慢性鼻窦炎对中耳功能的影响

目的：研究慢性鼻窦炎的病变范围、病程长短对中耳功能的影响。方法：利用纯音测听及声阻抗检测５６例慢性鼻窦炎患者的纯音听力,鼓室导抗图和咽鼓管功能。结果：慢性鼻窦炎虱咽鼓管功能异常４８．３％,鼓室导抗图异常４２．０％,气导听阈提高３３．９％,前组鼻窦炎和中耳功能比较有级性差异（Ｐ〈０．０１）,病程〉５年和≤５年比较,有极显著性差异（Ｐ〈０．０１）。结论：慢性鼻窦炎对中耳功能的影响,随着病变范围的扩大,     

腭裂与中耳功能障碍的相关性

目的：探讨腭裂手术对患者中耳功能的影响,为早期改善患者中耳功能提供依据。方法：对112例(224耳)腭裂患者进行年龄分组,采用声导抗、纯音测听或听性脑干反应检查。65例腭裂伴分泌性中耳炎患者在作腭裂修复术的同时,行鼓室置管术,术前术后作听力学检测,术前对鼓室分泌物作细菌培养。结果：腭裂患者常伴有不同程度的中耳功能障碍,腭裂修复术能明显改善患者中耳功能(P＜0.05)。鼓室分泌物Ｇ+、Ｇ-细菌培养阳性率为22.86%、23.53%,且多为低毒性条件致病菌。结论：腭裂患者常有中耳功能障碍,应重视其早期预防与治疗,早期修复腭裂有助于咽鼓管功能恢复。     

潜水员中耳气压伤与乳突气房的关系

已有研究阐明咽鼓管功能与乳突气房大小的关系,以及咽鼓管功能与中耳气压伤的关系,为了探讨潜水员中耳气压伤与乳突气房大小之间可能存在的关系,选择经过筛选的潜水员24人(48耳)进行研究,其     

关于中耳粘液腺的研究

已有研究表明:正常情况下咽鼓管腺体是局限在咽鼓管软骨部的粘膜下。在12孕周胎儿从咽口处开始形成,至27孕周停止,咽鼓管骨部则无腺体形成。这些腺体为管状腺泡的浆液粘液性腺体,有分泌浆液及粘液的功能。同样亦已有人发现在临床表现正常的和病     

中耳手术的一些基本概念

中耳手术已有数百年的历史 ,早期的手术主要目的是开放引流。上个世纪 5 0年代初期 ,德国的Wullstein和Z llner提出鼓室成形术的概念以及分型后 ,开始了真正的保留或重建听觉的功能性手术。此后许多学者在此基础上作了进一步发展 ,出现了许多新的分型和术式 ,很多名称有时很容易产生混淆。为了便于临床工作者的应用 ,下面对中耳手术的一些基本概念进行概述。中耳手术的基本要求　　一、彻底清除病变彻底清除病变是中耳手术最为重要的部分。不管采取留桥、移桥、断桥术式 ,其前提必须是保证彻底清除病变 ,避免复发。长期随访证明[1 3 ] ,留…     

腭裂对中耳传音和咽鼓管功能的影响

目的：了解腭裂对中耳传音和咽鼓管功能的影响及其影响的程度。方法：对４１例腭裂患者进行耳科学常规检查、咽鼓管咽口形态观察、声导抗测试,并与听力正常人进行对照。结果：腭裂患者中鼓膜病变率达８９．０％,咽鼓管咽口呈裂隙状形态达５９．５％,鼓室压图异常达８３．１％,镫骨肌反射消失率达８４．４％,与正常人对照,有极显著性差异。腭裂患者并发分泌性中耳炎的比率为７４．０％。结论：由于腭裂患者存在鼻另碚的易感染性     

