咽鼓管-鼓室气流动态法对咽鼓管异常开放症的诊断价值

目的 :探讨咽鼓管异常开放症的检测方法。方法 :比较鼓室导抗图法、Morim itsu法和咽鼓管 -鼓室气流动态法 (TTAG法 )检测 2 0耳咽鼓管异常开放症患者的阳性率。结果 :鼓室导抗图法阳性者 5耳 ,阳性率 2 5 % ,Morim itsu法阳性者 12耳 ,阳性率 6 0 % ,TTAG法阳性者 2 0耳 ,阳性率 10 0 %。结论 :TTAG法是诊断和随访咽鼓管异常开放症最有价值的手段。     

应用声导抗仪检测咽鼓管鼓室功能

借助声导抗仪进行定量的Valsalva和反Valsalva咽鼓管鼓室功能测试，得出正常人Valsalva法引起的中耳声顺变化值为0．57±0．23ml，反Valsalva法为0．26±0．12ml。不同咽鼓管功能状态者，其鼓室的压力和顺应性明显影响测值。提示本测试对咽鼓管狭窄、阻塞或开放均有诊断意义；此外，根据声导抗仪所描记的曲线也可分析咽鼓管功能障碍的类型和程度，作为临床治疗的参考指标；本方法具有简便、定量等优点。     

分泌性中耳炎C型鼓室导抗图咽鼓管功能的检测

目的：探讨分泌性中耳炎（ＳＯＭ）、鼓室导抗图为Ｃ型患者的咽鼓管功能。方法：检测捏鼻吞咽法和捏鼻鼓气法后的鼓室导抗图,峰压点的移动进行量化处理,评价３０例ＳＯＭ（４２耳）的咽鼓管功能,并与正常对照组相比较。结果：咽鼓管功能障碍者５２．３８％,与正常对照组相比有显著性差异（Ｐ〈０．０５）。结论：咽鼓管功能障碍是ＳＯＭ的病因之一,但并非唯一因素。     

鼓膜穿孔患者鼓室成形术前咽鼓管功能评价

咽鼓管功能与中耳的生理功能、病理状态及中耳疾病的疗效密切相关,尤其对鼓室成形术的预后起重要作用,我科用声导抗仪对二类鼓膜穿孔患者进行检测以判断其咽鼓管功能状态,报告如下：１ 资料和方法１．１ 临床资料 ３４例鼓室成型术患者中,男２０例,女１４例。慢性中耳炎所致鼓膜穿孔组：病程６个月以上者,１９例１９耳,平均年龄３５岁（１５～６６岁）,外伤性鼓膜穿孔组：病程２个月以上者１５例１５耳,平均年龄３２岁（１４～６１岁）。１．２ 检测方法 自动 Ｔｏｙｎｂｅｅ法,将 ＡＺ２６型声导抗仪之探头置于患侧外耳道内并分…     

鼓室成形术后的咽鼓管功能检测及意义

目的探讨咽鼓管功能对慢性化脓性中耳炎鼓室成形术后疗效的影响。方法用咽鼓管鼓室-气流动态图(tube-tympanoaerodynamicgraphy,TTAG)法及音响法对53耳鼓室成形术后的咽鼓管功能进行检测,并分析鼓室成形术后咽鼓管功能正常耳与异常耳的鼓膜生长及听力变化情况;并用鼻窦镜观察咽鼓管咽口,分析咽鼓管咽口与咽鼓管功能的关系。结果53耳鼓室成形术后咽鼓管功能正常37耳,其中29耳鼓膜生长良好;咽鼓管功能异常16耳中,有4耳鼓膜生长良好,比较咽鼓管功能正常耳与异常耳鼓膜生长良好耳数,两者有显著性差异(P<0.05);53耳术后有9耳咽鼓管咽口充血肿胀,其中2耳咽鼓管功能正常,7耳咽鼓管功能不良,提示术后咽鼓管功能障碍与咽鼓管咽口病变有关。结论慢性化脓性中耳炎鼓室成形术后咽鼓管功能与疗效关系密切,术后咽鼓管功能障碍可能是导致手术失败的原因之一。     

