造影レ線法による耳管機能の研究　　実験的・臨床的観察

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  • Contrast Roentgenographic Studies of the Eustachian Tube Function
  • ゾウエイ レセンホウ ニヨル ジカン キノウ ノ ケンキュウ ジッケンテキ リ

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In order to clarify the processes of the tubal opening, and to examine the pump-like clearance function of the tube, contrast roentgenographic studies of the tube were conducted in 7 monkeys and 10 human beings. Experiment 1: Cineradiographic studies of the tube during selective stimulation of the levator and the tensor muscles were carried out in 4 monkeys. The levator stimulation produced a dilation of the pharyngeal orifice, but no tubal opening. On the other hand, tensor stimulation produced complete opening of the tube by outward displacement of the lateral wall of the tube. Experiment 2: During swallowing, simultaneous recording of the cineradiogram of the tube with an EMG of the tubal muscles was carried out in 3 monkeys. It was revealed that synchronously to the tensor activity, the cartilaginous tube opened for a very short time (ca. 250msec) by outward displacement of its lateral wall. On the other hand, the pharyngeal orifice of the tube dilated for a relatively long time (ca. 450msec) synchronously to the levator activity. This time lag between the two parts of the tube seemed to help its pumping function. Experiment 3: Serial roentgenography of the tube using a film-changer was carried out in 10 patients with perforated ear drum caused by chronic otitis media. First, it was revealed that the opening process of the tube in human beings was exactly the same as that observed in animals. Second, the slit-like tubal lumen was a little oblique at rest, and it opened through outward displacement of the lateral wall of the tube. Third, the so-called isthmus of the tube was obscure in many cases. Experiment 4: Cineradiography of the tube during swallowing was carried out in 10 patients in the same way as experiment 3. It was found that the tube had a pump-like function to pool fluid in it during the tensor contraction, and to expel it at the end of contraction in the pharynx.<br>It was concluded that the tube opened by the tensor contraction and closed by its relaxation. At the same time combination of contractions and relaxations of the tensor caused the pump-like function of the tube to expel any foreign body in the tympanum toward the pharynx.

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