Application Of Balloon Dilation Eustachian Tuboplasty Combined With Tympanocentesis And Myringotomy In Otitis Media With Effusion

Objective: To study and analyze the outcomes of balloon dilation eustachian tuboplasty combined with tympanocentesis and myringotomy in the treatment of otitis media with effusion,so as to provide a theoretical basis for the treatment of otitis media with effusion.Methods: From March 2015 to July 2016,32 patients(41 ears)of otitis media with effusion were treated with in the department of Otorhinolaryngology Hospital in Longgang District,Shenzhen.All of these subjects met the diagnostic criteria of otitis media with effusion: The mean value of the difference between the bone conduction resistance of pure tone audiometry and the air resistance of pure tone audiometry(500,1000,2000 and4000Hz)≧ 15 d B,the tympanogram shows the curve of "B" type or "C" type,the endoscopic examination showed that the tympanic membrane combined was complete but along with tympanic effusion,no symptoms of nasopharyngeal tumor or adenoid hypertrophy,and their medical treatment was more than 3 months.The patients were divided into two groups according to their own situations.Group A was treated with balloon dilation eustachian tuboplasty combined with tympanocentesis(n=15,20 ears),and group B was performed for patients treated by myringotomy(n=17,21 ears).All patients underwent endoscopic examination,pure tone audiometry,acoustic impedance test,and eustachian tube dysfunction score(ETDQ-7)before the operation and in 2 weeks,1 and 3months after the operation.Finally,we analyzed the data collected in the research.Results: Group A: Two weeks later,the cure rate was 45%(9/20),the improvement rate was 40%(8/20),the ineffective rate was 15%(3/20),the effective rate was 85%(17/20);One month later,the cure rate was 85%(17/20),the improvement rate was 10%(2/20),the ineffective rate was 5%(1/20),the effective rate was 95%(19/20);Three months later,the cure rate was 90%(18/20),the improvement rate was 5%(1/20),the ineffective rate was5%(1/20),the effective rate was 95%(19/20).Group B: Two weeks later,the cure rate was28.6%(6/21),the improvement rate was 66.7%(14/21),the ineffective rate was 4.8%(1/21),the effective rate was 95.3%(20/21);One month later,the cure rate was 47.6%(10/21),the improvement rate was 0%(0/21),the ineffective rate was 52.4%(11/21),the effective rate was 46.7%(10/21);Three months later,the cure rate was 47.6%(10/21),the improvement rate was 0%(0/21),the ineffective rate was 52.4%(11/21),the effective rate was 47.6%(10/21).There was a significant difference(P <0.05)between the treatment results of group A and group B in the data collected in 1 month later and 3 months later.According to the scores collected in 1 month later and 3 months later,we can see that there are significant differences(P <0.05)between the scores of group A and B groups;and there also was a significant difference(P <0.05)in the scores of 1 month later and 3months later just in group A.Conclusion: Balloon dilation eustachian tuboplasty combined with tympanocentesis has a better short-term effect than myringotomy in the treatment of patients with chronic otitis media but except the situations of swollen bumps inside the nose and throat and chronic secretory otitis media with effusion caused by nasosinusitis.Compared with myringotomy,balloon dilation eustachian tuboplasty combined with tympanocentesis is safer,effective and feasible because of its few traumatic injuries and stable efficacy in short-term clinical.