正常人咽鼓管功能的综合法检测

目的：探讨综合法对正常人咽鼓管功能检测的实用性。方法：对３０例（６０耳）正常人分别检测静态时,捏鼻吞咽和捏鼻鼓气后的鼓室导抗图,其峰压点分别为Ｐ１,Ｐ２和Ｐ３,以Ｐ１－Ｐ２〉１０ｄａＰａ和Ｐｍａｘ－Ｐｍｉｎ〉１５ｄａＰａ判断为咽鼓管功能正常。     

儿童鼓室成形术与术前咽鼓管功能评估的作用

为阐明能否通过外耳道内滴入滴耳液这种咽鼓管功能测试法预测儿童鼓室成形术的结果,本文回顾分析有关术前咽鼓管功能与鼓室成形术成功率关系的研究。结果表明无论是成人或儿童其术前咽鼓管功能测试结果产不能可靠地预测鼓室成形术的成功或失败。但许多文献已提示年龄是预测手术成功的重要因素。由于咽鼓管功能随年龄增长而成熟,故可能既往没有被测量的咽鼓管发育的某些方面如长度和容积与随年龄增长的成功率上升有关,但这方面至今尚未完全明确。因此作者认为不要仅凭年龄而否定手术,手术的时机最好依患者的具体情况而定。     

慢性中耳炎咽鼓管鼓室口病变对咽鼓管功能的影响

目的 :探讨慢性中耳炎咽鼓管鼓室口病变与咽鼓管功能障碍的关系。方法 :用鼓室镜及咽鼓管功能检查仪对 4 4例 (45耳 )慢性中耳炎患者 ,进行术前咽鼓管鼓室口观察和咽鼓管功能检查 ,并对检查结果进行对比分析。结果 :4 5耳慢性中耳炎中 ,咽鼓管鼓室口正常 17耳 ,骨刺增生、黏膜肿胀等轻度病变者 18耳 ,黏膜肿胀或肉芽增生致管腔明显狭窄的重度病变有 10耳 ,其中 9耳咽鼓管功能呈阻塞型改变。结论 :咽鼓管鼓室口及骨部的骨刺增生、黏膜肿胀、肉芽形成是慢性中耳炎的常见病变 ,鼓室口及骨部的阻塞是导致慢性中耳炎咽鼓管阻塞的原因。     

复合法对慢性化脓性中耳炎患者咽鼓管功能的判定

为探讨慢性化脓性中耳炎患者咽鼓管功能简便而有效的检查方法，对９６例慢性化脓性中耳炎待手术者，采用复合法判定其咽鼓管功能，并与声阻抗法检查进行比较。结果示，鼓气测压法和鼓室滴药法虽存在一定的片面性，但由二者结合的复合法判定结果与声阻抗法的符合率可达９６．９％。     

咽鼓管置管术在各种鼓室成形术中的应用

目的 :探讨咽鼓管置管术在各种鼓室成形术中的应用及疗效。方法 :对按不同方式进行听骨链重建、鼓室成形术的 71耳患者术中同时行咽鼓管置管术。结果 :除 5例继发鼓膜穿孔、术后流脓外 ,余均一次手术成功 ,未见再穿孔。手术失败与不同病种、不同术式间的差异无显著性意义。结论 :咽鼓管置管术对防止咽鼓管再粘连有效。     

The effects of grommet insertion on Eustachian tube function

A prospective study on the effect of grommet insertion on the passive Eustachian tube opening pressure was undertaken in children's ears with otitis media with effusion. After an initial immediate improvement following aspiration of the middle ear no further change in Eustachian tube function occurred over 4 subsequent weeks. Grommet insertion probably has no effect on Eustachian tube function.     

An exploration method of the Eustachian tube for intact and perforated drums: Tubal-impedance-manometry

Summary The author describes an exploratory method of the Eustachian tube: tubal-impedance-manometry. This method comprises two types of techniques, the one applicable to patients whose eardrum is intact, the other to cases of tympanic perforation. The instrumentation and the examination techniques are described.The discussion allows the results to be incorporated into a clinical perspective: T.I.M. with closed eardrums will deal principally with localizing an eventual tubal problem. On the other hand, T.I.M. with open eardrums will be more specifically viewed as a pre-surgical examination (tympanoplasty).     

