Yaginuma Y, Kobayashi T, Takasaka T
Department of Otolaryngology, Tohoku University School of Medicine, Sendai, Japan.
Am J Otol. 1996 Jan;17(1):108-10.
To clarify the role of habitual sniffing caused by nasal diseases in the pathogenesis of middle ear diseases, 112 pediatric patients with secretory otitis media (183 ears) were examined for associated nasal diseases and habitual sniffing. Middle ear pressure and nasopharyngeal pressure were simultaneously measured during forceful sniffing. Fifty-four percent of the patients with secretory otitis media had allergic rhinitis and/or chronic sinusitis. Sixty percent of the patients with nasal diseases habitually sniffed, whereas only 30.8% of those without nasal diseases had this habit. In the patients with the habit of sniffing, a higher negative pressure tended to be created in the nasopharynx on forceful sniffing than in the patients who did not sniff. Thirty-one of 112 patients (27.7%) were positive on the sniff test. Of these 31 patients, 20 were associated with the habit of sniffing, and in 14 of the 20 patients, nasal diseases were considered to be the primary cause of the habit of sniffing. That is, in 14 of the 112 patients (12.5%) with secretory otitis media, the patients with nasal diseases frequently sniffed and their middle ears were evacuated. This study suggests that in many patients, sniffing provoked by nasal diseases plays an important role in the pathogenesis of secretory otitis media through the creation of negative nasopharyngeal pressure. This mechanism is presumed to be present in approximately one-tenth of pediatric patients with secretory otitis media.
为阐明鼻腔疾病引起的习惯性吸鼻在中耳疾病发病机制中的作用，对112例分泌性中耳炎患儿（183耳）进行了相关鼻腔疾病和习惯性吸鼻检查。在用力吸鼻时同时测量中耳压力和鼻咽压力。54%的分泌性中耳炎患者患有过敏性鼻炎和/或慢性鼻窦炎。60%的鼻腔疾病患者有习惯性吸鼻，而无鼻腔疾病的患者中只有30.8%有此习惯。有吸鼻习惯的患者在用力吸鼻时鼻咽部产生的负压往往高于无吸鼻习惯的患者。112例患者中有31例（27.7%）吸鼻试验呈阳性。在这31例患者中，20例与吸鼻习惯有关，在这20例患者中的14例中，鼻腔疾病被认为是吸鼻习惯的主要原因。也就是说，在112例分泌性中耳炎患者中的14例（12.5%）中，患有鼻腔疾病的患者频繁吸鼻，中耳得以排空。本研究表明，在许多患者中，鼻腔疾病引发的吸鼻通过产生鼻咽负压在分泌性中耳炎的发病机制中起重要作用。据推测，这种机制在约十分之一的分泌性中耳炎患儿中存在。
