[Study on middle ear ventilation using positional tympanometry--post mastoidectomy ear].

Abstract

The middle ear is a cavity surrounded by solid bone, lined with mucosa with a lumen filled with gas. To examine this unique ventilation system under atmospheric pressure, the middle ear pressure of 50 normal ears was previously examined. Positional tympanometry, whereby the middle ear pressure is increased as the subject assumes the lateral position under atmospheric pressure was used. As a result, (1) The middle ear pressure was elevated by the change from the sitting position to the lateral position. Venous pressure was regarded as causative factor of this pressure elevation. (2) The elevation of the middle ear pressure in the lateral position suggested gas production from the mastoid cells of the middle ear. In this study, a proportion of the mastoid cells were removed to resect a tumor of the internal acoustic meatus in conjunction with resection of an acoustic tumor. After resection the area was filled with fascia and fatty tissue. The middle ear pressure of each subject was monitored to determine the effect of a decrease in the mastoid cell volume on middle ear pressure. The results were continuously recorded every 12 seconds for the lower ear when the subjects were in the lateral position. The following results were obtained. (1) The elevation of the middle ear pressure due to positional change among subjects which had had acoustic tumors resected was noticeably greater than the elevation in normal ears. This is thought to have been the result of an elevation in cerebrospinal fluid pressure attributable to positional change, along with an elevation in intravenous pressure. (2) We made comparisons of increases in middle ear pressure 10 minutes after assuming the lateral position in 14 ears after acoustic tumor resection and in 21 normal ears. No noticeable differences were found in the middle ear pressure increases between the two groups despite the fact that the volume of the mastoid cells in the group that had tumors resected had been greatly reduced.