内镜下改良自体软骨咽鼓管咽口成形术对咽鼓管异常开放的疗效分析

Efficacy analysis of modified endoscopic autologous cartilage eustachian tube pharyngeal orifice tuboplasty on patulous eustachian tube

周兢程;伏振豪;王方园;贾建平;赵丹珩;刘娅;朱荔;侯琨;郭蒙园;张浩泽;丁雨麟;李晓龙;侯昭晖

1:中国人民解放军总医院第六医学中心耳鼻咽喉头颈外科医学部听觉与平衡觉全国重点实验室国家耳鼻咽喉疾病临床医学研究中心聋病教育部重点实验室聋病防治北京市重点实验室

2:中国人民解放军医学院

摘要
目的 探究内镜下改良自体软骨咽鼓管咽口成形术对咽鼓管异常开放(patulous eustachian tube, PET)患者的疗效。方法 回顾性分析27例(30耳)临床诊断为咽鼓管异常开放并且接受内镜下改良自体软骨咽鼓管咽口成形术患者的临床资料。使用自体软骨经下鼻甲后端切口,填充于咽鼓管咽口外侧壁,在不影响吞咽时咽鼓管运动功能的情况下,使咽口塌陷情况得到充分填充。手术前后使用咽鼓管功能障碍7项问卷(eustachian tube dysfunction questionnaire-7,ETDQ-7)、视觉模拟量表(visual analogue scale, VAS)、医院焦虑抑郁量表(hospital anxiety and depression scale, HADS)进行评估,以评价手术疗效。结果 27例患者术前与术后抑郁评分无显著差异(P>0.05),但术后焦虑评分、ETDQ-7和VAS评分较术前显著下降(P<0.05)。27例患者中,9例患者症状显著缓解,13例部分缓解,5例症状与术前无明显差异,没有患者出现术后症状恶化情况,治疗的总有效率(显著缓解+部分缓解)约为81.48%(22/27)。所有手术均成功进行,除2例发生分泌性中耳炎外,无其他重大并发症。结论 内镜下改良自体软骨咽鼓管咽口成形术能显著改善咽鼓管异常开放患者的症状,且手术安全性高,并发症发生率低,值得推广。
关键词
咽鼓管异常开放;咽鼓管咽口形成术;疗效
基金项目(Foundation):
国家耳鼻咽喉疾病临床医学研究中心资助,国家重点研发计划(2023YFC2508405)
作者
周兢程;伏振豪;王方园;贾建平;赵丹珩;刘娅;朱荔;侯琨;郭蒙园;张浩泽;丁雨麟;李晓龙;侯昭晖
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