| BackgroundGlue ear is a kind of secretory otitis media that has not been cured for a long time.The exudate in tympanum is gradually concentrated.The clinical treatment of this disease is rather difficult.At present,the commonly used methods are: conservative treatment with drugs commonly used in adults,simple tympanopuncture or incision,tympanotomy and catheterization,eustachian tube blowing,etc.;conservative treatment with general drugs is mainly used in children,and local tympanotomy and catheterization if necessary.However,no matter adults or children,the above treatment methods are not ideal,which often leads to the patient’s delayed condition,and finally leads to hearing loss and tympanic membrane adhesion,which brings great pain to the patient.In recent years,it is advocated that eustachian tube balloon expansion combined with tympanic membrane tube placement should be used to treat the glue ear,so as to make the cartilage of eustachian tube fracture,hard and thin,and the tissue around isthmus tube cavity fibrosis,improve the normal physiological function of eustachian tube cilia,promote the normal distribution of surfactant,and restore normal drainage,Break the vicious circle.We try to use eustachian tube balloon dilation combined with tympanic membrane catheterization to treat some cases of glue ear.The details are as follows.ObjectiveTo explore the clinical effect of eustachian tube balloon dilatation combined with tympanic membrane catheterization in the treatment of glue ear.Methods97 patients(128 ears)with glue ear were randomly divided into three groups:observation group: 31 cases(42 ears),Eustachian tube balloon dilation combined with tympanotomy.Control group A: 44 ears of 35 cases,tympanotomy and catheterization alone.Control group B: 42 ears of 31 cases were treated with eustachian tube balloon dilation alone.All the patients were examined by otoendoscopy,otoacoustic emission,nasal sinus CT and temporal bone CT before operation to make clear the diagnosis and exclude the contraindications;the outpatient reexamination was performed 9 months,12 months and 18 months after operation,and acoustic impedance test,otoendoscopy,nasal endoscopy,pure tone threshold audiometry,Valsalva test,eustachian tube manometry and eustachian tube dysfunction score questionnaire were conducted.To evaluate the hearing improvement and the condition of the tympanic chamber of the patients so as to determine the therapeutic effect.ResultsThe effective ears(normal ears)in the observation group were significantly higher than those in the control group(P< 0.01)at 9,12 and 18 months after operation,and those in the observation group were significantly higher than those in the control group(P< 0.01)at 18 months after operation,and those in the observation group were significantly higher than those in the control group(P< 0.01)There was no significant difference between the control group A and the control group B in 18 months,but there was significant difference in 9 and 12 months(P< 0.05).9 months,12 months and 18 months after operation,the effective ear of tympanum(normal ear),Valsalva examination,normal hearing ear and eustachian tube pressure measurement of the observation group were significantly higher than those of the control group A(P< 0.01),significantly higher than those of the control group B(P< 0.05),and the difference between the control group A and the control group B was significant(P< 0.05).The scores of etdq-7 in the observation group were significantly lower than those in the control group(P There was significant difference between two months and 18 months(P< 0.05).ConclusionEustachian tube balloon dilatation combined with tympanic membrane catheterization is safe,simple,minimally invasive,with few complications and good tolerance.It can significantly improve the function of eustachian tube in patients with glue ear,improve the hearing of patients,reduce the tympanic membrane adhesion and invagination,and regulate the pressure balance in tympanic chamber,which is worthy of clinical application. |
PDF Full Text Request