Significance of adenoidectomy in the treatment of secretory otitis media.
Explore the source record for details and available documents.
Adenoidectomy↗
Biomedical subjects
I Honjo
Publications and source records attributed to I Honjo.
Clearance function of eustachian tube and negative middle ear pressure.
Two experimental studies were performed using 18 cats in order to elucidate the mechanism of the long-lasting course of otitis media with effusion. First, the middle ear (ME) pressure was monitored for 2.5 to 7 hours after filling the whole ME space with saline. On average, -150 mm H2O of negative ME pressure was induced in 3.1 hours. Second, the residual volume of saline with antibiotics, which was put into the ME space 2 to 7 days before, was compared between the side on which tubal ventilatory function was abolished (resection of tensor veli palatini muscle and hamulus pterygoideus) and the opposite, control side. The percentage of the residual volume to the original volume put into the ME was significantly higher on the experimental side (Wilcoxon's ranking test, t = 27.0, p less than .05), and in one ear on the experimental side, the ME pressure showed-150 mm H2O just before the bulla was opened 2 to 7 days later. These results seem to indicate that tubal ciliary clearance function can induce negative ME pressure when there is fluid in the ME, and that the negative ME pressure induced by clearance of the ME fluid may disturb further clearance of the ME fluid. This condition may cause the long-lasting course of otitis media with effusion.
Animals↗
Pathogenesis of experimental otitis media with effusion caused by a combination of eustachian tube dysfunction and immunosuppression.
Inflammatory factors appear to play an important role in the development of otitis media with effusion (OME). However, otitis media experimentally induced by endotoxin injection or secondary immunoresponse was not persistent. In order to produce refractory OME, two pathologic conditions were necessarily combined: tubal ventilatory dysfunction and suppression of the immunologic defense mechanism by immunosuppressive drugs. In the presence of these two pathologic conditions, all cases that evidenced negative middle ear pressure due to tubal dysfunction developed OME. In the control group with either tubal dysfunction or immunosuppression alone, only 1 of 20 ears developed OME. Transtubal infection due to negative middle ear pressure caused by tubal ventilatory dysfunction may be one of the most important etiologic factors in OME.
Animals↗
Malignant fibrous histiocytoma of the liver: a case report and review of the literature.
Primary malignant fibrous histiocytoma (MFH) of the liver is reported in a 79-year-old man. The tumor, measuring 8.0 x 8.0 x 6.0 cm, was located in the left lobe of the liver and consisted of spindle cells in a storiform pattern intermingled with bizarre giant cells. Immunohistochemically, most of the tumor cells expressed vimentin. Cytoplasmic immunoreactivity for alpha 1-antichymotrypsin was documented in the giant cells. However, epithelial expression could not be demonstrated.
Aged↗
The influence of middle ear pressure on the lateral vestibulospinal tract neurons in cats.
The influence of changes in middle ear pressure on the lateral vestibulospinal tract (LVST) neurons was investigated in anesthetized cats. The activities of some LVST neurons increased with negative pressure and decreased with positive pressure. This tendency was stronger when pressure changes were applied to the contralateral middle ear than to the ipsilateral side. The influence of changes in middle ear pressure on LVST neurons was opposite to that on the vestibular nerve, suggesting the existence of inhibitory inter- and commissural neurons.
Animals↗
Experimental study of the mobility of the vocal fold mucosa.
Explore the source record for details and available documents.
Aged↗
Electrical pacing for dynamic treatment of unilateral vocal cord paralysis. Experiment in long-denervated muscle.
In order to explore the possibility of clinical application of laryngeal pacing as a treatment for unilateral vocal cord paralysis, we examined the reactivity of atrophic muscle to electrical stimulation in dogs whose recurrent laryngeal nerves were damaged by crushing, dissection followed by resuturing, or a 3-cm neurectomy. The threshold level to induce enough vocal cord adduction reached the maximum at 2 weeks after nerve injury, decreased with time, and never surpassed 7 V in each case. On the basis of results of these preliminary probings, laryngeal pacing was conducted on a dog 15 months after resection of the laryngeal nerve. Adduction of the paralyzed vocal cord for synchrony with the intact cord was achieved by 7 V of electrical stimulation of the thyroarytenoid muscle that was triggered by signals from the cricothyroid muscle.
Animals↗
Middle ear pressures of children with otitis media with effusion.
