Impact of Evolution on the Eustachian Tube
Impact of Evolution on the Eustachian Tube
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DOI：
10.1097/mlg.0b013e31815ddaa0
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发表时间：
2008-03-01
期刊：
影响因子：
2.6
通讯作者：
Bluestone, Charles D.
中科院分区：
文献类型：
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作者：
Bluestone, Charles D.
我认为人类似乎是唯一的物种，发展中耳炎。如果野生动物患上了严重程度的中耳疾病，那么它们在进化过程中就会被淘汰，因为它们无法在捕食者中生存下来，因为它们会失去听力。为什么人类会患中耳炎？进化产生了重大影响。众所周知，人类早出生了12个月，这是适应两足动物和我们的大大脑的结果，随着时间的推移，导致与非人类灵长类动物相比，女性骨盆出口相对较小。过早出生的后果不仅是我们的免疫系统不成熟，而且在生命的第一年，咽鼓管太短且松软。但是为什么中耳炎在老年人中仍然很常见呢？还有什么适应性是人类独有的？我们发展了与喉和舌骨下降相关的语言，沿着腭突的减少（即，面部扁平），导致腭形态的变化，与其他灵长类动物相比。比较解剖学和生理学研究已经证明了人类和猴子之间的显着差异，特别是在咽鼓管的肌肉中。与吞咽时的扩张相反，咽旁缩窄是人类和某些慢性中耳积液猴模型中常见的输卵管功能障碍。我的假设是，输卵管狭窄患者的慢性渗出性中耳炎是语言适应的结果，最有可能的是，腭帆提肌是原因。
I posit that humans appear to be the only species that develops otitis media. If animals in the wild had developed middle-ear disease to any significant degree, they would have been selected out during evolution because they would not have survived their predators given the associated hearing loss. Why do humans have otitis media? Evolution has had a significant impact. It is well known that humans are born 12 months too early, which is the result of adaptations to bipedalism and our big brain that, over time, resulted in a relatively small female pelvic outlet compared with nonhuman primates. As a consequence of too early a birth, not only is our immune system immature, but the eustachian tube is too short and floppy in the first year of life. But why is otitis media still common in older individuals? What other adaptation is uniquely human? We developed speech that was associated with descent of the larynx and hyoid bone, which, along with a decrease in prognathism (i.e., facial flattening), resulted in a change in palatal morphology as compared with other primates. Comparative anatomic and physiologic studies have demonstrated significant differences between humans and monkeys, especially in the muscles of the eustachian tube. Paradoxic constriction, as apposed to dilation, on swallowing is a common tubal dysfunction in humans and certain monkey models with chronic middle-ear effusion. My hypothesis is that chronic otitis media with effusion in patients with tubal constriction is a consequence of adaptation for speech and that, most likely, the levator veli palatini muscle is the cause.