突根治加鼓室成形术,观察组行改良完壁式乳突根治加鼓室成形术并同期咽鼓管球囊扩张,记录两组术前及术后咽鼓管功能问卷评分（ETDQ 7）、干耳时间、纯音电测听及鼓室导抗图检查结果,比较两组患者的治疗效果。结果所有患者成功接受手术,术后随访6个月至1年,术前ETDQ 7评分、Valsalva测试、正负压平衡试验及纯音电测听（4PTA）对照组和观察组无统计学差异（P>0.05）;术后6个月对照组和观察组ETDQ 7评分、纯音测听（4PTA）阈值均较术前明显降低（P<0.05）;术后6个月对照组和观察组ETDQ 7评分、纯音测听（4PTA）阈值、鼓室导抗图、鼓膜内陷征象及干耳时间两组对比差异有统计学意义(P均<0.05)。结论咽鼓管功能不良是中耳胆脂瘤的一个重要因素,小样本随访发现改良完壁式乳突根治加鼓室成形术同期咽鼓管球囊扩张治疗中耳胆脂瘤并咽鼓管功能障碍的短期效果良好,但其远期疗效有待对更大样本进一步观察。 相似文献
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Facial nerve baroparesis is a rare complication of middle ear barotrauma reported almost exclusively in overpressure events related to diving and flying. Until the development of Eustachian tube balloon dilation, no diving compatible options existed to effectively and safely prevent recurrence. We present a case of a U.S. Navy diver with a history of repeated ipsilateral facial nerve paresis that occurred during diving. The patient underwent Eustachian tube balloon dilation of the affected side. Following surgery, the patient completed a recompression chamber simulated dive that allowed the patient to return to diving. The patient has been symptom‐free for 12 months following dilation. Laryngoscope, 129:E412–E414, 2019 相似文献
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《Acta otorrinolaringologica espanola》2020,71(3):181-189
ObjectiveThere is a great variability in diagnosis of obstructive Eustachian tube dysfunction and its treatment by balloon Eustachian tuboplasty (BET). The aim of this paper was to present a consensus on indications, contraindications, methodology, complications and results after BET.Material and methodsWe obtained a consensus on BET, after a systematic review of the literature on BET from 1966 to November 2018, using MESH terms «Eustachian tube and (dilation or dysfunction)», including a total of 1.943 papers in Spanish, English, German and French. We selected 139 papers with a relevant abstract, including two international consensuses, seven systematic revisions, and two randomised control trials on BET.ResultsThe indications for BET are barotrauma, serous otitis media, adhesive otitis, atelectatic middle ear and failure after tympanoplasty, once obstructive Eustachian tube dysfunction is confirmed. BET is more effective in barotrauma and serous otitis media. There are high- evidence reports on BET showing good results that persist long-term, as compared to conservative medical treatment.ConclusionsBET is a surgical, minimally invasive treatment that has shown its effectiveness and safety in obstructive Eustachian tube dysfunction in adults and children. It is most effective in barotrauma and serous otitis media. 相似文献
