THE EUSTACHIAN TUBE FUNCTION TEST IN HEALTHY SUBJECTS
The eustachian tube function was investigated in 100 ears of 50 healthy individuals in their 20s to 50s with no ear disease, by inspecting the opening of the eustachian tube (ET) using sonotubometry and impedance methods (Valsalva maneuver, Toynbee maneuver, deep breathing, and sniffling). Of the 10...
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| Published in | JIBI INKOKA TEMBO Vol. 62; no. 3; pp. 114 - 120 |
|---|---|
| Main Authors | , |
| Format | Journal Article |
| Language | Japanese |
| Published |
Society of Oto-rhino-laryngology Tokyo
15.06.2019
耳鼻咽喉科展望会 |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0386-9687 1883-6429 |
| DOI | 10.11453/orltokyo.62.3_114 |
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| Abstract | The eustachian tube function was investigated in 100 ears of 50 healthy individuals in their 20s to 50s with no ear disease, by inspecting the opening of the eustachian tube (ET) using sonotubometry and impedance methods (Valsalva maneuver, Toynbee maneuver, deep breathing, and sniffling). Of the 100 ears, the ET opening was found to be positive patent by sonotubometry in 82.0%, with during the Valsalva maneuver in 82.0%, and with during the Toynbee maneuver in 65.0%, and by all three methods in 51%. In sonotubometry, the duration of tubal opening ranged from 105 to 2,455 msec, with a mean of 569.5 msec. The ET opening was negative closed in a total of 35 ears by sonotubometry or during the Valsalva maneuver, and it was considered that these ears were at a higher risk of middle ear pressure injury. A total of 16 ears showed a “prolonged duration” of opening of more than 1,000 msec, or “movement of the tympanic membrane” during deep breathing or sniffling, and were believed to be at a higher risk of showing a patulous Eustachian tube in the presence of some trigger. It may be necessary to evaluate the ET status comprehensively based on a subject's symptoms, physical findings, and results of multiple ET function tests. |
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| AbstractList | The eustachian tube function was investigated in 100 ears of 50 healthy individuals in their 20s to 50s with no ear disease, by inspecting the opening of the eustachian tube (ET) using sonotubometry and impedance methods (Valsalva maneuver, Toynbee maneuver, deep breathing, and sniffling). Of the 100 ears, the ET opening was found to be positive patent by sonotubometry in 82.0%, with during the Valsalva maneuver in 82.0%, and with during the Toynbee maneuver in 65.0%, and by all three methods in 51%. In sonotubometry, the duration of tubal opening ranged from 105 to 2,455 msec, with a mean of 569.5 msec. The ET opening was negative closed in a total of 35 ears by sonotubometry or during the Valsalva maneuver, and it was considered that these ears were at a higher risk of middle ear pressure injury. A total of 16 ears showed a “prolonged duration” of opening of more than 1,000 msec, or “movement of the tympanic membrane” during deep breathing or sniffling, and were believed to be at a higher risk of showing a patulous Eustachian tube in the presence of some trigger. It may be necessary to evaluate the ET status comprehensively based on a subject's symptoms, physical findings, and results of multiple ET function tests.
