成人の耳管機能と耳圧外傷について Tubal function and pressure injury of the ear in adults
During the past eighteen months, 49 cases of diving accident were seen in our outpatient unit. Pressure injuries to the middle ear owing to tubal dysfunction occured most frequently as the primary accident sustained in an underwater pressure environment. However, in eleven of our cases (15 ears) of sensory neural deafness, most frequently involving high tone hearing loss, was determine & to be clearly attributable to pressure. In particular, with respect to auditory disturbance in beginner divers, the considerable veriety of dysfunctions, including low tone hearing loss, reflect the variable conditions present at the time of injury. During evaluation of Eustachian tube function in these diving accident victims by means of the sonotubometric function test employing Valsalva's method in which intranasal pressure serves as a parameter at the time of tubal opening, it became apparent that many beginners had no knowledge of or experience with Valsalva's method. It has been known that about 12% of normal adults have no knowledge or experience with this method. Knowledge of the correct application of Valsalva's method is imperative in the proper training of divers. Thus, competence should be demonstrated by all divers' training personnel in the performance of Valsalva's method as a countermeasure for pressure injuries and as a middle ear function test utilizing tympatometry.
耳鼻と臨床 35(2), 189-196, 1989