A Study on Systematic Clinical Functional Test of the Eustachian Tube and Its Applications (No.2)

输卵管功能障碍是引起中耳炎并影响其预后的重要因素。因此，该领域的主要研究目标是针对各种输卵管功能障碍的诊断和治疗。本课题旨在探讨一种可用于临床的系统的输卵管功能障碍检测方法。咽鼓管通常在吞咽时主动打开，以达到通气、气压平衡和中耳腔引流的目的。为了检验这些功能成就，得出以下结论：(1)管声测试方法将提供一种合适且简便的方法来检查主动开口对吞咽动作的影响。(2)压力测试可以定量地揭示管材整体结构的压差释放功能紊乱。为了制定输卵管功能障碍的治疗方案，分析功能障碍的发生部位及其机制是必不可少的。内镜检查将是最合适的，以明确功能障碍的部位及其机制。咽鼓管内窥镜的最新方法总结如下：(a)用普通的柔性纤维镜观察咽管口及其相关结构，即咽管环体、腭膜、肥大腺样体和咽管环体及其行为。(b)用通道纤维镜观察导管的软骨部分。充气作用下的行为将是诊断的重要信息，特别是对于有弯曲管的病例。(c)采用直径0.65mm的超薄光纤检查管的骨性部分。这将显示管峡的狭窄，这是最难发现的部位，以及骨部分。(4)为了研究管道各部位的压力释放机理，引入了超薄压力传感器，并对其利用进行了研究。应用本方法对小儿胆脂瘤及上颌腭异常患者的输卵管功能障碍进行了临床研究，发现潜伏性顺应管的存在率很高。少

Tubal dysfunction is an important factor which plays a prominent role to originate otitis media and influence its prognosis. Therefore, main targets of research in this field are directed toward diagnosis and treatment of various kinds of tubal dysfunction.In this research project, a systematic method of testing tubal dysfunction utilizable on clinical basis is investigated.1. The eustachian tube normally behaves active opening on swallowing to achieve ventilation, air pressure balance and drainage of the middle ear cavity. To test these functional achievement of the tube, the following conclusions were made: (1)Tubo-acoustic testing method will extend an appropriate and easy method of checking active opening on swallowing action. (2)Manometric tests will reveal disorders of release function of pressure difference of the tube quantitatively as a whole structure.2. In order to plan the treatment of tubal dysfunction, it is indispensable to analyze the site of functional disorder and its … More mechanism. (3)Endoscopic examination will be most appropriate to clarify the site of dysfunction and its mechanism. State-of-the-art methods of the eustachian tube endoscopy are summarized as follows: (a)The pharyngeal tubal orifice and related structures, that is, the tubal torus, palatal velum, hypertrophied adenoid and tubal torus, and their behaviors are observed with usual flexible fiberscopes. (b)The cartilaginous portion of the tube is observed with a channeled fiberscope. The behaviors under air inflation will be an important information for diagnosis, especially in cases with compliant tube. (c)The osseous portion of the tube is checked with the introduction of the ultra-thin fiberoptics of 0.65mm in diameter. This will reveal the stenosis at the tubal isthmus, the most difficult-to -detect site, and the osseous portion. (d)In order to investigate pressure release mechanism of each site of the tube, an ultra-thin pressure transducer is introduced and its utilization is investigated.3. With this procedures, tubal dysfunction in cases with pediatric cholesteatoma and maxillo-palatal abnormalities were investigated clinically, and a high rate existence of latent compliant tube is revealed. Less