しん出性中耳炎の耳管咽頭口粘液線毛機能

Abstract

The mucociliary function of the nose and eustachian tube orifice was examined by the saccharin test in 46 patients with OME (otitis media with effusion), aged 12 to 79 years, to determine whether impaired mucociliary function of these areas plays a pathogenic role in OME. The control group included 29 normal subjects, aged 20 to 70 years, who had no diseases of the nose or ears.The saccharin test of the nose was performed as reported previously, and the normal upper limit was determined to be 11 minutes. For the evaluation of mucociliary function around the eustachian tube orifice, a nasoendoscope (Olympus ENF-type P) with a thin tube and syringe attached was used to apply the saccharin solution plus gentian violet. A drop of saccharin solution could be accurately placed at the eustachian tube orifice with the nasoendoscope monitor, and the time for the subject to report a sweet taste was recorded up to 15 minutes. The normal upper limit of the saccharin time around the eustachian tube orifice was determined to be 4 minutes. Both tests were performed on the right side in the normal controls, on the side of the affected ear in patients with unilateral OME, and on the right side in patients with bilateral OME.Mucociliary function around the eustachian tube orifice was found to be impaired significantly and correlated well with that of the nose. It is therefore possible that mucociliary dysfunction of these areas increases the risk of infection via the eustachian tube or prolongs inflammation in the middle ear.