Middle ear (ME) pressures were measured in 30 children with chronic otitis media with effusion (OME) transtubally with the use of a catheter pressure transducer (Mikro-tip, PC-330F). They were found to range from 40 to -185 mm H2O, the average being mildly negative (-54.33 +/- 59.04 mm H2O). About two thirds of these children had pulsating changes of ME pressure; the range of the pressure change was between 10 and 50 mm H2O. The ME pressure tended to be lower in ears with serous effusion than in those with mucoid effusion, but there was no significant difference between them.
Child↗
Responses and anatomical connections of peripheral vestibular neurons innervating otolith organs.
The response patterns of the Scarpa's neurons and lateral vestibular nucleus (LVN) neurons that respond to lateral and antero-posterior tilting were investigated using cats. The following observations were made: 1) The Scarpa's neurons that respond to lateral tilting have directional sensitivity physiologically and may innervate the utricular macula; 2) The LVN neurons that respond to lateral tilting are found mostly in the ventral part of the LVN and also have directional sensitivity. They project toward the spinal cord into the lateral vestibulo-spinal tract.
Acoustic Maculae↗
Laryngeal pacing in unilateral vocal cord paralysis. An experimental study.
In an attempt to remobilize a unilaterally paralyzed vocal cord, experiments were made in five adult dogs. Adduction of the paralyzed vocal cord for phonation in synchrony with the intact cord was achieved by electrical stimulation of the adductor muscles that was triggered by the signals from the cricothyroid muscle. The difference in the level of action potentials of the cricothyroid muscle between during phonation and during respiration was used for setting the threshold so as to differentiate phonation from respiration. Nearly synchronous movement of the two vocal cords thereby attained during phonation greatly improved the voice quality that was hoarse without the paced stimulation.
Action Potentials↗
Transtympanic endoscopic findings in patients with otitis media with effusion.
Using a fine, rigid endoscope (Olympus, SES-1711K), we examined the middle ear, including the tympanic orifice of the eustachian tube, of children with otitis media with effusion (OME) in its active stage (26 ears), in the convalescent stage (13 ears), and during treatment with ventilation tubes for 10 days to 6 months (five ears) through myringotomy with the patients under general anesthesia. Several color photographs of representative ears are shown. In the active stage of OME, edema (73.1%) and hyperemia (23.1%) were characteristic features of the middle ear mucosa, and normal mucosa was seen in only one ear (3.1%). The tympanic orifice of the eustachian tube, which could be examined in 12 ears, were stenosed with edema in four ears (33.3%) or plugged with effusion in three ears (25.0%) in this group. In the convalescent stage of OME, dilated vessels were most often seen (69.2%), but the rest of the patients had normal mucosa (30.8%) in the middle ear, and none of them had edema nor hyperemia. The tympanic orifice of the eustachian tube, which could be examined in five ears, was clearly patent in all the patients in this group. One ear that was treated with a ventilation tube for 1 month showed dilated vessels and less severe inflammation than did ears that were in the active stage of OME, and three ears that were treated for more than 3 months showed almost normal middle ear mucosa.
Child↗
Positron emission tomographic study of auditory sensation in a patient with a cochlear implant.
The speech comprehension ability of patients with a cochlear implant is fairly good even when information from the implant device is insufficient. It is presumed that the higher brain system has important roles in discriminating speech. The purpose of the present study was to investigate the function of the auditory cortices of a patient with a cochlear implant before and after sound signal inputs. In this study, we used positron emission computed tomography, which can detect brain activity by providing quantitative measurements of the metabolic rates of oxygen and glucose. Without sound signals, the auditory cortices of the patient showed remarkably low metabolic rates. However, with the cochlear implant device, the activity returned to near normal levels. These findings suggest that the activation of the speech comprehension mechanism of the higher brain system can be initiated by sound signals from the implant device.
Acoustic Stimulation↗
Experimental conditions for the development of persistent otitis media with effusion.
The purpose of this study was to investigate sufficient conditions for the development of long-lasting otitis media with effusion (OME) without any organic obstruction of the eustachian tube. Three experimental conditions were employed using 20 adult cats (27 ears). Only tubal ventilatory dysfunction with transection of the tensor veli palatini muscle and excision of the pterygoid hamulus resulted in a small incidence of OME (7.1%), which lasted for 5 weeks. Instillation of Escherichia coli endotoxin into the middle ears formed only a transient OME in 50% of the animals. Combination of these two procedures brought a high incidence of OME (85.7%), most of which lasted for more than 8 weeks. These studies showed that tubal ventilatory dysfunction alone was not a sufficient condition for the development of OME but was important for prolongation of the pathological state of OME. The production of inflammatory exudate was considered to be a trigger for the formation of OME.
