Article record

老年患者咽鼓管功能障碍的全球疾病负担：病理生理学、临床后果、诊断挑战与治疗前景——一项基于SANRA的研究

The Global Burden of Eustachian Tube Dysfunction in Older Patients: Pathophysiology, Clinical Consequences, Diagnostic Challenges and Therapeutic Perspectives-A SANRA-Based Study.

综述 Meta耳科IF 3.3Q1

文献信息

PMID	42793541
原文	在 PubMed 查看原文 ↗
发表日期	2026
作者	Giannicola Iannella 查看其他 17 位作者 Pasquale Pio Caputo；Antonino Maniaci；Jerome R Lechien；Giovanni Cammaroto；Carlos M Chiesa-Estomba；Pierre Guarino；Giovanni Salzano；Luigi Angelo Vaira；Stéphane Gargula；Hilal Dincer D'Alessandro；Patrizia Mancini；Manuele Casale；Antonio Moffa；Elena Russo；Annalisa Pace；Giuseppe Magliulo；Armando De Virgilio
作者单位	Department of Sense Organs, Sapienza University of Rome, 00185 Rome, Italy. 查看其他 10 条单位信息 Department of Medicine and Surgery, University of Enna Kore, 94100 Enna, Italy.；Department of General Surgery, Faculty of Medicine, University of Mons (UMONS), Avenue du Champ de Mars, 6, B7000 Mons, Belgium.；Head and Neck Department, ENT & Oral Surgery Unit, G.B. Morgagni, L. Pierantoni Hospital, 47121 Forlì, Italy.；Department of Otorhinolaryngology-Head and Neck Surgery, Hospital Universitario Donostia, 20003 San Sebastian, Spain.；Otolaryngology Head and Neck Unit, "Santo Spirito" Hospital, 65124 Pescara, Italy.；Department of Innovative Technologies in Medicine & Dentistry, University "G. d'Annunzio" Chieti-Pescara, 66013 Chieti, Italy.；Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, 80131 Naples, Italy.；Maxillofacial Surgery Operative Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy.；ENT-HNS Department, Aix Marseille University, APHM, CNRS, IUSTI, La Conception University Hospital, 13284 Marseille, France.；Unit of Otolaryngology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy.
期刊	Healthcare (Basel, Switzerland)
SCI 分区	Q1
IF	3.3
研究类型	综述 Meta · 临床
所属专科	耳科

中文摘要

目的： 批判性总结关于老年人咽鼓管功能障碍（ETD）负担的现有证据，重点关注与年龄相关的病理生理学、诊断挑战、治疗策略及其与主要老年临床问题的相互作用。
方法： 本叙述性综述依据叙述性综述文章评估量表（SANRA）进行。系统检索并批判性评价了PubMed索引的、涉及ETD与衰老的原始研究、系统综述、荟萃分析、共识声明和临床指南。证据以叙述性方式综合，特别强调适用于老年人群的研究。
结果： 现有证据表明，衰老会在整个咽鼓管-中耳单元引起进行性结构和功能改变，包括软骨钙化、肌肉退化、黏膜萎缩和神经肌肉协调受损。这些变化可能增加对ETD的易感性，而ETD反过来可能加重老年性聋、前庭功能障碍、交流障碍，并可能通过增加感觉损害的累积负担而促进衰弱和认知脆弱性。然而，专门来自老年队列的证据仍然有限，特别是在长期结局和治疗干预方面，且不足以确立ETD为这些疾病的独立决定因素。
结论： ETD应被视为老年人听力相关残疾的一个诊断不足且可能可改变的促成因素。需要提高临床认识、标准化诊断路径以及针对老年人的前瞻性研究，以阐明及时诊断和治疗ETD能否减轻听力损害的整体负担、改善功能独立性并提高老龄化人群的生活质量。

英文摘要

Objective: To critically summarize current evidence regarding the burden of Eustachian tube dysfunction (ETD) in older adults, focusing on age-related pathophysiology, diagnostic challenges, therapeutic strategies and its interaction with major geriatric clinical implications. Methods: This narrative review was conducted according to the Scale for the Assessment of Narrative Review Articles (SANRA). PubMed-indexed original studies, systematic reviews, meta-analyses, consensus statements and clinical guidelines addressing ETD and ageing were systematically identified and critically appraised. Evidence was synthesized narratively with particular emphasis on studies applicable to geriatric populations. Results: Current evidence demonstrates that ageing induces progressive structural and functional alterations throughout the Eustachian tube-middle ear unit, including cartilage calcification, muscular degeneration, mucosal atrophy and impaired neuromuscular coordination. These changes may increase susceptibility to ETD, which in turn can exacerbate presbycusis, vestibular dysfunction, communication disability and potentially contribute to frailty and cognitive vulnerability by increasing the cumulative burden of sensory impairment. However, evidence specifically derived from geriatric cohorts remains limited, particularly regarding long-term outcomes and therapeutic interventions and is insufficient to establish ETD as an independent determinant of these conditions. Conclusions: ETD should be recognized as an underdiagnosed and potentially modifiable contributor to hearing-related disability in older adults. Greater clinical awareness, standardized diagnostic pathways and prospective geriatric-focused studies are needed to clarify whether timely diagnosis and treatment of ETD can reduce the overall burden of hearing impairment, improve functional independence and enhance quality of life in ageing populations.