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

目的探讨中耳胆脂瘤并咽鼓管功能障碍患者使用改良乳突根治术联合咽鼓管球囊扩张术治疗的临床效果。方法回顾性分析86例(86耳)中耳胆脂瘤并咽鼓管功能障碍患者的临床资料,按照手术方式分为球囊组(41例)和非球囊组(45例)。非球囊组采用改良乳突根治术,球囊组采用改良乳突根治术联合咽鼓管球囊扩张术。记录2组患者术前及术后6个月平均听阈、气骨导差、声导抗、七项咽鼓管功能障碍症状评分量表(ETDQ-7)及干耳时间,并评估鼓膜愈合情况。结果2组患者术后6个月平均听阈、气骨导差、声导抗、ETDQ-7评分及干耳时间比较,差异有统计学意义(P<0.05);球囊组鼓膜愈合率较非球囊组高,差异具有统计学意义(P<0.05)。结论对于合并咽鼓管功能障碍的中耳胆脂瘤,改良乳突根治术联合咽鼓管球囊扩张术的近期疗效改善明显。

Application of modified radical mastoidectomy combined with eustachian tube balloon dilatation in patients with middle ear cholesteatoma and eustachian tube dysfunction

Objective To investigate the clinical effect of modified radical mastoidectomy combined with eustachian tube balloon dilatation in patients with middle ear cholesteatoma and eustachian tube dysfunction.Methods The clinical data of 86 patients(86 ears)with middle ear cholesteatoma and eustachian tube dysfunction were retrospectively analyzed,the patients were divided into the balloon group(41 cases)and the non-balloon group(45 cases)according to the surgical method.Modified radical mastoidectomy was performed in the non-balloon group,while modified radical mastoidectomy combined with eustachian tube balloon dilatation was performed in the balloon group.The average hearing threshold,air bone gap,acoustic immittance,the seven-item eustachian tube dysfunction questionnaire(ETDQ-7)score before and 6 months after operation and dry ear time were recorded in the two groups,and the healing of the tympanic membrane was evaluated.Results There were statistically significant differences in the average hearing threshold,air bone gap,acoustic immittanc,ETDQ-7 score 6 months after operation and dry ear time between the two groups(P<0.05).The healing rate of the tympanic membrane in the balloon group was higher than that in the non-balloon group,and the difference was statistically significant(P<0.05).Conclusion The short-term curative effect of modified radical mastoidectomy combined with eustachian tube balloon dilatation in the treatment of middle ear cholesteatoma and eustachian tube dysfunction is obviously improved.