Nemechek A J, Pahlavan N, Cote D N
Department of Otolaryngology-Head and Neck Surgery, Tulane University School of Medicine, New Orleans, Louisiana 70112-2699, USA.
Otolaryngol Head Neck Surg. 1997 Nov;117(5):475-9. doi: 10.1016/S0194-59989770017-2.
Eustachian tube dysfunction frequently results in clinical evidence of otitis media with effusion (OME). Surface active substances, surfactants, are hypothesized to play a role in normal eustachian tube function. Recent work in a rodent model has demonstrated improved eustachian tube function with topical application of surfactants to the middle ear. A novel, noninvasive, and clinically practical method of delivering surfactant to the eustachian tube was studied in a gerbil model of OME. Otitis media with effusion was experimentally induced in 20 gerbils by transtympanic inoculation of heat-killed Streptococcus pneumoniae. This represents a well established model for creating a serous effusion in the gerbil that significantly increases eustachian tube opening pressure. Effusion developed in 27 of 40 ears (67.5%) after inoculation. An inhaled nebulized surfactant was used to treat the animals with microscopically confirmed OME in one or both ears. The treatment period was 5 days. Eustachian tube opening studies were performed on both affected and nonaffected animals. Successful eustachian tube opening pressures were obtained in 30 of 36 ears (83.3%). The mean opening pressure for ears without effusion (healthy ears) was 42.8 mmHg. The mean opening pressure for ears with effusion in animals treated with nebulized surfactant was 41.4 mmHg. The difference between these mean values was not statistically significant (t = 0.32; p > 0.50). This pilot study suggests that inhaled nebulized surfactant may be efficacious in treating eustachian tube dysfunction when manifested in disorders such as OME.
咽鼓管功能障碍常常导致中耳积液（OME）的临床证据。表面活性物质，即表面活性剂，被认为在正常咽鼓管功能中发挥作用。最近在啮齿动物模型中的研究表明，向中耳局部应用表面活性剂可改善咽鼓管功能。在OME沙鼠模型中研究了一种将表面活性剂输送到咽鼓管的新颖、无创且临床实用的方法。通过经鼓膜接种热灭活的肺炎链球菌，在20只沙鼠中实验性诱发中耳积液。这是一个在沙鼠中建立的用于产生浆液性积液的成熟模型，该积液会显著增加咽鼓管开放压力。接种后，40只耳朵中有27只（67.5%）出现了积液。使用吸入雾化表面活性剂治疗一只或两只耳朵经显微镜确诊为OME的动物。治疗期为5天。对受影响和未受影响的动物都进行了咽鼓管开放研究。36只耳朵中有30只（83.3%）成功获得了咽鼓管开放压力。无积液耳朵（健康耳朵）的平均开放压力为42.8 mmHg。接受雾化表面活性剂治疗的有积液耳朵的平均开放压力为41.4 mmHg。这些平均值之间的差异无统计学意义（t = 0.32；p > 0.50）。这项初步研究表明，当咽鼓管功能障碍表现为如OME等疾病时，吸入雾化表面活性剂可能对其治疗有效。
