Masahiko Hattori

Prognosis of Secretory Otitis Media in Relation to Viscoelasticity of Effusions in Children

Both elasticity (G′) and viscosity (η′) of middle ear effusions (MEEs) were measured with an oscillating sphere magnetic rheometer and compared with continuance of fluid retention in 93 ears of 69 children with otitis media with effusion (OME). The ears were divided into four groups according to the viscoelastic properties of MEEs at the first myringotomy. Eighty-four percent of the ears in group 2 were free from effusion within 4 months; the difference from the other groups was statistically significant. These results indicate that the mucociliary clearance function plays an important role in the process of recovery from OME.

Rheologic Properties of Nasal Mucus from Patients with Chronic Sinusitis

The rheologic properties of nasal mucus from the patients with chronic sinusitis was determined by the oscillating sphere magnetic rheometer. The increase in the elastic modulus (G’) and the decrease in the dynamic viscosity (η’) of mucoid and mucopurulent nasal mucus indicate that both types of nasal mucus possess the network of transient cross-links between macromolecules. The G’ and the η’ of 12 mucopurulent nasal mucus was significantly high compared with those of 13 mucoid mucus (p < 0.01), and those of mucopurulent mucus were out of the optimal range for mucociliary transport. Results suggest that abnormally high viscoelasticity of nasal mucus is one of the causes of reduced nasal mucociliary clearance in chronic sinusitis.

A comparative study of the ciliary area of the maxillary sinus mucosa and computed tomographic images.

Abstract The ciliary area of the maxillary sinus mucosa and coronal sinus computed tomographic (CT) scans were studied in 36 maxillary sinuses of 28 patients with chronic sinusitis. Tissue specimens allowed ciliary surfaces to be observed under scanning electron microscopy, allowing surfaces to be expressed in terms of ciliary area (CA) as the percentage of mucosal surface occupied by cilia. The opacity produced by mucosal swelling and secretion in the maxillary sinus on CT was assessed by two methods: Min’s and modified van der Veken’s methods. Both techniques indicated an inverse correlation between opacity of the maxillary sinus and CA. Our findings suggest that the opacity of maxillary sinus on CT could be a significant parameter for predicting the surface conditions of ciliated maxillary mucosa prior to sinus surgery.

Viscoelastic properties of middle ear effusions from pediatric otitis media with effusion and their relation to gross appearance

SummaryThe viscosity and the elasticity were measured in 146 individual middle ear effusions (MEEs) from 93 children with otitis media with effusion (OME). The effusions were classified into serous or mucoid type by their macroscopic appearance. The distribution of elasticity showed two peaks, corresponding to the peaks of serous and mucoid types of effusions. There were a small number of effusions in the intermediate range of elasticity, where the effusions were most effectively transported by the cilia. These findings suggests that the MEEs of pediatric OME are accumulations of rheologically suboptimal fluid in the middle ear cavity.

Clinical study on the use of ampicillin suppositories (Herpen) in children undergoing tympanotomy for otitis media with effusion.

The children with otitis media with effusion treated with tympanotomy, ampicillin rectal suppositories (Herpen®) were given.1) Herpen suppositories containing 125mg or 250mg of ABPC, were inserted 3 times a day for 7 days following tympanotomy.2) The effectiveness of the therapy was evaluated by subjective symptoms, ear drum findings, mobility of the ear drum, air-bone-conduction threshold, tympanogram, and acoustic otoscopy. The findings is nearly all the patient improved. Ear discharge after tympanotomy was not observed.3) Slight diarrhea was occured in 2 patients, and a few complained of anal pain.The above results indicate that ABPC suppositories are useful in the treatment of otitis media with effusion in children with tympanotomy.