Eustachian Tube Dysfunction in Adhesive Otitis Media: Obstructive Versus Patulous Types.

IF 2.6 3区医学 Q1 OTORHINOLARYNGOLOGY

Otolaryngology- Head and Neck Surgery Pub Date : 2025-05-01 Epub Date: 2025-02-17 DOI:10.1002/ohn.1169

Seong Hoon Bae, Tae Uk Cheon, Sung Il Cho, Gi-Sung Nam

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引用次数: 0

Abstract

Objective: Understanding the distinct subtypes of adhesive otitis media (AdOM) is crucial for appropriate treatment such as balloon Eustachian tuboplasty (BET), particularly in distinguishing between patulous and obstructive Eustachian tube (ET) function. Nevertheless, AdOM caused by patulous Eustachian tube dysfunction (ETD) remains underexplored. This study aims to describe the detailed characteristics and define the patulous type of AdOM associated with patulous ETD (PET).

Study design: A prospective cohort study.

Setting: A total of 62 ears of patients diagnosed with AdOM, PET, and traumatic perforation were included from a tertiary referral center (university hospital).

Methods: Obstructive-AdOM, patulous-AdOM, PET, and a control group with traumatic perforation patients underwent endoscopic examinations, completed symptom questionnaires, and had passive ET opening pressure evaluated using a modified inflation-deflation test following tympanostomy tube insertion.

Results: Patulous-AdOM was identified in 43% of the patients and was characterized by significantly lower median opening pressures (222 daPa) than those in patients with obstructive-AdOM (400 daPa) and PET (below 100 daPa). Habitual sniffing was reported in 92.3% of patients with patulous-AdOM, and reduced mastoid pneumatization was observed in both the patulous and obstructive subtypes.

Conclusion: Accurate differentiation between patulous-AdOM and obstructive-AdOM is essential because BET may exacerbate symptoms in patients with patulous characteristics. A comprehensive evaluation of ET function is critical before initiating treatment, underscoring the need for tailored approaches to manage AdOM.

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粘连性中耳炎的咽鼓管功能障碍：梗阻性与扩张性。

目的：了解粘连性中耳炎（AdOM）的不同亚型对于适当的治疗（如球囊咽鼓管成形术（BET））至关重要，特别是在区分扩张和阻塞性咽鼓管（ET）功能方面。然而，由扩张性咽鼓管功能障碍（ETD）引起的AdOM仍未得到充分的研究。本研究旨在描述与扩张性ETD （PET）相关的AdOM的详细特征和定义扩张性类型。研究设计：前瞻性队列研究。背景：来自三级转诊中心（大学医院）的诊断为AdOM、PET和外伤性穿孔的患者共62耳。方法：阻塞性- adom、扩张性- adom、PET和创伤性穿孔的对照组患者接受内窥镜检查，完成症状问卷，并在鼓室造瘘管插入后使用改良的充气-减压试验评估被动ET开口压力。结果：43%的患者发现了扩张性adom，其特征是中位开口压力（222 daPa）明显低于阻塞性adom （400 daPa）和PET（低于100 daPa）患者。92.3%的扩张型adom患者有习惯性嗅探，扩张型和梗阻型的乳突气化程度均有所降低。结论：准确鉴别扩张性adom和梗阻性adom是必要的，因为BET可能加重扩张性adom患者的症状。在开始治疗之前，对ET功能进行全面评估是至关重要的，强调需要量身定制的方法来管理AdOM。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Otolaryngology- Head and Neck Surgery 医学-耳鼻喉科学

CiteScore

6.70

自引率

2.90%

发文量

250

审稿时长

2-4 weeks

期刊介绍： Otolaryngology–Head and Neck Surgery (OTO-HNS) is the official peer-reviewed publication of the American Academy of Otolaryngology–Head and Neck Surgery Foundation. The mission of Otolaryngology–Head and Neck Surgery is to publish contemporary, ethical, clinically relevant information in otolaryngology, head and neck surgery (ear, nose, throat, head, and neck disorders) that can be used by otolaryngologists, clinicians, scientists, and specialists to improve patient care and public health.