Sadé J
Sackler School of Medicine, Ear Research Laboratory, Tel Aviv University, Israel.
J Laryngol Otol. 1994 Feb;108(2):95-100. doi: 10.1017/s0022215100126003.
It has been classically hypothesized that a mass in the nasopharynx causes an obstacle to air flow through the eustachian tube, thereby creating a negative pressure in the middle ear followed by an effusion. However, examination of the relevant data concerning the supposed obstruction of the eustachian tube by nasopharyngeal carcinomas, choanal polyps and adenoids does not seem to support this cause and effect relationship. Evidence points to other more sophisticated mechanisms which cause negative pressure and an effusion in pathological middle ear conditions. While the hypothesis of a nasopharyngeal mass as the usual obstructive cause of middle ear effusion is hard to maintain, evidence does exist to support the origin of middle ear infection, as seen in acute and secretory otitis media, as being associated, at times, with an ascending infection from the nasopharynx.
传统观点认为，鼻咽部肿物会阻碍空气通过咽鼓管流动，从而在中耳形成负压，进而导致中耳积液。然而，对有关鼻咽癌、后鼻孔息肉和腺样体导致咽鼓管梗阻的相关数据进行研究后发现，这似乎并不支持这种因果关系。有证据表明，在病理性中耳疾病中，导致负压和积液的是其他更为复杂的机制。虽然鼻咽部肿物是中耳积液常见梗阻原因这一假说难以成立，但确实有证据支持中耳感染（如在急性和分泌性中耳炎中所见）有时源于鼻咽部的上行感染。
