耳管開放症症例における耳管機能検査の検討 Eustachian tube function tests (tubo-tympano-aerodynamic graphy and sonotubometry) in patients with patulous eustachian tube

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著者

    • 村上 大輔 MURAKAMI Daisuke
    • 九州大学大学院医学研究院 耳鼻咽喉科学分野 Department of Otorhinolaryngology, Faculty of Medicine, Kyushu University
    • 君付 隆 KIMITSUKI Takashi
    • 九州大学大学院医学研究院 耳鼻咽喉科学分野 Department of Otorhinolaryngology, Faculty of Medicine, Kyushu University
    • 小宗 静男 KOMUNE Shizuo
    • 九州大学大学院医学研究院 耳鼻咽喉科学分野 Department of Otorhinolaryngology, Faculty of Medicine, Kyushu University

抄録

病歴、症状、呼吸時の鼓膜所見から耳管開放症と診断できる症例でも耳管機能検査が陰性であることも多い。本研究では、病歴、症状、呼吸時の鼓膜所見から耳管開放症と考えられた症例の耳管機能検査陽性率を検討し、診断における耳管機能検査の有用性を検討した。耳管機能検査による陽性率は、インピーダンス法によるTTAGで53.1%、sonotubometryで84.4%でありsonotubometryはTTAGと比べ有意に陽性率が高かった。TTAGの陽性率が低い原因として嚥下によるsonotubometryと比較してバルサルバ通気によるTTAGの耳管開放率が低いことが一因と考えられた。バルサルバ法で上手く耳管開放が出来ない症例、特に片側耳管開放症例、呼吸性鼓膜動揺の認めない症例の診断においてsonotubometryはTTAGより有意に陽性率が高く、そのような症例の診断においては耳管開放症を示唆するスクリーニング検査としてTTAGを補完する事ができ有用な検査と考えられた。

Most of patients with patulous eustachian tube (PET) are diagnosed by the clinical history, symptoms and eardrum findings during respiration. In addition, the results of eustachian tube function tests are useful to diagnose PET. However, we often experienced the clinical findings showing clearly PET but the results of eustachian tube function tests showed negative. Thus we analyzed eustachian tube function tests including tubo-tympano-aerodynamic graphy (TTAG) and sonotubometry of the patients with PET diagnosed by the clinical history, symptoms and eardrum findings during respiration. Then, we also compared the results of tubal function tests using TTAG and sonotubometry in the patients with unilateral or bilateral PET, or PET with or without eardrum movement during respiration. The positive rate of TTAG and sonotubometry of the patients with PET was 53.1% and 84.4%, respectively. Thus the positive rate of sonotubometry of the patients with PET was significantly higher than TTAG. The positive rate of sonotubometry in the patients with unilateral PET or PET without eardrum movement during respiration was significantly higher than TTAG. Moreover, the tubal opening was obtained significantly more easily by sonotubometry than TTAG and the rate of tubal opening in response to Valsalva maneuver of the patients with unilateral PET was significantly lower than bilateral PET.<br>These results suggested that sonotubometry was more useful as a screening test for the diagnosis of the patients with unilateral PET or PET without eardrum movement during respiration, including the patients with PET who were not responding to Valsalva maneuver than TTAG, and that sonotubometry could be complementary to TTAG for the diagnosis of those patients with PET.

収録刊行物

  • Otology Japan

    Otology Japan 21(3), 233-237, 2011-07-25

    日本耳科学会

参考文献:  15件中 1-15件 を表示

被引用文献:  1件中 1-1件 を表示

各種コード

  • NII論文ID(NAID)
    10030285110
  • NII書誌ID(NCID)
    AN10358085
  • 本文言語コード
    JPN
  • 資料種別
    ART
  • ISSN
    09172025
  • データ提供元
    CJP書誌  CJP引用  J-STAGE 
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