| Objective: To compare the efficacy of balloon dilation eustachian tuboplasty combined with tympanotomy tube insertion and only tympanotomy tube insertion in the treatment of chronic secretory otitis media that was not cured after conservative treatment.Design: Retrospective cohort study: Data collected from the secretory otitis media patients who visited the first affiliated hospital of Dalian Medical University from September 2016-February 2018.Selected the patients who had been taken the tympanotomy tube insertion surgery joint balloon dilation eustachian tuboplasty after conservative treatment,whose follow-up data was complete for the experimental group,marked group A.The number of the group A’s patient was 24(26 ears).And selected the patients who barely had been taken the tympanotomy tube insertion surgery,whose follow-up data was also complete for the control group,marked group B.The number of the group B’s patient was 25(26 ears).Data collection was performed pre-operation,1 month,3 months,6 months and 12 months after the operation.Main outcome measures: Eardrum image under otoscope,mustachio tube pharynx under nasal endoscope,pure tone threshold,acoustic conduction resistance,mustachio tube function and mustachio tube dysfunction score questionnaire.Preoperative and postoperative ETDQ-7 score,ABG and effective rate of patients in the two groups and the same group were comparable.T test is performed on DTDQ-7 score and ABG,and chi-square test is performed on the effective rate.Result: In both groups,the time of taking off the tube was about 5 months after the operation,and the closure of tympanic membrane perforation in the review at the 6months after the surgery.Independent sample t test was necessary to provide for age of group A and group B,and the difference was not statistically significant(t =0.270,P=0.788 > 0.05).A chi-square test was conducted on the two groups,and the difference of the effective rate was not statistically significant(P=0.5 > 0.05).ABG and ETDQ-7 score of groups A and group B at 1,3,6 and 12 months after surgery were statistically significant compared with those before surgery(P < 0.05).Score of ABG and ETDQ-7 in group A decreased gradually from pre-operation to 6 months after surgery.The score of ABG and ETDQ-7 in group A also decreased at 12 months after surgery,but increased compared with the score at 6 months after surgery.At 1,3and 6 months after surgery,the function of the eustachian tube was slightly improved and the hearing was gradually improved.At 12 months after surgery,the function of the eustachian tube was improved was higher than that before surgery,and reduced compared with that at 1,3 and 6 months after surgery.The score of ABG and ETDQ-7 in group B reduced gradually from pre-operation to 3 months after surgery,and increased slightly at 6 and 12 months after surgery,which was lower than that before surgery.The function of hearing and eustachian tube at 1,3,6 and 12 months after surgery was preferable to that before surgery.The function of hearing and eustachian tube was gradually improved at 1 and 3 months after surgery,and the function of hearing and eustachian tube was reduced at 6 and 12 months after surgery compared with that at 1 and 3 months after surgery.Independent sample t test was used to test the ABG and ETDQ-7 score of group A and group B before operation,1,3,6 and 12 months after operation.Preoperative ABG and ETDQ-7 score of group A and group B were not statistically significant(P>0.05).Comparison of ABG between group A and group B at 1 and 3 months after surgery showed no statistical significance(P > 0.05),while comparison of ABG between group A and group B at 6 and 12 months after surgery showed statistical significance(P < 0.05).The comparison of ETDQ-7 score between group A and group B for 1 month,3 months,6 months and 12 months after surgery showed statistical significance(P < 0.05).The X±S,ABG and ETDQ-7 at 1,3,6,12 months after surgery were Compared between group A and group B,and it showed that group Bvalues were greater than group A.The hearing improvement of group A at 6 and 12 months after surgery were better than that of group B,and the eustachian tube function improvement of group A at 1,3,6 and 12 months after surgery were also better than that of group B.The effective rate of group A at 1,3,6 and 12 months after surgery was higher than that of group B.A chi-square test was conducted on the effective rate of the two groups after surgery,and the difference in the effective rate of the two groups at 1,3and 6 months after surgery was not statistically significant(P > 0.05),but the difference in the effective rate between the two groups at 12 months after surgery was statistically significant(P < 0.05).Conclusion1.Tympanostomy or balloon dilation of eustachian tube in the treatment of chronic secretory otitis media has a certain effect in the short term.2.For the treatment of chronic secretory otitis media,tympanostomy combined with balloon dilation is more effective than tympanostomy alone.3.Tympanostomy combined with eustachian tube balloon dilation is a good choice for chronic secretory otitis media. |