中耳通气引流与鼓室成形术

正常的中耳形态是保持听觉传导通路的基础。维持中耳腔正常生理压力状态的必要条件是正常的咽鼓管功能和中耳腔内各部位通道畅通。咽鼓管功能障碍对任何类型中耳炎症的发生都是重要的因素。鼓室黏膜具有气体吸收和交换以及分泌和排泄功能，正常的咽鼓管功能调节鼓室气体的流通和鼓室压力。中耳气体引流通道有两处狭窄，第一处为咽鼓管，     

中耳与咽鼓管淋巴组织粘膜内浸润

淋巴组织粘膜内浸润(MALT)的组织学特征为固有层内淋巴组织团状集聚,通常有一生发中心。本文对99例年龄自出生后1天至86岁的人体颞骨,取咽鼓管的垂直切面,火棉胶包埋标本,从组织病理学角度检测其咽鼓管、中耳和乳突中MALT分布情况。 结果显示,44例1个月至7岁的婴幼儿中22例有MALT,发生率为50％;26例18岁以上的成人中仅2     

中耳胆脂瘤的再手术分析

７０年代以前中耳胆脂瘤的手术以根治为主，７０年代以后，更多地考虑到听力重建，有了完壁式、保留外耳道后壁的一期听力重建，或扩大的、轮廓化根治后一期、二期听力重建。无论何种方式都需要结合实际病例的具体情况来应用，每种方式都有一定的复发和再手术比例。本文旨在回顾性分析近十年（初次手术可追溯到２０年前）中耳胆脂瘤再手术的情况，分析再手术的原因、效果和初次手术应该汲取的教训，以及应如何重视咽鼓管功能重建等问题。1 材料与方法1．１ 病例资料 ５１例（６６耳）再手术患者．男２８例，女２３例，年龄１４～７０岁，平…     

Direct measurement of middle ear pressure through the eustachian tube

Summary We report a method for measuring middle ear pressure through the eustachian tube. We used a 1-mm-diameter micro-tip catheter pressure transducer (Mikro-tip) and inserted this into the tympanic cavity through the eustachian tube. In preliminary studies, we measured four normal ears, two ears with tubal dysfunction, one ear with a dry perforation and 13 ears with otitis media with effusion (OME). Among those ears with OME, three showed negative middle ear pressure, three slight positive pressure and one normal pressure. These findings suggest that our transtubal method is reliable and useful for measuring middle ear pressure.     

A comparative study on efficiency of middle ear pressure equalization techniques in healthy volunteers

Objective

To compare success rates of middle ear inflation device (Ear Popper ^©), Valsalva maneuver and Toynbee maneuver in middle ear pressure equalization in healthy adults.

Materials and methods

Adult volunteers with otoscopically healthy ears were enrolled to the study. In a prospective setting, 60 ears of 35 volunteers were divided into two groups according to eustachian tube (ET) functions tested using the nine step inflation deflation test. Group A: good eustachian tube function at nine step inflation deflation test (30 ears), Group B: possible dysfunction of the ET at nine step inflation deflation test (30 ears). All the volunteers performed Valsalva maneuver, Toynbee maneuver and Ear Popper^© application, respectively. The efficiencies of all the three techniques were statistically compared first overall, then paired-wise between the two groups.

Results

There was no statistical difference in success rates of middle ear pressure equalization techniques in 60 ears, regardless of ET function results (Valsalva and Toynbee maneuvers 51.7% effective, Ear Popper^© 43.3% effective). There was also no statistical difference among the middle ear pressure shifts obtained by these three techniques. In almost half of the subjects in whom at least one technique was unsuccessful, the other two was effective. When the groups were separately compared; there was no significant difference between Valsalva and Toynbee maneuvers, whereas Ear Popper^© was found more effective in Group A (56.7% vs. 30%, p = 0.037).

Conclusion

No statistical difference in equalization of the middle ear pressure was found among Valsalva maneuvers, Toynbee maneuvers and Ear Popper^© in healthy adults under physiological conditions. Using alternative techniques may improve the success individually when a technique fails.     

