頚部深部受容器と関連する耳管機能異常--proprio-vegetative reflexとしての耳管機能異常に対する神経耳科学的アプロ-チ (天理よろづ相談所病院耳鼻咽喉科開設15周年記念論文集)
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We found that patients with cervical pain often complained of fullness of the ear and moreover, these two complaints tended to change paralleling the course of treatment. To elucidate how tubal dysfunction is induced or enhanced by overexcitement of the cervical proprioceptors, the following examinations were conducted. Patients who suffered from cervical pain with or without fullness of the ear were examined using Kumazawa's tubotympanoaerography, where changes in the pressure of both the external ear canal and the nasopharyngeal cavity were examined using Valsalva's maneuver. In order to see the excitability of the adrenergic components in the central nervous system, the equilibrium test with adrenalin loading of Hinoki was carried out. Before and after procainization of tender spots of the neck, the tubal function and the equilibrium function (the righting reflex) were examined. From the results of the above-mentioned experiments, the following conclusions were drawn. Two types of tubal dysfunction, stenotic and paturous type, are probably induced by means of over-excitement of cervical proprioceptors, with more frequent occurrence of the former type. The activities of the autonomic and the somatic systems of a higher order, which respond to centripetal impulses from the cervical proprioceptors, seem to be considerably different between the two types of tubal dysfunction. Furthermore, it is postulated that in certain groups of patients with cervical pain, tubal dysfunction, particularly tubal stenosis can be produced as a result of hyperexcitability of adrenergic components in the hypothalamo-brain stem system, although the central mechanism of a paturous type still remains unsolved.
- 耳鼻咽喉科臨床学会の論文
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