しん出性中耳炎例の鼻腔粘液線毛機能 サッカリンテストによる

Abstract

The etiology of otitis media with effusion (OME) is still unknown. However, an inflammatory reaction to a bacterial infection originating in the nasopharynx is thought to be one of the main factors responsible for OME, and impaired mucociliary clearance of the nose and nasopharynx may increase the chance of infection through the Eustachian tube.Nasal mucociliary function was examined with the saccharin test in 115 noses of 61 patients with OME aged 8 to 92 years. Myringotomies were performed in almost all cases and aspirated middle ear effusions were classified into serous, mucoid and purulent types.1) Prolonged saccharin times (over 11 minutes) were noted in 84.3% of 61 patients with OME.2) The patients were divided into two proups; 35 patients had OME and chronic sinusitis (group A) and 26 patients had OME without sinusitis (group B). Prolonged saccharin times were found in 86.4% in group A and 81.6% in group B—not a statistically significant difference.3) Greatly prolonged saccharin times (over 30 minutes) were found in 45.5% in group A and 14.3% in group B—a significant difference. Thus, mucociliary function in the nose was thought to be impaired more severely in group A than group B.4) Bilateral OME and mucoid type effusion were found more frequently in group A than group B.5) The main cause of impaired nasal mucociliary function in group A was thought to be chronic inflammation of the nasal mucosa. On the other hand, acute upper respiratory infection preceding the development of OME was assumed to cause impaired nasal mucociliary clearance in group B.However, in group B, impaired nasal mucociliary function may be congenital in some cases without inflammatory findings by anterior rhinoscopy or episodes of acute upper respiratory infection