SEKI Hiroyuki THE JIKEI UNIVERSITY SCHOOL OF MEDICINE,OTOLARYNGOLOGY,ASSISTANT, 医学部, 助手 (90236076)
ARAI Shuichi THE JIKEI UNIVERSITY SCHOOL OF MEDICINE,OTOLARYNGOLOGY,ASSISTANT, 医学部, 助手 (70193042)
SEKI Tetsuro THE JIKEI UNIVERSITY SCHOOL OF MEDICINE,OTOLARYNGOLOGY,ASSISTANT, 医学部, 助手 (50196945)
YABE Takeshi THE JIKEI UNIVERSITY SCHOOL OF MEDICINE,OTOLARYNGOLOGY,LECTURER, 医学部, 講師 (00221648)
KAMIDE Yosuke THE JIKEI UNIVERSITY SCHOOL OF MEDICINE,OTOLARYNGOLOGY,LECTURER, 医学部, 講師 (10177579)
|Budget Amount *help
¥2,100,000 (Direct Cost : ¥2,100,000)
Fiscal Year 1995 : ¥1,000,000 (Direct Cost : ¥1,000,000)
Fiscal Year 1994 : ¥1,100,000 (Direct Cost : ¥1,100,000)
Animal study : Tympanic adhesion was observed in a group in which the tympanic opening of the eustachian tube had been closed and the mucosa of the middle ear cavity had been damaged. Tympanic adhesion occurred as a result of granulation in some snimals, while adhesion of a thin tympanic membrane was seen in other animals. It was found that impaired gas exchange function of the middle ear mucosa, as well as poor ventilation of the eustachian tube, is an important factor of tympanic adhesion.
Molecular biological study : Epidermal growth factor (EGF), EGF receptor (EGF-R), and transforming growth factor (TGF) whose receptor is EGF-R were studied with respect to localization of their mRNA by in situ hybridization method employing various tissues of adhesive otitis media. In the inflammatory granulation type, in which subepithelial inflammatory cell infiltration is seen, expression of EGF was similar to that seen with cholesteatoma, and expression of EGF-R and TGF was also strong. In fibro
us granulation and hyalinization types, in which subepithelial layr inflammatory cells are absent, expression of EGF was not seen, and expression of EGF-R and TGF was weak. These findings suggest that, when there is active pathological changes in the subepithelial layr, epidermal proliferation may be further promoted, and cholesteatoma may be developed.
Gas exchange function of middle ear cavity : Middle ear pressure and gas exchange function of the middle ear cavity were examined after operation for adhesive otitis media. As middle ear mecosa improved, middle ear cavity pressure tended to increase, and gas-generating function of the middle ear cavity recovered. However, in patients undergoing extensive removal of tympanic mucosa, increase in the pressure of the middle ear cavity tended to be poor because of delayd epithelization of middle ear mucosa.
Eustachian tube function : Postoperative function of the eustachian tube was studied mainly based on the acoustic method. Many patients tested positive fot the acoustic test both before and after operation. Duration of time of open/closure of the eustachian tube differed, ranging from 100 msec to 6000 msec. When pre- and post-operative values were compared, no definite tendency was detected. In patients exhibiting re-adhesion of tympanic membrane postoperatively, preoperative eustachian tube was narrow in some cases, but it was normal in others, Hence, it is difficult to make accurate prognosis based on pre-operative eustachian tube function. Less