滲出性中耳炎に対する耳管通気の意義
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The significance of inflation of the middle ear through the eustachian tube on ears with otitis media with effusion (OME) was investigated from the aspects of middle ear ventilation and preservation of the patency of the eustachian tube.1. Middle ear pressure was serially monitored in ten ears with OME by tympanometry after catheter inflation. From a positive deflexion just after the inflation, the middle ear pressure decreased rapidly to negative within ten minutes.2. Conditions of the middle ear effusion of a patient with OME showed no remarkable change in magnetic resonance images recorded before and after three catheter inflations (every other day) of the middle ear.3. On both of the two temporal bones obtained from two children with OME, a thick effusion rich in cellular elements was found filling the bony portion of their eustachian tubes.4. The viscosity of middle ear effusion was significantly higher in the bony portion of the eustachian tube than in the hypotympanum.5. The eustachian tube function of a patient with OME following upper respiratory infection is described. The eustachian tube was obstructed, but after catheter inflation through it, its functions rapidly became normal, and her OME was cured in one week.The above observations indicate that inflation through the eustachian tube is more likely to exert its therapeutic effect by the preservation or the reestablishment of the patency of the eustachian tube than by ventilation of the middle ear.
- 耳鼻咽喉科臨床学会の論文
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