射频消融咽鼓管成形术治疗慢性中耳炎伴流脓和鼓室造口导管过早挤出。

YuGuang Li, JingYu Zeng, XiaoHua Li
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引用次数: 0

摘要

研究目的本研究评估了射频消融(RFA)咽鼓管成形术对鼓室造口术(TT)过早挤出患者慢性中耳炎伴流脓(COME)的治疗效果及相关并发症。材料与方法:对 23 例患有慢性中耳炎、鼓室造口管过早挤出和粘液增稠的患者进行了鼓室成形术和鼓室造口管重新插入术。对导管保留、穿孔闭合、听力改善和并发症进行了评估。结果:所有 23 位 COME 患者和 TT 早泄患者的鼻咽咽鼓管(ET)口后垫或后壁都有明显的粘膜肥厚病变或粘膜息肉样病变。所有手术均在手术室内进行,全身麻醉后 20 分钟内完成。气骨间隙前后的增益为 18.3 ± 2.5 dB。19例患者的TT至少保留了12个月,而2例患者需要在术后8至9个月时有意过早拔管,2例患者发生过早挤出。因此,导管保留成功率为 91.3%(21/23)。在有意拔管的 21 耳患者中,穿孔闭合率为 81.0%(17/21)。所有患者均未报告与 RFA 相关的严重不良事件,也未报告 ET 穿孔。不过,有 1 例 ET 耳道出现前后壁瘢痕挛缩,4 例患者出现 ET 耳道狭窄。结论对于鼻咽部 ET 口粘膜增厚的患者,RFA 咽鼓管成形术联合 TT 插入是一种治疗顽固性 COME 的简单、微创技术。这种技术可防止 TT 过早挤出。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Radiofrequency Ablation Eustachian Tuboplasty for the Treatment of Chronic Otitis Media with Effusion and Premature Extrusion of the Tympanostomy Tube.

Objective: This study evaluated the effects of radiofrequency ablation (RFA) eustachian tuboplasty on the treatment of chronic otitis media with effusion (COME), and associated complications, in patients with premature extrusion of the tympanostomy tube (TT). Materials and Methods: Tuboplasty and T-tube reinsertion were performed in 23 ears with COME, a history of premature TT extrusion, and thickened mucus. Tube retention, perforation closure, hearing improvement, and complications were evaluated. Results: All 23 patients with COME and previous premature TT extrusion had remarkable mucosal hypertrophic disease or mucosal polypoid changes in the posterior cushion or posterior wall in the nasopharyngeal eustachian tube (ET) orifice. All surgeries were completed within 20 minutes after general anesthesia and were performed in the operating room. Pre-and post-air-bone gap gain was 18.3 ± 2.5 dB. The TT was retained for at least 12 months in 19 patients, whereas intentional premature removal at postoperative 8 to 9 months was required in 2 patients and premature extrusion occurred in 2 patients. Thus, the tube retention success rate was 91.3% (21/23). Of the 21 ears with intentional removal, the perforation closure rate was 81.0% (17/21). None of the patients reported RFA-related serious adverse events or a patulous ET. However, a scar synechia of the anterior-posterior wall was seen in 1 ET orifice, and stenosis of the ET orifice in 4 patients. Conclusions: RFA eustachian tuboplasty combined with TT insertion is a simple and minimally invasive technique for the treatment of intractable COME in patients with a thickened mucosa of the nasopharyngeal ET orifice. This technique may prevent premature TT extrusion.

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