Eustachian tube and middle ear diseases

渗出性中耳炎（OME）恢复期患者不能解除中耳内的负压，这被认为是OME患者咽鼓管功能障碍的诱因。然而.切断猫腭帆张肌束，中耳内仅产生-200mmH_2O，不足以产生中耳积液。认为咽鼓管功能障碍和炎症过程产生的液体是治疗OME的必要条件。中耳负压和耳廓收缩也会影响内耳功能，引起暂时性感音神经性听力损失或平衡失调。认为中耳疾病引起的内耳功能障碍有待进一步研究，本研究建立的中耳压力负荷咽鼓管声测法是检测腭裂和中耳乳突瘤患者咽鼓管关闭障碍的有效方法。咽鼓管狭窄多见于分泌性中耳炎、慢性中耳炎和中耳瘤患者，而非器质性咽鼓管狭窄。在本研究中进行的术前咽鼓管功能测试中，正压测试的结果与鼓室成形术的结果相关。腺样体切除术作为治疗OME的有效性在一个大的系列中得到了证实。此外，本研究还证实了经鼓室电离子导入治疗骨肉瘤的新方法。

Patients in the convalescent stage of otitis media with effusion (OME) were not able to dissolve negative pressure loded in the middle ear, which was considered to be predisposing eustachian tube dysfunction in the patients oh OME. HOwEVER. transection of tensor veli palativi nuscle in cat brought about only -200mmH_2O in the middle ear, which was not sufficient for the production of middle ear effusion. Not only eustachian tube dysfunction but also production of fluid by inflammatory process were considered to be necessary for fhe envelopment of OME. Also, negative middle ear pressure and earbrum restraction were found to inflnence inner ear function causing temporary sensorineural hearing loss or disequilibrium. Further investigaion on inner ear dysfunction caused by middle ear diseases was considered to be encessary.Sonotubometry with middle ear peedssue loading developed in this study was found to be a useful method for detectinh closing failure og the eustachian tube, Which was frequently found in patients with cleft palate and middle ear cholesteatoma. Not an organic stenosis of the eustachian tube but the impairment of its active ventilatory function was found frequently in patients with OME, chronic otitis media and cholesteatoma. Among preoperative eustachian tube function tests performed in this study, results of positive pressure test correlated with the outcome of tympanoplasty. Efficacy of adenoidectomy as a treatment of OME was confirmed in a large series. In addition, efficacy of transtympanic iontophoresis, a new method for the freatment of ome, was also confirmed in this study.