头颈部放疗后阻塞性与开放性咽鼓管功能障碍的比较
Obstructive versus patulous Eustachian tube dysfunction after head and neck radiotherapy.
文献信息
| PMID | 42966795 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Ciou-Nan Ye |
| 作者单位 | Department of Otolaryngology, Head and Neck Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan. |
| 期刊 | European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery |
| SCI 分区 | Q1 |
| IF | 2.3 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 耳科 |
中文摘要
目的： 描述头颈部放疗后阻塞性和开放性咽鼓管功能障碍（ETD）表型的特征，并评估其与治疗后阶段及临床因素的关联。
方法： 本横断面研究纳入100名已完成头颈部癌症调强放疗的成人。患者按放疗后时间分组（< 3个月、3个月至1年、1至3年、> 3年）。通过症状评估和客观检查将ETD表型分为阻塞性ETD（OETD）、开放性ETD（PETD）或两者均无。
结果： ETD表型分布在放疗后各阶段间存在显著差异（p = 0.018）。OETD在3个月内最常见（7/18 [38.9%]），在> 3年后较少见（5/44 [11.4%]），而PETD在1至3年（3/16 [18.8%]）和> 3年（9/44 [20.5%]）更常见。在13例PETD患者中，12例（92.3%）报告在前屈或躺下时改善。在探索性logistic回归中，校正鼻咽癌（NPC）状态后，较晚放疗后阶段与PETD之间的关联减弱（校正比值比[OR]，1.75；95%置信区间[CI]，0.84-3.66；p = 0.137），而NPC仍与PETD相关（校正OR，9.47；95% CI，2.49-36.04；p < 0.001）。
结论： OETD在较早的放疗后队列中更为突出，而PETD在较长期随访中更常被识别。明显的晚期开放型模式在很大程度上受NPC状态影响。这些发现为放疗后ETD提供了产生假设的框架，并支持以表型为导向的临床评估。
英文摘要
PURPOSE: To characterize obstructive and patulous Eustachian tube dysfunction (ETD) phenotypes after head and neck radiotherapy and evaluate their associations with post-treatment stage and clinical factors.
METHODS: This cross-sectional study enrolled 100 adults who had completed intensity-modulated radiotherapy for head and neck cancer. Patients were categorized by time since radiotherapy (< 3 months, 3 months-1 year, 1-3 years, and > 3 years). ETD phenotypes were classified as obstructive ETD (OETD), patulous ETD (PETD), or neither using symptom assessment and objective testing.
RESULTS: ETD phenotype distribution differed significantly across post-radiotherapy stages (p = 0.018). OETD was most common within 3 months (7/18 [38.9%]) and less frequent after > 3 years (5/44 [11.4%]), whereas PETD was more frequent at 1-3 years (3/16 [18.8%]) and > 3 years (9/44 [20.5%]). Among 13 patients with PETD, 12 (92.3%) reported improvement with forward bending or lying down. In exploratory logistic regression, the association between later post-radiotherapy stage and PETD was attenuated after adjustment for nasopharyngeal cancer (NPC) status (adjusted odds ratio [OR], 1.75; 95% confidence interval [CI], 0.84-3.66; p = 0.137), whereas NPC remained associated with PETD (adjusted OR, 9.47; 95% CI, 2.49-36.04; p < 0.001).
CONCLUSION: OETD was more prominent in earlier post-radiotherapy cohorts, whereas PETD was more frequently identified during longer-term follow-up. The apparent late-stage patulous pattern was substantially influenced by NPC status. These findings provide a hypothesis-generating framework for post-radiotherapy ETD and support phenotype-directed clinical evaluation.