新型鼻咽腔鏡による耳管・鼓室造影法--特に先天性外耳道閉鎖症の聴力改善手術への寄与
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概要
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There are two prerequisites for the indication of hearing-improvement operation in cases of atresia auris congenita, that is, confirmation of the site, and size of the tympanic cavity and the patency of the eustachian tube.For this purpose tubotympanographic examinations were carried out with the aid of newly devised nasopharyngoscope. At a clear sight of the pharyngeal ostium of the eustachian tube, a polyethylene tube, 1.3mm in outside diameter, was inserted into the eustachian tube through a narrow metal pipe attached to themaininstrument until it came into the tympanum. After the nasopharyngoscope was drawn out while the polyethylene tube was kept remained, 0.2-0.5m1 of contrast medium (80% Angio Conray) warmed to body temperature beforehand in order to avoid inducing nausea and vertigo, was poured through the tube. X-ray examinations were performed in the Schuller and Hirtz positions. In noncooperative patients, e.g., infants and young children, those procedures were done under general anesthesia with intramuscular injections of Ketamine hydrochloride. Since 1970, 23 cases were examined with no complications nor sequelae. Another merit of this method was in identification of missing tympanic cavity by ventilation through the indwelling polyethylene tube during surgery.Additional findings were presented regarding the figure of the pharyngeal ostium of the eustachian tube in malformed ear. Morphological aberrations were seen more frequently in malformed patients than the normal, suggesting a correlation of malformed development between the sound conducting apparatus and the eustachian tube.
- 一般社団法人 日本耳鼻咽喉科学会の論文