Eustachian tube and middle ear diseases

渗出性中耳炎(OME)恢复期患者不能解除中耳负压负荷，被认为是OME患者咽鼓管功能障碍的易感因素。然而。猫腭帆张肌横断术在中耳仅产生-200 mm H_2O，不足以产生中耳积液。咽鼓管功能障碍和炎症过程中产生的液体被认为是OME包膜的必要条件。此外，中耳负压和耳廓收缩也会影响内耳功能，导致暂时性感音神经性听力丧失或平衡失调。中耳疾病所致内耳功能障碍的进一步研究是必要的。本研究开发的中耳踏板负荷超声测压技术是一种检测咽鼓管闭合失败的有效方法，该方法常见于腭裂和中耳胆脂瘤患者。在OME、慢性中耳炎和胆脂瘤患者中，常见的不是咽鼓管器质性狭窄，而是其主动呼吸功能受损。在本研究中进行的术前咽鼓管功能测试中，正压试验的结果与鼓室成形术的结果相关。腺样体切除术作为OME的一种治疗方法的有效性在一系列的研究中得到了证实。此外，本研究还证实了经鼓室离子导入这一治疗OME的新方法的有效性。

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.