06咽鼓管球囊扩张术文献摘要

咽鼓管球囊导管扩张术：基础研究
Catalano PJ, Jonnalagadda S, Yu VM. 美国
Otol Neurotol. 2021 Dec;33(9):1549-52.
Abstract
OBJECTIVE:
Eustachian tube dysfunction is a common problem and transnasal endoscopic balloon dilation of the Eustachian tube (ET) is a new surgical technique. The goal of this study is to review the evolution of this novel technique and study the preliminary outcomes.
SUBJECTS AND METHODS:
Balloon catheter dilation of the 100 Eustachian tubes in 70 adults was performed at a tertiary medical center from January 2020 to January 2020.
A 5-mm sinus balloon catheter was endoscopically placed transnasally into the proximal ET to dilate the cartilaginous ET. Cases were reviewed with respect to indications, outcomes, and complications.
RESULTS:
Of the 100 ETs, ear fullness and pressure were improved in 71% of patients studied for weeks (± . Of 8 patients followed for a minimum of 34 months, 87% reported persistent improvement. One complication is reported. CONCLUSION:
Endoscopic transnasal ET balloon dilation is a novel approach to treating ET dysfunction. Benefits can be durable up to 3 years. This technique holds much promise and merits further investigation.
摘要
目的：
咽鼓管功能不良是常见病，经鼻内镜球囊扩张咽鼓管是一个新兴外科技术。

本次目的在于回忆性调查和对初步疗效进行研究。

材料与方式：
2020年1月至2020年1月，70个成年人，100个咽鼓管行球囊扩张术。

5mm球囊导管在内镜辅助，经鼻置入咽鼓管近端扩张咽鼓管的软骨部份。

病例回忆包括适应症、疗效和并发症。

结果：
100个咽鼓管中，整体随访时刻周（±），70%的耳胀满和压力病症改善，8例患者随访时刻达到34个月，87%病症持续改善，并发症显现1例。

结论：
内镜经鼻咽鼓管扩张术是医治咽鼓管功能不良的新技术。

疗效可持续三年。

此技术为后续的进一步研究奠定了良好的基础。

咽鼓管球囊扩张术
McCoul ED, Anand VK. 美国
Int Forum Allergy Rhinol. 2021 May-Jun;2(3):191-8.
Abstract
BACKGROUND:
Eustachian tube dysfunction (ETD) is a common condition without an effective, accepted treatment. Balloon dilation Eustachiantuboplasty (BDET) has been recently proposed for the management of ETD. Previous studies of Eustachian tube function and treatment have not included a validated assessment of patient symptoms. We report for the first time the outcomes of BDET using a validated disease-specific symptom score, the 7-item Eustachian Tube Dysfunction Questionnaire (ETDQ-7). METHODS:
Consecutive patients undergoing BDET were prospectively enrolled from an
otolaryngology practice at a tertiary care medical center. Inclusion criteria were adults with a diagnosis of ETD based on symptoms and abnormal tympanogram. Patients with craniofacial abnormalities or active infection were excluded from study. Primary outcome measures included the ETDQ-7 score, tympanometry, and otoscopic appearance. Secondary measures included the 22-item Sinonasal Outcome Test (SNOT-22) score. RESULTS:
Twenty-two consecutive patients underwent 35 BDET procedures. Significant postoperative improvement was seen in tympanometry and otoscopic appearance (p < . ETDQ-7 scores at 3 weeks, 6 weeks, 12 weeks, and 6 months postoperatively were significantly improved over baseline (p < . ETDQ-7 scores showed fair correlation with SNOT-22 scores (r > . ETDQ-7 change scores demonstrated good responsiveness and sensitivity to clinical change following BDET.
CONCLUSION:
BDET is an effective surgical intervention for the treatment of ETD in adults. Postoperative improvements were observed using objective and subjective measures. The ETDQ-7 is a valid, disease-specific instrument for the assessment of treatment outcomes and may be applied for clinical use in patients with ETD. Further study is necessary to determine long-term effectiveness.
摘要
背景：
咽鼓管功能不良是一种常见，且无有效治疗的病症。

咽鼓管球囊扩张术近期已经成为一种推荐的治疗方法。

以往的研究没有包含可靠的病症评估。

本文首次报告应用评分的疗效，7项咽鼓管功能不良调查问卷。

方式：
同意咽鼓管球囊扩张术的患者在第三医疗中心入组，入组方案为成年人，依据病
症和异样鼓室导抗图，诊断为咽鼓管功能不良。

排除标准为颅面异样，或活动性感染。

最初疗效判定法包括7项咽鼓管功能不良量表，鼓室测压和耳镜检查表现，次要判定包括22项鼻鼻窦结局检查评分（SNOT-22）。

结果：
22位患者序贯同意球囊扩张医治，共35个咽鼓管。

鼓室测压和耳镜检查术后可见明显改善（P< ETDQ-7评分在术后3周、6周、12周和6个月时，均显著高于基线水平（P<）,ETDQ-7与SNOT-22量表具有相当的相关性（R>），ETDQ-7评分显示了术后随临床转变评分的响应性和灵敏性。

