Sapci Tarik, Mercangoz Ersin, Evcimik M Fatih, Karavus Ahmet, Gozke Eren
Department of Otorhinolaryngology-Head & Neck Surgery, Fatih Sultan Mehmet Training and Research Hospital, 34752 Kadikoy-Istanbul, Turkey.
Eur Arch Otorhinolaryngol. 2008 Mar;265(3):271-8. doi: 10.1007/s00405-007-0435-5. Epub 2007 Sep 13.
Although there are several factors affecting the pathogenesis of chronic otitis, the pathological process has not been entirely defined yet. One of the theories suggested for the development of middle ear diseases is tubal dysfunction. The aim of the study is to analyze the function of the tensor veli palatini (TVP) muscle electromyographically in chronic middle ear pathologies and to evaluate the role of this muscle in eustachian tube dysfunction and pathogenesis of associated middle ear diseases by comparing with the results of healthy individuals.
A prospective, controlled, clinical trial. We enrolled 24 patients with chronic middle ear pathologies into our study and 18 controls without any previous ear problem. Electromyographic (EMG) needle was inserted into the TVP muscles in all patients transnasally. Functions of the TVP muscle were analyzed by using the amplitudes of the motor unit potential (MUP) and MUP durations detected on EMG. MUP amplitudes and MUP durations were compared statistically in all groups. When the mean MUP amplitudes and durations obtained from TVP muscles of all ears from the patient group were compared to the mean MUP amplitudes and durations obtained from healthy individuals, no statistically significant difference was observed between sick ears and control ears. Values obtained from the sick ears needed to be compared with mean values obtained from the control group separately, since absence of statistically significant difference cannot mean that we should ignore individual muscle dysfunction. The results we obtained from our study support that in the formation of different middle ear pathologies, myogenic defects in the eustachian tube have limited effects, except for existence of a predisposing factor like palate pathology. In all patients with chronic middle ear disease it is not appropriate to expect functional muscle dysfunction, however evaluation of TVP muscle function correctly may be helpful for bringing up the underlying possible muscle and nerve pathologies not in all patients.
虽然有多种因素影响慢性中耳炎的发病机制，但病理过程尚未完全明确。中耳疾病发展的一种理论是咽鼓管功能障碍。本研究的目的是通过肌电图分析腭帆张肌（TVP）在慢性中耳病变中的功能，并与健康个体的结果进行比较，评估该肌肉在咽鼓管功能障碍及相关中耳疾病发病机制中的作用。
一项前瞻性、对照临床试验。我们招募了24例慢性中耳病变患者进入研究，以及18例既往无耳部问题的对照者。所有患者均经鼻将肌电图（EMG）针插入TVP肌肉。通过使用肌电图检测到的运动单位电位（MUP）的幅度和MUP持续时间来分析TVP肌肉的功能。对所有组的MUP幅度和MUP持续时间进行统计学比较。当将患者组所有耳朵的TVP肌肉获得的平均MUP幅度和持续时间与健康个体获得的平均MUP幅度和持续时间进行比较时，患耳与对照耳之间未观察到统计学上的显著差异。由于缺乏统计学上的显著差异并不意味着我们应该忽略个体肌肉功能障碍，因此需要将患耳获得的值与对照组获得的平均值分别进行比较。我们从研究中获得的结果支持，在不同中耳病变的形成中，除了存在如腭部病变等易感因素外，咽鼓管的肌源性缺陷影响有限。在所有慢性中耳疾病患者中，期望出现功能性肌肉功能障碍是不合适的，然而正确评估TVP肌肉功能可能有助于发现并非所有患者潜在的可能的肌肉和神经病变。
