| Research Abstract |
Guinea pigs were treated with intratympanic instillation of 1) S. aureus, 2) bacterial endotoxin, 3) influenza A, histamine, and 5) platelet-activating factor (PAF). Guinea pigs were also treated with x-ray irradiation and exposure to nitrogen dioxide. Ilese factors except for intratympanic inoculation of S. aureus could result in experimental outis media with effusion (OME). Intratympanic instillation of endotoxin, influenza A, histamine, and PAF induced self-limiting OME in guinea pigs. On the other hand, irradation and nitrogen dioxide exposure induced prolonged OME in guinea pigs. The following results were obtained from functional as well as morphological examination of the tubotympanic mucociliary systrm in the above-mentioned animals. Thee pathological factors are involved in the pathogenesis of OME, which included (1) increased number and/or activity of goblet cells, (2) increased exudation due to an increased vascular permeability, and (3) reduction in ciliary activity. Middle
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ear effusions were retained reduction in ciliary activity was superposed on either of (1) increased number and/or actibvity of goblet cells or (2) increased exudation due to an increased vascular permeability. Our stud has also demonstrated that cilia locating in the eustachian tube and the middle ear close to the tympanic orifice play a significant role in the clearance of surplus fluid in the tubotympanum. On the other hand, cilia locating in the supen'or bulla had no important role in the tubotympanic mucociliaiy clearance. Middle ear effusions were cleared to the pharynx when cilia in the eustachian tube and the middle ear near the orifice recovered. their beadng activity. An inference has been derived from the experimental fact that medication leading to normalization or enhancement of ciliaiy activity in such cilia should alleviate, OME.
We also gave some mediation whose ciliostimulatory effects are, confinned by our pervious study, to guinea pigs with OME. Up to date, we confirmed that 2 kinds of medicine (S-carboxymethylcysteine and Sai-Rei-To) could stimulate ciliary activity, resulting in resolution of middle ear effusions. Our clinical tdal using these two medicines are going to confirm clinical usefulness of these medicines. Less
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