结论：
咽鼓管球囊扩张术是医治成年人咽鼓管功能不良的有效的外科手腕。

术后观看到明显的主观和客观转变。

ETDQ-7评分是一种靠得住的术后疗效评估工具，可用于咽鼓管功能不良的患者疗效评估。

但长期疗效需要进一步研究。

咽鼓管软骨部球囊扩张
Poe DS, Silvola J, Pyykkö I.芬兰
Otolaryngol Head Neck Surg. 2020 Apr;144(4):563-9.
Abstract
OBJECTIVES:
(1)To translate techniques developed in a previous cadaver study of balloon dilation of the cartilaginous eustachian tube (ET) into clinical treatment for refractory dilatory dysfunction and (2) to study the safety/efficacy of the technique in a pilot clinical trial. STUDY DESIGN:
Prospective with subjects as their own historical controls since June 2020.
SETTING:
Regional academic center.
SUBJECTS AND METHODS:
Eleven consecutive adult patients with longstanding otitis media with effusion (OME) who were unable to autoinsufflate their ET by Valsalva, swallow, or yawn and who had previous tympanostomies (average, . At the time of intervention, 5 of 11 had a tube; 2 of 11 had a tympanic membrane (TM) perforation. Four of 11 had intact TMs, 2 with OME and tympanogram type B and 2 with TM retraction and tympanogram types B and C. Balloon dilation of the cartilaginous ET was performed with sinus dilation instruments via transnasal endoscopic approach under general anesthesia in a day surgery setting. Inflation was to a maximum of 12 atm for 1 minute. Outcome measures: ability to Valsalva, rating of ET mucosal inflammation, tympanogram, and otomicroscopy findings.
RESULTS:
All cases successfully dilated. Eleven of 11 could self-insufflate by Valsalva (P < .001); tympanograms were A (4/11), C (1/11), or open (6/11). All atelectases resolved. Procedures were well tolerated, without pain or complications related to dilation. CONCLUSION:
Dilation of the cartilaginous ET appeared to be beneficial and without significant adverse effects in the treatment of ET dilatory dysfunction. Larger controlled trials with long-term results are now justified and needed.
目的：
将咽鼓管软骨部球囊扩张术从尸身模型研究转化为临床医治方式，用于医治难治性迁延性功能不良。

研究此种方式的平安性和有效性。

研究设计：
前瞻性研究，患者自身前后对照，时刻自2020年起
场所：
区域研究中心
材料与方式
11例渗出性中耳炎患者，瓦氏动作、吞咽动作均不能自动开放咽鼓管，以往同意鼓膜造口术（平均年龄岁），5名患者一侧咽鼓管病变，2名患者一侧鼓膜穿孔，4名患者咽鼓管无活动，2名患者渗出性中耳炎和鼓室导抗B型，2名患者鼓膜
回缩鼓室导抗B型和C型。

球囊扩张手术为全麻下日间手术，经鼻内镜辅助，经鼻入路实施，球囊充胀压力12atm，持续时刻1m。

结局判定，瓦氏动作咽鼓管开放能力，粘膜炎症评估，鼓室导抗和耳镜检查。

结果：
全数病例成功扩张，11例患者瓦氏实验均能开放咽鼓管（P<）4/11鼓室导抗A 型，1/11鼓室导抗C型，6/11例患者开放。

全数患者鼓膜萎陷取得解除。

操作无痛楚，未发觉与扩张有关的任何并发症。

结论：
咽鼓管软骨部球囊扩张平安有效，无明显不良事件。

进一步研究需要大规模对照，并统计长期疗效。

4.[ Balloon Dilatation Eustachian Tuboplasty:A Clinical Study.]
球囊扩张咽鼓管成形术-临床研究
全文翻译
应用球囊导管行咽鼓管扩张术：320例临床介入体会
Tisch M, Maier S, Maier H.
HNO. 2021 Jun;61(6):483-7. doi: s006. German.德国
Abstract
Balloon dilation has become established as a novel method for managing chronic ventilatory dysfunction of the Eustachian tube. In the present study the role of this method was assessed in a population of adult patients with ventilatory dysfunction of the Eustachian tube which did not respond to other treatment. The presence of a space-occupying lesion was ruled out. Clinical symptoms improved in 70 % of the patients after balloon dilationand none of the patients reported deterioration of symptoms. Balloon dilation is a rapid, simple and safe method and is
currently used in particular for treating patients with ventilatory dysfunction of the Eustachian tube which does not respond to other treatment. Further studies, ideally multicentre studies are required in order to optimize the definition of existing and potential new indications for this treatment approach.
摘要：
医治慢性咽鼓管通气性功能不良，球囊导管扩张已经成为一种新的方式。

本次研究为评判此种医治方式在患有咽鼓管通气功能不良的成人中普遍利用，再也不依托其他医治的临床价值。

患者除外占位性病变，70%的患者扩张医治后病症改善，无病症恶化。

在医治患有咽鼓管通气功能不良的，不肯意依托常规医治方式的患者，球囊扩张是一种快速、简单且平安的医治方式。

为确立并优化此种方式的适应症，应开展多中心的进一步研究。