鼻すすりによる中耳腔圧減少の検出 ティンパノメトリーを用いた方法

Abstract

Middle ear pressure (MEP) changes induced by sniffing were measured directly through a perforation of the tympanic membrane caused by otitis media with effusion (OME). Indirect measurements of MEP changes due to sniffing using tympanometry were also performed with healthy ears. This indirect method is easy to carry out and is non-invasive. Using tympanometry, showed that MEP decrease was induced by sniffing. Improvement in middle ear pressure of OME patients was measured the same way. One hundred OME patients aged one to eleven years were examined and their MEP changes were measured by tympanometry before and after sniffing or sobbing, during crying, and after swallowing. By statistical analysis, it is estimated that sniffing ability starts at the age of two. The incidence of MEP decrease by sniffing was 27.5% in patients over two years old, and that by sobbing was 18.8% in patients under five years old. Decreased MEP was not improved by swallowing in 20%. The ability to correct MEP was, however, higher in older children than in younger. It was concluded that using tympanometry, 1) the detection rate of MEP decrease by sniffing is lower than that by direct measurement of MEP; 2) MEP decrease by sniffing or sobbing occurs more easily in OME patients than with normal ears ; and 3) OME may occur and continue due to dysfunction of the Eustachian tube ; tubal closing failure and/or mechanical incomplete obstruction of the tube.