耳疾患をもたない健常者の耳管機能を調べるため, 20~50歳代の50人100耳について音響法, インピーダンス法 (バルサルバ法, トインビー法, 深呼吸, 鼻すすり) による耳管の開閉を検討した。 音響法では82.0%, インピーダンス法ではバルサルバ法で82.0%, トインビー法で65.0%が陽性を呈した。 音響法, バルサルバ法, トインビー法の3法すべてが陽性となったのは51%であった。 音響法における耳管開放時間は 105~2,455msec で平均値は 569.5msec であった。 音響法またはバルサルバ法で耳管の開閉が確認されない症例が全部で35耳あり, 中耳圧外傷のリスクが若干高いと考えられた。 開閉持続時間が 1,000msec を超える “音響法延長” 症例, および深呼吸, 鼻すすりによる “鼓膜変動” 症例があわせて16耳に認められ, 何らかの誘因とともに耳管開放症の症状が出る可能性のある潜在的な症例と推測された。 健常者でも耳管機能検査は正常パターンを示さないこともあるため, 耳管の状態を把握するためには自覚症状, 理学的所見, 複数の耳管機能検査の結果を総合して判断していくことが必要と考えた。 The eustachian tube function was investigated in 100 ears of 50 healthy individuals in their 20s to 50s with no ear disease, by inspecting the opening of the eustachian tube (ET) using sonotubometry and impedance methods (Valsalva maneuver, Toynbee maneuver, deep breathing, and sniffling). Of the 100 ears, the ET opening was found to be positive patent by sonotubometry in 82.0%, with during the Valsalva maneuver in 82.0%, and with during the Toynbee maneuver in 65.0%, and by all three methods in 51%. In sonotubometry, the duration of tubal opening ranged from 105 to 2,455 msec, with a mean of 569.5 msec. The ET opening was negative closed in a total of 35 ears by sonotubometry or during the Valsalva maneuver, and it was considered that these ears were at a higher risk of middle ear pressure injury. A total of 16 ears showed a “prolonged duration” of opening of more than 1,000 msec, or “movement of the tympanic membrane” during deep breathing or sniffling, and were believed to be at a higher risk of showing a patulous Eustachian tube in the presence of some trigger. It may be necessary to evaluate the ET status comprehensively based on a subject's symptoms, physical findings, and results of multiple ET function tests. |
| Author | Sekine, Taiki Tsuji, Tomihiko |
| Author_FL | 辻 富彦 関根 大輝 |
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| References | 24) 菊地俊晶, 小林俊光, 大島猛史, 高田生織, 大島英敏, 他: 耳管開放症診断における音響耳管法 (Sonotubometry) の問題点 ―高い偽陽性率と検査法の位置づけ―. Otol Jpn 23: 193-197, 2011. 13) 一般社団法人日本耳科学会: 耳管機能検査マニュアル (2016). https: //www.otology.gr.jp/common/pdf/guideline_jikankensa2016.pdf. 7) 山口 隆: 耳管機能の年齢変化について (第一編) ―正常者の耳管機能―. 日耳鼻 97: 668-673, 1994. 19) Virtanen H: Patulous eustachiantube dignostic evaluation by sonotubometry. Acta Otolaryngol86: 401-407, 1978. 25) Smith ME, Tysome JR: Test of eustachian tube function: a review. Clin Otolaryngol 40: 300-311, 2015. 10) 大滝 一, 高橋 姿, 藤岡 治, 浦野正美, 中野雄一: 高齢者滲出性中耳炎の臨床的検討. Otol Jpn 5: 11-15, 1996. 12) 山口 隆, 隅上秀伯: 耳管機能の年齢変化と滲出性中耳炎の発症年齢について. 耳鼻 42: 1-6, 1996. 15) 大久保 仁, 渡辺 勈, 小山澄子, 奥野修次, 苦瓜智彦, 他: 成人の耳管機能と耳気圧外傷について. 耳鼻 35: 189-196, 1989. 20) 熊沢忠躬, 本庄 巖, 本田啓二: インピーダンスメーターによる動的耳管機能測定の試み. 耳鼻臨床 72: 1415-1423, 1979. 18) 一般社団法人 日本耳科学会: 耳管開放症診断基準案2016. https: //www.otology.gr.jp/common/pdf/guideline_jikan2016.pdf. 14) 柳田則之: 第13章高気圧酸素治療における中耳への影響Ⅳ耳管機能検査による検討. 日本耳鼻咽喉科学会 第95回総会 宿題報告 耳気圧外傷の基礎とその臨床. 柳田則之編: 名鉄局印刷 1994, 138-143. 9) 辻 富彦, 山口展正, 堀内博人, 森山 寛: 検診における成人の耳管機能 ―青年群を中心とした検討―. 耳展 39: 64-68, 1996. 4) 熊沢忠躬, 本庄 巖, 本田啓二: 気流動態法による耳管機能検査 ―正常範囲の確立. 臨床耳科 1: 4-5, 1974. 22) 大田重人: 耳管機能検査の実際. Otol Jpn 24: 835-841, 2014. 