Iwao Honjo

Experimental Study of the Eustachian Tube Function with Regard to its Related Muscles

Utilizing electromyography and electrical muscle stimulation, the muscle responsible for opening the Eustachian tube was examined im 12 dogs. Different time values for tubal opening and levator activity indicate little contribution of the levator in the functioning of the tube. By relatively low stimulation of the tensor, the tube opened consistently, while the levator failed to produce any dilation of the tube, regardless of the amount of stimulation, in 6 dogs. Thus, it is concluded that the sole muscle responsible for tubal opening is the tensor, while the levator does not participate in the functioning of the tube.

Aerodynamic evaluation of eustachian tube function. Preliminary report on normal subjects.

SummaryA clinical test for evaluating Eustachian tube function and normal range of recordings obtained by this test were reported. Simultaneous registration of ear canal and pharyngeal pressures were made during Valsalvas maneuver and deglutition. One hundred recordings of normal subjects were classified into 3 types; normal 77%, obstructive 11% and patent 10%. Thus with the provision of information regarding the normal ear, evaluation of many different functional disorders of the tube is quite feasible.

Aerodynamic pattern of eustachian tube dysfunction

SummaryDetailed aerodynamic patterns for various disorders of the Eustachian tube function were reported. Simultaneous recording of the pressure in the ear canal and the pharyngeal cavity during Valsalvas maneuver and deglutition permitted an objective evaluation of different tubal dysfunctions. The patient with occluded tube showed either disturbance of the air flowing into the tube or outflowing from the tympanum to the pharynx. Depending on the degree of patency, the patulous tube showed either a synchronous change of the tympanal pressure with that of the pharyngeal cavity or an early and sudden drop of the tympanal pressure without deglutition. Through this rather simple aerodynamic technique, evaluation of different tubal dysfunction is possible.

Experimental Study of the Pumping Function of the Eustachian Tube

To determine the muscle responsible for the pumping function of the Eustachian tube and to examine the detailed processes of this function, we conducted (1) a measurement of tympanal pressure during swallowing and during selective stimulation of the tensor and the levator muscles, and (2) visual and radiographic observation of fluid in the tube; in cats, dogs and a monkey. the results were: (1) formation of negative pressure in the tube by contraction of the tensor muscle; and (2) displacement of the fluid from the tympanum to the pharynx through the tube by repeated contractions of the tensor. It was concluded that contractions and relaxations of the tensor muscle cause the pumping function of the tube, which expells any fluid from there into the pharynx.

Role of the Tensor Veli Palatini Muscle in Movement of the Soft Palate

To examine the role of the tensor veli palatini muscle in palatal movement, we conducted 1) quantitative measurement of palatal movement by selective stimulation of the tensor and levator muscles, and 2) EMG recording of the two muscles during phonation. The results were: 1) negligible palatal movement upon tensor stimulation, despite a marked velar elevation by levator stimulation; and 2) little EMG activity of the tensor and marked EMG activity of the levator during phonation. It was concluded that the tensor plays no role in the palatal function.

Role of the levator veli palatini muscle in movement of the lateral pharyngeal wall

SummaryIn order to examine both the site and the muscle responsible for inward movement of the lateral pharyngeal wall, the following 3 observations were made. 1. Radiographic observation of the lateral wall by pasting a lead marker to the torus tubarius. 2. Cinematographic analysis of the lateral wall movement in relation to the velar elevation. 3. Anatomical observation of the levator muscle and the torus. Our conclusion was that the lateral wall movement was an inward displacement of the torus tubarius caused by contraction of the levator veli palatini muscle.

Electromyographic study of patients with dysfunction of the eustachian tube

SummaryIn order to determine how often dysfunction of the tube might arise from dysfunction of the tubal muscles, electromyographic examination of the muscles was carried out on 34 patients with occluded or patent tube. Using a monopolar needle electrode inserted through the nose, selective EMG of the tensor and levator veli palatini muscles were picked up during swallowing. It was found that the patients showed neither abnormally reduced nor increased muscle activity. Comparison of muscle activity of the normal tube and of both the occluded and patent tube revealed no significant differences. Therefore, myogenic cause of tubal dysfunction seems improbable from the clinical viewpoint.

Role of Passavant's ridge in cleft palate speech.

SummaryIn order to reevaluate the role of Passavants ridge, 10 adult cleft palate patients with a marked ridge were examined by a radiographic and cineradiographic method. Following results were obtained: 1. Height of the ridge varies with the vowels. 2. Height of the ridge in consonant syllable phonation is not related to velopharyngeal closure required for each consonat but to the succeeding vowels. 3. Tongue position for vowel phonation has a great effect on the appearance of the ridge. In conclusion, formation of Passavants ridge is not associated with the degree of velopharyngeal closure necessary for the specific speech sound, but is closely related to the tongue position for vowel production. Thus the significance of Passavants ridge in cleft palate speech remains quite doubtful.

Acoustic analysis of the inflation sound in Eustachian catheterization.

ZusammenfassungZur Prüfung der Zuverlässigkeit des Katheterismus der Ohrtrompete als Test einer Tubenfunktionsstörung wurde an 130 Tuben eine sonagraphische Analyse des Einblasegeräusches durchgeführt. Dabei zeigten für den jeweiligen Funktionszustand objektive Untersuchungsmethoden und Sonagraphie praktisch identische Resultate. Weiter konnte mittels eines Tubenmodells gezeigt werden, daß der Ton bei der Tubenstenose vorwiegend durch Luftwirbel am pharyngealen Tubenostium entsteht.SummaryTo check the reliability of the Eustachian tube catheterization as a test of tubal dysfunction, a soundspectrographic analysis of inflation sound was carried out in 130 tubes. A close correlation between each tubal condition classified by objective tests and their soundspectrographic features indicated the reliability of the test. The origin of an inflation sound in obstructive tubes which displayed three sonagraphic types was examined by a tubal model. It was revealed that the stenotic sound mainly originated from turbulent air at the tubal orifice.

Selective external carotid angiography in diagnosis of head and neck tumors

SummaryUsing a double needle and X-ray television monitoring, selective angiography of the external carotid artery was performed in 25 patients with head or neck tumors. Good correlation was obtained between the surgical and radiographic findings. Location and invasion of the tumor, and in some cases the nature of the tumor, were determined by this technique, based on the dislocation, disappearance of hypervascularization of the artery. In combination with another radiographic method, selective external carotid angiography seems to be a promising technique for diagnosis of head and neck tumors.