Miura M, Takahashi H, Honjo I, Hasebe S, Tanabe M
Department of Hearing and Speech Sciences, Graduate School of Medicine, Kyoto University, Japan.
Laryngoscope. 1998 May;108(5):683-6. doi: 10.1097/00005537-199805000-00011.
To investigate the influence of gas exchange function through the middle ear mucosa on the development of sniff-induced middle ear diseases, the authors examined the mastoid pneumatization among patients with sniffing habit using computed tomography, and also examined the change of negative middle ear pressure induced by sniffing using tympanogram. In 20 ears with cholesteatoma or adhesive otitis media, the areas of mastoid cavity measured at the level of the lateral semicircular canal were significantly smaller than those in 26 ears with otitis media with effusion (OME) or attic retraction and in eight normal ears with sniffing habit (P < .01 and P < .0001, respectively). In 26 ears with OME or attic retraction, the areas of mastoid cavity were significantly smaller than those in eight normal ears with sniffing habit (P < .0001). By contrast, in the four ears with sniff-induced middle ear disease, the recovery of negative middle ear pressure in 5 minutes without swallowing was less than 10 mm H2O, whereas in all seven ears with normal eardrum, negative middle ear pressure recovered by more than 20 mm H2O in 5 minutes. These findings suggested that impairment of gas exchange function through the middle ear mucosa, as well as eustachian tube dysfunction, might be closely related to the development of sniff-induced middle ear diseases.
为了研究通过中耳黏膜的气体交换功能对嗅诱发性中耳疾病发展的影响，作者使用计算机断层扫描检查了有嗅鼻习惯患者的乳突气化情况，并使用鼓室图检查了嗅鼻引起的中耳负压变化。在20例患有胆脂瘤或粘连性中耳炎的耳朵中，在外侧半规管水平测量的乳突腔面积明显小于26例患有中耳积液（OME）或上鼓室回缩的耳朵以及8例有嗅鼻习惯的正常耳朵（分别为P <.01和P <.0001）。在26例患有OME或上鼓室回缩的耳朵中，乳突腔面积明显小于8例有嗅鼻习惯的正常耳朵（P <.0001）。相比之下，在4例患有嗅诱发性中耳疾病的耳朵中，在不吞咽的情况下5分钟内中耳负压的恢复小于10 mm H2O，而在所有7例鼓膜正常的耳朵中，5分钟内中耳负压恢复超过20 mm H2O。这些发现表明，通过中耳黏膜的气体交换功能受损以及咽鼓管功能障碍可能与嗅诱发性中耳疾病的发展密切相关。