8) 大野文夫, 勝田兼司, 石川 勉, 坂本邦彦: 能動的耳管開閉能の加齢による変化. 耳鼻臨床 89: 305-309, 1996. 11) 内水浩貴, 山本耕司, 森山 寛: 成人発症の滲出性中耳炎と乳突蜂巣発育度との関係. 耳展 53: 280-286, 2010. 16) 北島尚治, 北島明美, 北島清治: 耳管機能検査を用いたスキューバダイバー患者のダイビング再開判定. 宇宙航空環境医学 50: 37-44, 2013. 6) 小川 明, 大沼秀行, 稲上健一, 吉川尚文, 大久保 仁, 他: 加齢による耳管機能の変化. 耳鼻臨床 80: 1529-1533, 1987. 17) 大野文夫: 圧と耳管開閉能 ―音響耳管機能検査法における測定―. 耳鼻臨床 81: 373-384, 1988. 21) 熊沢忠躬, 本庄 巖, 本田啓二: 耳管機能検査法における Perlman 法と気流動態法の比較. 日耳鼻 78: 10-18, 1975. 2) 山口展正: 耳管機能検査法. 耳展 37: 706-716, 1994. 3) 大田重人: 耳管機能検査の実際. Otol Jpn 24: 835-841, 2014. 5) 島田士郎, 山口展正, 佐野真一, 本多芳男: 正常者の耳管換気能について. 臨床耳科 14: 110-111, 1987. 1) 大島猛史: 耳管機能検査. 耳喉頭頸 88: 406-411, 2016. 23) 村上大輔, 君付 隆, 小宗静男: 耳管開放症例における耳管機能検査の検討. Otol Jpn 21: 233-237, 2011. |
| References_xml | – reference: 7) 山口 隆: 耳管機能の年齢変化について (第一編) ―正常者の耳管機能―. 日耳鼻 97: 668-673, 1994. – reference: 23) 村上大輔, 君付 隆, 小宗静男: 耳管開放症例における耳管機能検査の検討. Otol Jpn 21: 233-237, 2011. – reference: 8) 大野文夫, 勝田兼司, 石川 勉, 坂本邦彦: 能動的耳管開閉能の加齢による変化. 耳鼻臨床 89: 305-309, 1996. – reference: 6) 小川 明, 大沼秀行, 稲上健一, 吉川尚文, 大久保 仁, 他: 加齢による耳管機能の変化. 耳鼻臨床 80: 1529-1533, 1987. – reference: 20) 熊沢忠躬, 本庄 巖, 本田啓二: インピーダンスメーターによる動的耳管機能測定の試み. 耳鼻臨床 72: 1415-1423, 1979. – reference: 24) 菊地俊晶, 小林俊光, 大島猛史, 高田生織, 大島英敏, 他: 耳管開放症診断における音響耳管法 (Sonotubometry) の問題点 ―高い偽陽性率と検査法の位置づけ―. Otol Jpn 23: 193-197, 2011. – reference: 3) 大田重人: 耳管機能検査の実際. Otol Jpn 24: 835-841, 2014. – reference: 5) 島田士郎, 山口展正, 佐野真一, 本多芳男: 正常者の耳管換気能について. 臨床耳科 14: 110-111, 1987. – reference: 25) Smith ME, Tysome JR: Test of eustachian tube function: a review. Clin Otolaryngol 40: 300-311, 2015. – reference: 19) Virtanen H: Patulous eustachiantube dignostic evaluation by sonotubometry. Acta Otolaryngol86: 401-407, 1978. – reference: 15) 大久保 仁, 渡辺 勈, 小山澄子, 奥野修次, 苦瓜智彦, 他: 成人の耳管機能と耳気圧外傷について. 耳鼻 35: 189-196, 1989. – reference: 16) 北島尚治, 北島明美, 北島清治: 耳管機能検査を用いたスキューバダイバー患者のダイビング再開判定. 宇宙航空環境医学 50: 37-44, 2013. – reference: 2) 山口展正: 耳管機能検査法. 耳展 37: 706-716, 1994. – reference: 14) 柳田則之: 第13章高気圧酸素治療における中耳への影響Ⅳ耳管機能検査による検討. 日本耳鼻咽喉科学会 第95回総会 宿題報告 耳気圧外傷の基礎とその臨床. 柳田則之編: 名鉄局印刷 1994, 138-143. – reference: 11) 内水浩貴, 山本耕司, 森山 寛: 成人発症の滲出性中耳炎と乳突蜂巣発育度との関係. 耳展 53: 280-286, 2010. – reference: 12) 山口 隆, 隅上秀伯: 耳管機能の年齢変化と滲出性中耳炎の発症年齢について. 耳鼻 42: 1-6, 1996. – reference: 22) 大田重人: 耳管機能検査の実際. Otol Jpn 24: 835-841, 2014. – reference: 18) 一般社団法人 日本耳科学会: 耳管開放症診断基準案2016. https: //www.otology.gr.jp/common/pdf/guideline_jikan2016.pdf. – reference: 10) 大滝 一, 高橋 姿, 藤岡 治, 浦野正美, 中野雄一: 高齢者滲出性中耳炎の臨床的検討. Otol Jpn 5: 11-15, 1996. – reference: 1) 大島猛史: 耳管機能検査. 耳喉頭頸 88: 406-411, 2016. – reference: 13) 一般社団法人日本耳科学会: 耳管機能検査マニュアル (2016). https: //www.otology.gr.jp/common/pdf/guideline_jikankensa2016.pdf. – reference: 4) 熊沢忠躬, 本庄 巖, 本田啓二: 気流動態法による耳管機能検査 ―正常範囲の確立. 臨床耳科 1: 4-5, 1974. – reference: 17) 大野文夫: 圧と耳管開閉能 ―音響耳管機能検査法における測定―. 耳鼻臨床 81: 373-384, 1988. – reference: 9) 辻 富彦, 山口展正, 堀内博人, 森山 寛: 検診における成人の耳管機能 ―青年群を中心とした検討―. 耳展 39: 64-68, 1996. – reference: 21) 熊沢忠躬, 本庄 巖, 本田啓二: 耳管機能検査法における Perlman 法と気流動態法の比較. 日耳鼻 78: 10-18, 1975. |
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| SubjectTerms | deep breathing patulous Eustachian tube sonotubometry Valsalva maneuver バルサルバ法 深呼吸 耳管開放症 音響法 |
| Title | THE EUSTACHIAN TUBE FUNCTION TEST IN HEALTHY SUBJECTS |
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