Reflux of nasopharyngeal content into middle ear through the eustachian tube

Whether nasopharyngeal content passes into the middle ear in patients without any head and neck pathology during the recovery phase of anesthesia is shown with an objective and prospective method. Thirty-eight patients, 21 female and 17 male, aged between 17 and 76, were included in the study. During the recovery phase of general anesthesia, 10 ml of 5 mCi Tc-99m-MAA was administered intranasally to the patients with a 10-F catheter. A manometer-adapted cuffed intubation tube was placed in the nasal passage so that the cuff was located at the choana. The pressure changes reflecting to the nasopharynx were recorded. The patients were extubated 10 min after the radionuclide was applied. The scintigraphic evaluation was done at the end of the 1st hour of the application of radionuclide. Transmission and emission views were taken with a gamma camera. Passage of nasopharyngeal content into the middle ear via the eustachian tube was not a statistically significant observation. The mean value of maximum pressure reflecting from the nasopharynx did not differ significantly between patients. Our study does not support the hypothesis that nasopharyngeal content passes directly through the eustachian tube into the middle ear and causes deleterious effects.     

The relationship between middle ear pressure and deviated nasal septum

The deviated nasal septum may be associated with middle ear problems, particularly on the side of nasal obstruction. This study aims to find out whether middle ear pressure (MEP) correlates with the degree of nasal obstruction secondary to a deviated nasal septum, and to examine changes in MEP following septal surgery. Patencies of the nasal passages (measured with a peak nasal inspiratory flowmeter) and MEP (measured with tympanometer) of 55 patients were obtained prior to surgery and 7.5 (6–10) months post-operatively [median (range)]. Forty patients completed the study. Results were analysed by linear regression. In the ear on the side of nasal blockage, MEP was -25.7±28.4 mm water pre-operatively, and following surgery increased significantly to -2.9±30.4 mm water (mean±sd ) (P < 0.001). Pre-operatively, it was inversely related to the difference in patencies between the two nasal passages (r = -0.32, P < 0.02). Post-operatively, its improvement correlated with the degree of reduction of asymmetry of airway patency (r = 0.56, P < 0.001).     

Seasonal allergic rhinitis and its effects on Eustachian tube function and middle ear pressure

Middle ear pressure was recorded from 396 ears and aural symptoms enquired of 198 adult subjects with seasonal allergic rhinitis. Evidence of Eustachian tube dysfunction was found in 24% of subjects. Increased duration of exposure to pollen over a further 2 weeks increased the incidence of Eustachian tube dysfunction to 48%. The development of Eustachian tube dysfunction did not correlate with the severity of nasal symptoms.     

中耳胆脂瘤手术同期行咽鼓管球囊扩张的临床观察

目的评价改良完壁式乳突根治加鼓室成形术同期行咽鼓管球囊扩张治疗中耳胆脂瘤并咽鼓管功能障碍的临床疗效。方法选取中耳胆脂瘤并咽鼓管功能障碍患者共64例,所有患者术前通过正负压平衡试验、鼓室滴药、Valsalva动作难易程度评分均证实为咽鼓管功能障碍。将患者随机分为对照组和观察组,其中对照组36例,观察组28例,对照组改良完壁式乳突根治加鼓室成形术,观察组行改良完壁式乳突根治加鼓室成形术并同期咽鼓管球囊扩张,记录两组术前及术后咽鼓管功能问卷评分（ETDQ 7）、干耳时间、纯音电测听及鼓室导抗图检查结果,比较两组患者的治疗效果。结果所有患者成功接受手术,术后随访6个月至1年,术前ETDQ 7评分、Valsalva测试、正负压平衡试验及纯音电测听（4PTA）对照组和观察组无统计学差异（P>0.05）;术后6个月对照组和观察组ETDQ 7评分、纯音测听（4PTA）阈值均较术前明显降低（P<0.05）;术后6个月对照组和观察组ETDQ 7评分、纯音测听（4PTA）阈值、鼓室导抗图、鼓膜内陷征象及干耳时间两组对比差异有统计学意义(P均<0.05)。结论咽鼓管功能不良是中耳胆脂瘤的一个重要因素,小样本随访发现改良完壁式乳突根治加鼓室成形术同期咽鼓管球囊扩张治疗中耳胆脂瘤并咽鼓管功能障碍的短期效果良好,但其远期疗效有待对更大样本进一步观察。     

