耳管機能検査の臨床的意義

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The important role of tests to measure the influence of eustachian tube function (ETF)in the pathogenesis of several middle ear diseases has been proposed, though various clinical problems remain in medical practice with respect to the eustachian tube (ET). With a view to developing therapies and prophylaxis for middle ear diseases caused by eustachian tube dysfunction (ETDF), we looked into the availability of eustachian tube function tests (ETFT) while reviewing the literature on relationships between middle ear diseases and ETF.<BR>Clinical evaluation of ETDF involves tympanograms and/or an air insuffiation with a tubal catheter. However, the results of these examinations do not reveal certain kinds of ETDF, for instance, floppy or open tubes, etc. Measuring ETF by sonotubometry, tubotympanoaerodynamography (TTAG), inflation-deflation testing (I-D test), or impedance audiometry might significantly increase the precision of pathophysiological diagnosis of ETDF. We believe that sonotubometry is the most convenient method to use for many middle ear diseases without effusions, while TTAG is a relatively difficult method for children. Further more, I-D test can be done under almost all aural conditions, if ventilation can be maintained via the tympanic membrane.<BR>We conclude that ETF measurement can be done more appropriately by the use of a combination of proper ETFT.
耳鼻咽喉科臨床学会の論文