耳鼻咽喉科領域における換気力学

Abstract

Organs in the upper respiratory tract -the ear, nose, throat and trachea, always contain air and act as a passage of air stream, which is closely related to essential functions of these organs, such as ventilation of the middle ear, sensation of smell, swallowing, phonation and respiration. Therefore, aerodynamic measurements of the upper respiratory tract would provide basic and important informations about both physiological and pathological conditions of these organs.Recently, aerodynamic method has been introduced and clinically employed in the field of otolaryngology. Some of the interesting research works are as follows;1. Aerodynamics of the nosea) Air stream in the nasal cavityObservations of air stream in the nasal cavity during respiration were made using the nose of a cadaver, patients after surgical removal of the upper jaw or a silicon model of the nasal cavity.b) Resistance in the nasal cavity during respiration Simultaneous registration of nasal air flow and differential pressure through the use of X-Y recorder permitted measurement of nasal resistance of each nasal flow rate. It was found nasal resistance increased in rhinitis hypertrophicance and decreased in rhinitis atrophicance.2. Aerodynamic measurement of velopharyngeal closureResistance of the velopharynx during speech was also measured by pressure-flow technique. Based on these results, indication of cleft palate operation was made.3. Aerodynamics of the Eustachian tubePressure change in the external ear canal during Valsalva's maneuver and deglutiton was found to represent air stream in the tube and tympanum. Comparison was made between the results obtained by aerodynamic method and Perlman's method, which has been widely used as a test for tubal dysfunction. It was found that aerodynamic method was more reliable and practical than Perlman's method in objective evaluation of the tubal function.Aerodynamic methods above-mentioned have contributed in solving many difficult problems in the field of otolaryngology. By clinical application of these technique more precise and effective diagnosis and treatment of the deseases in otolaryngology are quite promising.