Animals↗
The influence of caloric stimulation on the otolith organs in the cat.
The influence of caloric stimulation on the otolith organs was investigated in cats by recording the firing rate of the single vestibular nerve fiber originating from each otolith organ. Sixty-six percent of the vestibular nerve fibers originating from the otolith organs responded to the caloric stimulation. The caloric nystagmus occurred not only by the activities of the semicircular canal system but also by those of the otolith system.
Action Potentials↗
Viscosity of effusion in the middle ear and eustachian tube in patients with otitis media with effusion.
The viscosity of middle ear effusion (MEE) in the tympanic cavity and in the bony portion of the eustachian tube (ET) was compared in 11 specimens (10 patients) with otitis media with effusion (OME). Twenty microliters of effusion from the bony portion of the ET was sampled through myringotomy on the anterosuperior quadrant of the tympanic membrane with a micro-syringe with a curved needle. MEE in the hypotympanum was also sampled by separately puncturing the posteroinferior quadrant of the tympanic membrane. Using the microviscometer developed by one of the authors, the relative viscosity of these effusions were measured, and their natural logarithmic values were compared between the two sites mentioned above in each patient by obtaining their ratios (ET/ME). Effusion was found to have a significantly higher viscosity in the bony portion of the ET than in the hypotympanum (paired t-test: t = 3.859, p less than 0.01). In two patients with OME (serous mastoiditis) due to radiation to the temporal region, the ratios of the viscosity were comparatively small. On the other hand, excluding these two patients with serous mastoiditis mentioned above, the ratios were highest in two patients with a history of more than 60 days of hearing loss. These results were considered to be a clue to the possibility that viscous effusion aggravates ET function as a result of OME.
Adult↗
The trigeminal sensory innervation to the middle ear, eustachian tube, and pharynx: a study by the horseradish peroxidase tracer method.
The trigeminal sensory innervations to the middle ear, the eustachian tube, and the pharynx were examined using the horseradish peroxidase (HRP) method in cats. After HRP application to the middle ear and the eustachian tube, HRP-labeled cells were found mainly in the posterolateral portion and the anteromedial portion of the trigeminal ganglion, respectively. In the case of injection into the epipharynx and the mesopharynx, HRP-labeled cells were found in the anteromedial portion and the posterolateral portion, respectively. HRP-labeled cells were hardly observed when HRP was applied to the hypopharynx. These results indicate that trigeminal nerve sensory fibers branch to the middle ear, including the eustachian tube, epipharynx, and mesopharynx.
Animals↗
Eustachian tube function in OME patients with cleft palate. Special reference to the prognosis of otitis media with effusion.
Eustachian tube function was investigated in two groups of cleft palate patients who had otitis media with effusion. One group consisted of 16 ears that healed after one ventilatory tube insertion, the other consisted of 33 ears that needed repeated tube insertion and did not heal in 2 years. The latter group was characterized by low opening pressure and inability to sustain lower middle ear positive pressure. This decrease force in the Eustachian tube was considered to be related to the prognosis of otitis media with effusion in patients with cleft palate.
Adolescent↗
Eustachian tube function in tympanoplasty.
Prognostic value of preoperative Eustachian tube function was examined in 77 ears subjected to type 1 tympanoplasty. Eustachian tube function was evaluated by positive and negative pressure equalization tests, and clearance test. Based on the results of these three tests, the ears were classified into four grades. The outcome of the ear surgery was judged by postoperative hearing, presence of otorrhea, atelectasis and perforation of the eardrum. Results of the positive pressure equalization and clearance tests of the tube were correlated with the outcome of ear surgery, although the negative pressure equalization test had no correlation with it. The percentage of unsuccessful outcomes increased with the grade of tubal dysfunction, indicating that tubal function is closely associated with the outcome of ear surgery. Thus, it was revealed that the preoperative tubal function test including positive pressure test and clearance test are useful for predicting the prognosis of ear surgery.
Adolescent↗