扁桃体肥大与扁桃体切除术对成人咽鼓管功能的影响

文献信息

中文摘要

目的： 评估扁桃体切除术对伴有扁桃体肥大的成人咽鼓管功能的影响。
方法： 开展了一项前瞻性纵向观察性研究，纳入20例接受扁桃体切除术的III-IV度扁桃体肥大成年患者。评估在术前以及术后1个月和6个月进行。使用咽鼓管功能障碍问卷-7（ETDQ-7）评估提示咽鼓管功能障碍（ETD）的症状，并进行包括咽鼓管测压法（TMM）在内的客观测量。组内比较采用适当的统计学方法进行分析。
结果： 扁桃体切除术与耳闷胀感显著减轻相关，从术前的45%降至术后1个月的5%和术后6个月的15%（分别为p = 0.0039和p = 0.0391）。ETDQ-7评分在术后显著改善，从14.90 ± 8.61降至术后1个月的10.95 ± 6.84，并在6个月时保持稳定。听力损失无显著变化。然而，Valsalva动作表现、鼓室压图检查结果和TMM值随时间保持显著稳定。
结论： 扁桃体切除术与ETD主观症状的显著改善相关，尤其是耳闷胀感和ETDQ-7评分，而客观测量显示的变化有限。这些发现提示扁桃体切除术在部分选定患者中可能具有症状性获益，尽管客观功能改善仍不确定。

英文摘要

PURPOSE: To evaluate the effect of tonsillectomy on Eustachian tube function in adults with tonsillar hypertrophy.
METHODS: A prospective longitudinal observational study was conducted including 20 adult patients with grade III-IV tonsillar hypertrophy undergoing tonsillectomy. Assessments were conducted preoperatively and at 1 and 6 months postoperatively. Symptoms suggestive of Eustachian tube dysfunction (ETD) were evaluated using Eustachian Tube Dysfunction Questionnaire-7 (ETDQ-7), and objective measures including tubomanometry (TMM). Intragroup comparisons were analyzed using appropriate statistical methods.
RESULTS: Tonsillectomy was associated with a significant reduction in aural fullness, decreasing from 45% preoperatively to 5% at 1 month and 15% at 6 months (p = 0.0039 and p = 0.0391, respectively). ETDQ-7 scores significantly improved after surgery, declining from 14.90 ± 8.61 to 10.95 ± 6.84 at 1 month and remaining stable at 6 months. Hearing loss did not change significantly. However, Valsalva maneuver performance, tympanometric findings and TMM values remained significantly stable over time.
CONCLUSIONS: Tonsillectomy was associated with significant improvement in subjective symptoms of ETD, particularly aural fullness and ETDQ-7 scores, while objective measures showed limited changes. These findings suggest a potential symptomatic benefit of tonsillectomy in selected patients, although objective functional improvement remains uncertain.