Effects of combination of balloon Eustachian tuboplasty with methylprednisolone irrigation on treatment of chronic otitis media with effusion in adults.

Autor: Si Y; Department of Otolaryngology Head and Neck Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China; Institute of Hearing and Speech-Language Science, Sun Yat-sen University, Guangzhou 510120, China., Chen YB; Department of Otolaryngology Head and Neck Surgery, Third Affiliated Hospital of Sun Yat-sen, Sun Yat-sen University, Guangzhou, China., Chu YG; Institution for Drug Clinical Trial, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China., Chen SJ; Department of Otolaryngology Head and Neck Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China; Institute of Hearing and Speech-Language Science, Sun Yat-sen University, Guangzhou 510120, China., Xiong H; Department of Otolaryngology Head and Neck Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China; Institute of Hearing and Speech-Language Science, Sun Yat-sen University, Guangzhou 510120, China., Chen XM; Department of Otolaryngology Head and Neck Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China; Institute of Hearing and Speech-Language Science, Sun Yat-sen University, Guangzhou 510120, China., He WH; Department of Otolaryngology Head and Neck Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China; Institute of Hearing and Speech-Language Science, Sun Yat-sen University, Guangzhou 510120, China., Zheng YQ; Department of Otolaryngology Head and Neck Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China; Institute of Hearing and Speech-Language Science, Sun Yat-sen University, Guangzhou 510120, China., Zhang ZG; Department of Otolaryngology Head and Neck Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China; Institute of Hearing and Speech-Language Science, Sun Yat-sen University, Guangzhou 510120, China. Electronic address: zhangzz0369@126.com.
Jazyk: angličtina
Zdroj: American journal of otolaryngology [Am J Otolaryngol] 2018 Nov - Dec; Vol. 39 (6), pp. 670-675. Date of Electronic Publication: 2018 Jun 22.
DOI: 10.1016/j.amjoto.2018.06.016
Abstrakt: Purpose: Adult chronic otitis media with effusion (COME) is characterized by Eustachian tube dysfunction and mucosal inflammation, which management has long been a challenge because of high recurrence. This study was to investigate the pathological changes of Eustachian tube mucosa and optimized treatment.
Materials and Methods: Retrospective study of four groups: I: tympanic paracentesis, II: balloon Eustachian tuboplasty (BET), III: BET plus tympanic paracentesis, IV: BET and tympanic paracentesis with methylprednisolone irrigation. Biopsy of Eustachian tube mucosa was obtained preoperative and 1 month post. Recurrence ratio and Eustachian tube scores (ETS) were used to evaluate the effect of treatments.
Results: All patients showed narrowed with edematous and thickened Eustachian tube mucosa. At 1 month post-treatment, BET with methylprednisolone irrigation significantly decreased intraepithelial inflammation and restored the quality of epithelium and cilia. For group II to IV, The recurrence rate was significantly lower in group IV compared with the other two, but only significantly lower in group IV VS group II at 3 months and 6 months, no significant difference at 12 months. The recurrence rate was significantly higher in group I during follow-up. The ETS were improved in group II, III and IV after treatment. At 1 month and 3 months posttreatment, group IV had significant higher ETS compared with other groups (P < 0.05). There was no serious complications occurred.
Conclusion: Methylprednisolone irrigation could help to recover mucosal function. BET and tympanic paracentesis with methylprednisolone irrigation could be regarded as a good choice for COME in adults, which has less recurrence rate and prompt recovery of ET function.
(Copyright © 2018 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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