The Habit of Sniffing due to Nasal Diseases as a Cause of Secretory Otitis Media.

概要

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To clarify the role of nasal disease and the habit of sniffing in the pathogenesis of middle ear diseases, 123 pediatric patients with secretory otitis media (199 ears) were examined for associated nasal diseases and the habit of sniffing. Middle ear pressure and nasopharyngeal pressure were simultaneously measured during forceful sniffing.(1) More than half of the patients with secretory otitis media had allergic rhinitis and/or chronic sinusitis. (2) Fifty-nine percent of the patients with and 32% of those without nasal diseases sniffed habitually. (3) The patients with the habit of sniffing tended to create a higher negative pressure in the nasopharynx upon forceful sniffing than the patients who did not sniff. (4) In 27.8% of the patients with the habit of sniffing, negative pressure was observed in the middle ear during sniffing. In contrast, this occurred in only 16.5% of patients without the habit of sniffing.This study suggests that, in many patients with secretory otitis media, nasal disease plays an important role in its pathogenesis through the creation of negative nasopharyngeal pressure upon sniffing provoked by nasal diseases. This mechanism is presumed to be present in 5 - 10% of pediatric patients with secretory otitis media.
耳鼻咽喉科臨床学会の論文