Takahashi H, Hayashi M, Sato H, Honjo I
Department of Otolaryngology, Faculty of Medicine, Kyoto, Japan.
Arch Otolaryngol Head Neck Surg. 1989 May;115(5):581-4. doi: 10.1001/archotol.1989.01860290039011.
A study was performed to detect primary and secondary deficits in eustachian tube (ET) function in children with otitis media with effusion (OME). We examined ET function in the active and convalescent stages of OME in a total of 103 children (141 ears) and compared the results with those obtained in a control group of 34 ears. There were 27 children (33 ears) with OME in the convalescent stage and 76 children (108 ears) in the group with active OME. The test of ET function included the inflation-deflation test and dye clearance test. No cases of abnormally high tubal opening pressure were found in the convalescent OME group, and only 11% of ETs in the active OME group had high pressure. Negative middle ear pressure equalizing function, which was impaired in 97.2% of ETs in the active OME group, was still found to be impaired in 93.9% of ETs in the convalescent OME group. Eustachian tube clearance was impaired in 64.0% of ears with OME in the active stage; this percentage decreased considerably to 36.0% in ears in the convalescent stage of OME. We conclude that poor ability to equalize negative pressure is a fundamental deficit of ET function in OME; impaired clearance function of ET in the active stage of OME is not considered to be a primary cause of OME; there is almost no organic obstruction or stenosis of the ET in patients with OME.
一项研究旨在检测分泌性中耳炎（OME）患儿咽鼓管（ET）功能的原发性和继发性缺陷。我们对总共103名儿童（141只耳朵）OME的活动期和恢复期的ET功能进行了检查，并将结果与34只耳朵的对照组进行了比较。恢复期OME组有27名儿童（33只耳朵），活动期OME组有76名儿童（108只耳朵）。ET功能测试包括充放气试验和染料清除试验。恢复期OME组未发现咽鼓管开放压异常升高的病例，活动期OME组只有11%的ET有高压。活动期OME组97.2%的ET中耳负压平衡功能受损，恢复期OME组93.9%的ET仍有此功能受损。活动期OME患儿64.0%的耳朵咽鼓管清除功能受损；在OME恢复期，这一比例大幅降至36.0%。我们得出结论，负压平衡能力差是OME中ET功能的基本缺陷；OME活动期ET清除功能受损不被认为是OME的主要原因；OME患者的ET几乎没有器质性阻塞或狭窄。
