Petrova Petia, Freeman Sharon, Sohmer Haim
Department of Otolaryngology-Head & Neck Surgery, Hadassah University Hospital, Jerusalem, Israel.
Otol Neurotol. 2006 Aug;27(5):734-8. doi: 10.1097/01.mao.0000226296.28704.de.
To assess the effects of positive and negative middle ear pressures on auditory threshold.
Nonatmospheric middle ear pressures can alter auditory threshold by their effects on tympanic membrane and ossicular chain mobility.
Experiments were conducted on guinea pigs by inducing alterations in pressure (positive and negative) with a syringe connected to the middle ear bulla cavity, the magnitude of the pressure being assessed with a water manometer. Elevated middle ear fluid pressures were also induced by attaching a saline-filled vertical tube to the saline-filled middle ear. The effect of these altered middle ear air and fluid pressures were assessed by recording auditory nerve-brainstem evoked responses.
There was no effect on auditory threshold of positive middle ear air pressures (up to 250 mm H2O). A negative middle ear air pressure of -50 mm H2O induced a significant 9.5-dB threshold elevation, whereas more negative pressures (up to -150 mm H2O) did not induce an additional threshold elevation. Filling the middle ear cavity with saline induced a 10- to 16-dB elevation, whereas additional fluid pressures (up to 200 mm H2O) did not induce further elevations.
The major factor inducing threshold elevation in serious otitis media is not the alteration in middle ear pressure but rather the reduction in the volume of compressible air in the middle ear by the fluid.
评估中耳正压和负压对听阈的影响。
非大气压的中耳压力可通过影响鼓膜和听骨链的活动度来改变听阈。
通过连接到中耳鼓泡腔的注射器诱导压力变化(正压和负压),用水压计评估压力大小,在豚鼠身上进行实验。还通过将充满盐水的垂直管连接到充满盐水的中耳来诱导中耳液体压力升高。通过记录听神经-脑干诱发反应来评估这些改变的中耳气压和液压的影响。
中耳正压(高达250 mm H₂O)对听阈没有影响。-50 mm H₂O的中耳负压导致听阈显著升高9.5 dB,而更负的压力(高达-150 mm H₂O)并未导致额外的听阈升高。用盐水填充中耳腔导致听阈升高10至16 dB,而额外的液体压力(高达200 mm H₂O)并未导致进一步升高。
在严重中耳炎中导致听阈升高的主要因素不是中耳压力的改变,而是液体使中耳内可压缩空气的体积减少。