Abnormal middle ear pressures during experimental influenza A virus infection--role of Eustachian tube function

Introduction: Experimental infection of adults with influenza A virus, rhinovirus or RSV causes abnormal ME pressure in some, but not all subjects. The hypothesis tested in this study is that the response variability is caused by constitutional differences in the functioning of the Eustachian tube. Methods: 18 adult subjects were experimentally infected with influenza A virus. On five occasions before virus exposure, middle ear pressure (by tympanometry) and Eustachian tube function (by sonotubometry) were recorded bilaterally. Tests were repeated on days 1 through 8 and 10 after infection. Individual ears were classified with respect to the number of pre-exposure, positive sonotubometric testings and the middle ear pressure response to infection was compared between ears with Eustachian tube openings at all pre-infection test sessions (GR-A) and those with at least one negative test (GR-B). Results: Pre-exposure, 19, six, four, four, one and two ears had tubal openings on five, four, three, two, one and zero sessions, respectively. For that period, GR-A had significantly lesser average intra-ear and intra-group middle ear pressure variances compared to GR-B, but there were no between-group differences in the average middle ear pressure or in the number of observations of abnormal middle ear pressure. After virus exposure, middle ear pressure variances and the number of abnormal observations increased and the average pressure decreased in both groups, but the effects were more pronounced for GR-B ears. Conclusions: These results support the hypothesis that pre-existing good Eustachian tube function reduces the otological complications of viral upper respiratory tract infection.     

Visualization of the middle ear with high resolution computed tomography and superfine fiberoptic videomicroendoscopy

Ten temporal bone blocks were dissected from fresh postmortem specimens from patients succumbing to diseases unrelated to the ears. A superfine fiberoptic videomicroendoscope (SFV) was introduced through the eustachian tube into the middle ear, and middle ear structures were visualized. The cadaver temporal bone blocks were also studied with high-resolution computed tomography (HRCT). When HRCT gave good results SFV did not succeed well and vice versa. However, SFV provided topographic anatomical information of the middle ear structures while HRCT gave cross-sectional images of the anatomy of the tympanic cavity. The different types of information obtained by the two imaging technologies supplement each other and were found to improve diagnosis in such cases as external ear canal atresia. Received: 22 July 1997 / Accepted: 28 October 1997     

Effects of desflurane on middle ear pressure

OBJECTIVE: To evaluate the effects of desflurane on middle ear pressure. STUDY DESIGN: A prospective clinical study. METHODS: In this study, 38 ears of 19 male children that were scheduled for circumcision were included. Baseline tympanometry reading was performed on each ear just before anesthesia. After induction anesthesia with propofol a laryngeal mask was applied and desflurane administration was started. The next tympanometry reading was taken at 5th, 10th and 15th minute after administration and at the 10th minute after the cessation of desflurane. Data were analysed using Wilcoxon test. RESULTS: Mean MEP values before anesthesia in 38 ears of 19 boys were -10.32+/-33.14. After starting the administration of desflurane 5th minute mean value was 71.15+/-60.42, at the 10 th minute 111.56+/-59.03 and at the 15th minute it increased to 120.50+/-54.14, and these measurements were significantly higher than the starting value (p<0.001). After cessation of desflurane mean MEP value dropped to 57.56+/-79.06, but compared with the starting value this was also significantly higher (p<0.001). CONCLUSION: Desflurane may increase the middle ear pressure and it may be unsuitable for certain middle ear surgeries.