Patho-physiological Study of the Lower Air Way on the Cases of Laryngeal Disturba

Abstract

It is needless to say that cases with laryngeal disturbances develop various influences on the lower air way. I have patho-physiologically examined the lower air way of cases who underwent tracheotomy and total laryngectomy. The study was comprised of observations on the ciliary activity and bacteriogical, immunological observations. The following results have been obtained.1) As a preliminary examination, ciliary movement (beat numbers) of the tracheobronchial tree at different levels were measured in normal dogs by the rose-chamber method. It was demonstrated that the ciliary activity becomes reduced, though very slightly, in the peripheral part of the tracheo-bronchial tree. The decreasing degree in the activity was not so remarkable as that of the mucous flow rate reported by Kilburn (1970).2) The ciliary activity of the tracheo-bronchial tree at different levels in the rabbits at one week after tracheotomy was found to show the similar tendency as mentioned above for the normal dogs, except of the region where the mucous membrane was direcely damaged by the surgery. This fact suggests that the cleaning function on the lower air way is little affected by laryngeal disturbance.3) No bacterium was detected from the bronchus at the time of tracheotomy and laryngectomy. With the lapse of time after the surgery, however, bacteria became detected from the bronchus approximately in 2/3 cases of tracheotomy and a half of cases of laryngectomy, respectively. The strains of bacteria detected after tracheotomy were similar to those detected from the pharynx, while those detected after laryngectomy were not. This seems to indicate that bacteria in the pharynx fall down and invade to the lower air way when laryngeal disturbanc are caused4) By measuring anti-body titer of the serum and the bronchial secretion, the presence of bacteria responsible for inflammation on the lower air way was recognized. It was also made known that changes in the anti-body titer arein accordance with the progress of clinical sign.