EXPRESS：改良经耳道内镜下鼓膜切开术及中隔切开术治疗猫中耳炎——38只猫的回顾性研究

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中文摘要

目的： 本研究仅旨在描述一种便捷的微创技术，用于进入患有息肉样或非息肉样中耳炎的猫的中耳腹内侧腔。方法：回顾性检索有耳部症状的猫的病历。纳入标准为CT影像显示鼓腔内存在液体/软组织、耳内镜检查显示鼓膜异常和/或鼻咽镜检查显示咽鼓管开口异常。结果：共纳入38只单侧或双侧鼓泡积液且内镜异常的猫，治疗了43只耳。CT显示，所有接受治疗的耳均有背外侧和腹内侧腔积液。耳镜检查显示93%的鼓膜异常（28%变色，28%膨隆，16%破裂，21%有突出息肉）。在顺行鼻咽镜检查中，81%的同侧咽鼓管可见开放，19%部分或完全被分泌物或息肉样物质阻塞。所有病例均使用1 mm刚性Frazier吸引管进行经耳道内镜下鼓膜切开术及中隔切开术。治疗期间，所有耳均可见鼓泡黏膜衬里炎症，33%形成腔内息肉，随后经内镜下清创。所有猫均接受7天多西环素疗程和逐渐减量的泼尼松龙疗程。至出院时，术中或术后未见与手术相关的并发症。结论与意义：猫的经耳道内镜下鼓膜切开术及中隔切开术是一种快速、微创且看似安全的技术，可进入猫中耳的两个腔。短期和长期结局需在未来的研究中评估。

英文摘要

ObjectivesThis study solely aims to describe a convenient minimally invasive technique for access to the ventromedial compartment of the middle ear in cats with polypoid or non-polypoid otitis media.MethodsPatients' records were retrospectively retrieved from cats with otic symptoms. Cats were included based on the presence of fluid/soft tissue within the tympanic cavity on CT imaging, abnormal tympanic membranes on oto-endoscopy and/or abnormal auditory tube openings upon nasopharyngoscopy.ResultsA total of 38 cats with uni- or bilateral bulla effusion and endoscopic abnormalities were included and 43 ears were treated. On CT, all treated ears had effusion of both dorsolateral and ventromedial compartments. Otoscopy revealed an abnormal tympanic membrane in 93% (discoloration in 28%, bulging in 28%, rupture in 16% and a protruding polyp in 21%). On normograde nasopharyngoscopy, the ipsilateral auditory tube was visibly open in 81% and partly or completely obstructed with discharge or polypous material in 19%. A transcanal perendoscopic myringotomy and septotomy using a 1-mm rigid Frazier suction tube was performed in all cases. During treatment, inflammation of the mucosal lining in the bulla was seen in all ears, with intracavital polyp formation in 33%, which was subsequently perendoscopically debrided. All cats were treated with a 7-day course of doxycycline and a tapering course of prednisolone. No procedure-related complications were seen intra- or postoperatively to discharge.Conclusion and relevanceTranscanal perendoscopic myringotomy and septotomy in cats is a rapid, minimally invasive and apparently safe technique which allows access to both compartments of the feline middle ear. Short- and long-term outcome have to be evaluated in future research.