Abstract
1. In reviewing the literature regarding the regulation of middle ear pressure, the importance of gas ventilation by the middle ear mucosa instead of aeration through the Eustachian tube has received recent attention. It has since been clarified that gas-exchange by the middle ear mucosa plays an important role in the maintenance of middle ear pressure in the stable state.2. Middle ear gas-exchange is chiefly performed by the mucosa of the mastoid air cell system, as shown in experiments using piglets, whose middle ear has air cell systems resembling the human middle ear. In addition, middle ear pressure has been shown to be closely related to the partial pressure of carbon dioxide (CO2) in the blood.3. Until now, complete mastoidectomy has usually been applied in cases of chronic otitis media for the purpose of the eradication of pathological lesions. Since realizing the importance of the mastoid air cell system, mastoidectomy has been modified to focus on the removal of the severely pathological mucosa and the preservation of normal mastoid air cells. Favorable postoperative results have subsequently been obtained.
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