鼻干预减少了对压力均等管道安置的需要在无氧成年人中
Lawrance Lee1, Mihai A Bentan1, Elizabeth Mastoloni2
1Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Virginia Commonwealth University, Richmond, Virginia, USA.
用医疗或外科干预来治疗上呼吸道的亚托皮性疾病可以改善中耳和尤斯塔希管的功能. 这项研究发现,包括手术和单克隆抗体治疗在内的各种治疗方法,减少了对压力均衡管的需求.
科学领域:
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 过敏和免疫学 过敏和免疫学
- 肺部病理学 肺部病理学
背景情况:
- 上呼吸道的亚托皮性疾病,如过敏性鼻炎和喘,是常见的,可以影响欧斯塔基管的功能.
- 欧斯塔基管功能障碍 (ETD) 可以导致中耳问题,并影响生活质量.
研究的目的:
- 评价管理上呼吸道形病症对成年人中耳和欧斯塔基管功能的影响.
- 为了比较不同医疗和手术干预措施在改善ETD方面的疗效.
主要方法:
- 使用TriNetX研究网络进行的一项回顾性队列研究.
- 确定了具有亚托皮上呼吸道疾病和并发ETD的成年患者.
- 干预措施包括单克隆抗体 (mAb) 疗法,鼻子类固醇喷雾,功能性内镜外科手术 (FESS),低级轮下粘膜切除 (BITSMR) 的血管整形以及过敏免疫疗法.
- 主要结局是治疗前和治疗后压力均衡管 (PET) 放置率的变化.
主要成果:
- 所有评估的干预措施都显示了对PET安置需求的统计显著减少.
- 功能性内镜外科手术 (FESS) 的绝对风险降低率 (ARR) 是最大的10.0%,其次是隔膜整形/BITSMR (7.5%) 和mAb治疗 (5.5%).
- 局部鼻类固醇喷雾剂 (甲) 和过敏免疫疗法也显示出显著的ARR (分别为0.9%和2.4%).
- 单个mAbs (dupilumab,mepolizumab,omalizumab) 的ARR分别为6.5%,6.8%和3.4%,它们之间没有显著差异.
结论:
- 通过医疗和外科干预来管理上呼吸道的亚托皮性疾病与中耳功能的改善有关.
- 需要放置压力均管 (PET) 作为这种改进的可测量指标.
- 手术和医疗治疗都为患有同时存在的亚托皮性疾病和尤斯塔希管功能障碍的患者提供了好处.
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