Knut Flisberg

On Middle Ear Pressure

A new method for producing pressure variations in the pneumatic system of the human ear under control is described, i.e. the mastoid puncture technique. Several investigations are made; the volume displacement capacity of the normal ear drum, the role of the drum as a middle ear pressure regulator, vacuum effects on hearing and transudation, all these changes arc produced by intra-aural pressure variations under control. The accuracy of the previous methods for indirect determination of the middle tar pressure is analysed.

The Size of the Mastoid Air Cell System: Planimetry—Direct Volume Determination

In a material of healthy ears and ears with chronic otitis media the distribution of the air cell system has been measured with a direct volumetrical method and a planimetrical-roentgenological method. A high correlation between the two methods of measurement has been established.

Controlled “Ear Aspiration” of Air: A “physiological” test of the tubal function

A new method is described, making possible a study of the tubal function following direct application of negative (or positive) pressure into the ear space. Tubal passages of air are recorded as steplike pressure variations towards equilibration when air is sucked into the closed ear-manometer system during deglutition.

A Method for Determination of Blood Flow with 133 Xe in Human Nasal Mucosa

The 133Xe wash-out technique was used as a method for calculation of the blood flow in human nasal mucosa. The disappearance of 133Xe from the nasal mucosa was followed using scintillation detectors. In laryngectomies it was shown that the disappearance of 133Xe from the mucosa depended mainly on the blood flow. Leakage of 133Xe from the mucosa to the nasal air was unimportant. The disappearance rate of 133Xe was decreased by oxymetazoline and increased by histamine, mostly likely due to the effects of these vasoactive drugs on the mucosa blood flow. The 133Xe wash-out technique would seem to be a simple method to study nasal mucosal blood-flow changes in humans.

The Valve and “Locking” Mechanisms of the Eustachian Tube

In controlled “ear aspiration” experiments on normals it is shown that the air volumes passing through the tube during deglutition gradually decrease with lowering of the negative middle ear pressure. If tympanic inflations are performed simultaneously i.e. “aspiration” + inflation with a very slight overpressure, the air volumes passing the tube at identical middle ear pressures are far greater as compared with “aspiration” only.At “common cold” the tube can be “locked” by very small negative middle ear pressure. Now, if during the “locking” period attempts are made to open the tube by swallowing, further negative pressure spikes are simultaneously produced in the closed ear space thanks to the action of the muscular opening forces on the tube. In this way these forces oppose themselves. These phenomena are further illustrated by an ear-Eustachian tube model.

Ventilatory Studies on the Eustachian Tube A Clinical Investigation of Cases with Perforated Ear Drums

(1966). Ventilatory Studies on the Eustachian Tube A Clinical Investigation of Cases with Perforated Ear Drums. Acta Oto-Laryngologica: Vol. 62, No. sup219, pp. 1-79.

Treatment of Snoring—With and Without Carbon Dioxide Laser

Thirty patients with bedpartners complaining of their heavy snoring which had resulted in separate bedrooms were treated surgically. Three different methods were used, each group consisted of 10 patients. In group A conventional scalpel excision was used for uvulopalatopharyngoplasty including tonsillectomy. In groups B and C, patients with small tonsils were selected and therefore the tonsils were saved. Group B was operated with carbon dioxide laser under a microscope and using micromanipulator. The same kind of excision was used as in group A but the tonsils were saved. Group C was operated as group B but using conventional scalpel excision technique. With a starting-point of snoring score 3 preoperatively in all groups, the mean postoperative snoring score in Group A was 1.0, in Group B 0.2 and in Group C 1.1. Patients with postoperative snoring scores of 0 and 1 were regarded as successful responders to surgery. No serious side effects were noted due to treatment.

Vascular Responses to Feet Cooling in Normal and Allergic Nose: An analysis of some physical and physiologic variables

A method for permanent simultaneous recording of the temperature of the mucosa on symmetrical points of both inferior turbinates has been devised. Comparative measurements have been performed while the subjects are permitted to respire through only one of the nasal cavities while the other one is closed from air flow. This approach permits an analysis of several external and internal factors influencing the temperature of the nasal mucosa. By separating these factors an estimation can be made of how much of the temperature change measured is due to variations in peripheral blood flow during cold foot baths. The same initial temperature fall in the nasal temperatures was found in both the “normal” and the “vasomotor” groups. In the normals this fall was completely recovered while cold stimulus was still applied, as shown before; in the vasomotor patients, however, this initial fall was not recovered during the chilling period of 10 min. This experimental finding appears to depend on reflex vasoconstriction...

The relationship of middle ear disease to mastoid hypocellularity. A working hypothesis.

Human ears with poorly developed or undeveloped air cell systems are particularly susceptible to infection. Attempts have been made to define some physical factors related to the ear-Eustachian tube system. The incidence of inflammatory middle ear disease seems to be favoured by these factors under certain conditions, as in the hypocellular ear state.

Clinical Volume Determination of the Air-Filled Ear Space

A new method for exact clinical volume determination of the air-filled ear system is devised. The method is based on the general gas law. A volume variation between 0 to 2 5 ml is obtained from 8 5 cases.