4DCT在咽鼓管功能障碍患者咽鼓管功能评估中的应用

目的 通过4DCT(four-dimensional CT)动态评估咽鼓管功能障碍(Eustachian tube dysfuction,ETD)患者Valsava动作时的咽鼓管(Eustachian tube,ET)功能.方法 2018年11月～2019年3月期间就诊于首都医科大学附属北京安贞医院的ETD患者15例,...     

Reproducibility of sonotubometry as Eustachian tube ventilatory function test in healthy children

OBJECTIVES: To devise a simple and reliable diagnostic procedure to test Eustachian tube function routinely in an ENT outpatient setting. One method to measure ET ventilatory function is sonotubometry. The reproducibility of a recently updated sonotubometry set-up was tested in healthy children. METHODS: The test population comprised 61 school children aged from 6 to 8 years. Only otologically healthy children were included. Health state was established by means of a 12-item questionnaire. To test reproducibility, sonotubometric testing took place in two sessions of 10 acts of swallowing each. Spearman's coefficient was used to test the correlation between the two sets of measurements. All testing took place at a primary school in a nearby village. RESULTS: Opening of the ET was recorded in at least one of the two measurement sessions in 82% of the children. The first and second sessions were highly correlated, with a Spearman's coefficient of 0.89. CONCLUSIONS: In otologically healthy children, opening of the ET was recorded frequently using the updated sonotubometry set-up. Measurement results had high reproducibility. Therefore, the test forms a useful method to assess ET ventilatory function in otologically healthy children. The performance of this updated version needs to be established in children with otological diseases.     

The efficacy of the Eustachian Tube Dysfunction Questionnaire (ETDQ-7) for patulous Eustachian tube patient

Objective: To assess the efficacy of the Eustachian Tube Dysfunction Questionnaire (ETDQ-7) for patulous Eustachian tube (PET) patients.

Methods: A prospective survey of medical records identified 36 patients and 47 ears with PET, and 15 patients and 15 ears as control. The ETDQ-7, patulous Eustachian tube handicap inventory-10 (PHI-10) and Likert scale were evaluated. PET patients were divided into two groups based on severity of symptoms using the PHI score.

Results: The Cronbach α value of the PET group was 0.765. The average total score of the ETDQ-7 in the control group was 7.6?±?1.1 and 22.5?±?10.0 in the PET group (p?r?=?0.248, p?=?.09). The average total score of the ETDQ-7 in the mild or moderate PET group was 19.9?±?9.0 and 25.3?±?11.1 in the severe PET group and this was not statistically different (p?=?.08).

Conclusion: The highest ETDQ-7 score was also observed in PET patients and in ET dysfunction patients. These findings necessitate careful discrimination between ET dysfunction and PET in balloon dilation Eustachian tuboplasty (BET) based on ETDQ-7.     

咽鼓管异常开放症

咽鼓管是连接鼻咽部和中耳鼓室腔的管道结构,当由于各种原因导致咽鼓管失去静息时关闭功能而处于持续开放状态时,称为咽鼓管异常开放症(PET)。PET是一种常见的耳鼻咽喉科疾病,其典型症状为自听增强、闻及自身呼吸音、主观性耳鸣及耳闷胀感等。PET患者症状由于与咽鼓管开放不良的功能障碍症状相似,常容易被漏诊或误诊,本文围绕PET的诊断和治疗方面,对最新的研究进展进行了综述。诊断上,症状、体征和实验室检查是诊断PET的核心,然而尚没有单一的咽鼓管功能检查可以在没有其他临床观察和检查的情况下准确评估咽鼓管功能。治疗上,常见的治疗方法包括保守治疗及手术治疗,针对PET患者,可进行“阶梯式”治疗策略：即先增重、冲洗鼻腔、滴酸等保守治疗,若保守治疗效果不佳,症状严重且患者有强烈治疗需求者,可采用如鼓膜手术、堵塞咽鼓管、缩窄咽鼓管口创伤性的手术治疗。     

Efficacy of balloon Eustachian tuboplasty on the quality of life in children with Eustachian tube dysfunction

Abstract

Background: 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.