The Efficacy Of Balloon Dilation Eustachian Tuboplasty Combined With Tympanic Tube Insertion In The Treatment Of Chronic Otitis Media With Effusion

Objective: To investigate the efficacy of balloon dilation Eustachian tuboplasty(BET)combined with tympanic tube insertion(TTI)in the treatment of chronic otitis media with effusion(COME).Methods: A retrospective study was conducted on 29 COME patients(39 ears)treated with BET combined with TTI from April 2018 to June2019,18 patients(23 ears)with TTI and 20 patients(23 ears)with BET.All cases were followed up for 6 months or more.Preoperative Eustachian tube score(ETS),acoustic immittance measurement,pure tone average(PTA),air-bone gap(ABG)and Eustachian tube dysfunction questionnaire-7 score(ETDQ-7)were collected.ETDQ-7 scores at 1 week,2 weeks,1 month,3 months,and 6 months after surgery and follow-up at3-6 months with ETS,ABG,and PTA were used to evaluate the treatment effect.Results: In the BET group,ETS increased from 2.91±1.5 to 5.3±2.3(P<0.05),ETDQ-7 decreased from 3.59±0.39 to 1.43(P<0.05),5 patients(6 ears)experienced postoperative effusion.ETS increased from 2.65±1.77 to 3.52±2.41 in the TTI group(P>0.05),ETDQ-7 decreased from 3.8±0.38 to 1.14(P<0.05).Effusion recurred after extubation in 1 patient(2 ears),and tube is still preserved in 3 patients(4 ears).In the BET+TTI group,ETS increased from 2.44±1.73 before operation to 5.28±2.05 after operation(P<0.05),and ETDQ-7 decreased from 4.01±0.51 to 1.14(P <0.05),while effusion recurred after extubation in 3 patients(4 ear),and tube is still preserved in 2 ears.There was significant difference in ETS changes between TTI group and BET group(P <0.05),TTI group and BET+TTI group(P <0.05).The ETDQ-7 at 1 and 2 weeks after surgery and ABG changes in the BET group were significantly less than the other two groups.Conclusion: BET is a safe treatment that is beneficial for the recovery of adult patients with COME.However,the exploration of the efficacy of BET in combination with TTI still requires strong evidence from large sample multicenter randomized controlled studies.