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Titolo:
Hyperectasis: The hyperinflated tympanic membrane: The middle ear as an actively controlled system
Autore:
Sade, J;
Indirizzi:
Tel Aviv Univ, Fac Engn, Dept Biomed Engn, Ear Res Lab, IL-69978 Tel Aviv,Israel Tel Aviv Univ Tel Aviv Israel IL-69978 Res Lab, IL-69978 Tel Aviv,Israel Tel Aviv Univ, Sackler Sch Med, IL-69978 Tel Aviv, Israel Tel Aviv Univ Tel Aviv Israel IL-69978 ch Med, IL-69978 Tel Aviv, Israel
Titolo Testata:
OTOLOGY & NEUROTOLOGY
fascicolo: 2, volume: 22, anno: 2001,
pagine: 133 - 139
SICI:
1531-7129(200103)22:2<133:HTHTMT>2.0.ZU;2-M
Fonte:
ISI
Lingua:
ENG
Soggetto:
MASTOID PNEUMATIZATION; PRESSURE; TUBE; ATELECTASIS; AERATION;
Keywords:
middle ear pressure; middle ear gases; otitis media; secretory otitis media; atelectasis; chronic otitis media; cholesteatoma; eustachian tube;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
29
Recensione:
Indirizzi per estratti:
Indirizzo: Sade, J 14 Hagefen St, IL-47254 Ramat Hasharon, Israel 14 Hagefen St Ramat Hasharon Israel IL-47254 at Hasharon, Israel
Citazione:
J. Sade, "Hyperectasis: The hyperinflated tympanic membrane: The middle ear as an actively controlled system", OTOL NEURO, 22(2), 2001, pp. 133-139

Abstract

Objective: To describe and analyze a middle ear condition in which the steady state of the middle ear pressure is elevated above the atmospheric pressure. Setting and Study Design: This is a long-term survey of 59 patients from aprivate clinic who were observed on routine examination to have a ballooned out (hyperinflated) tympanic membrane. Intervention: All patients underwent hearing tests, tympanometry, and Shullers (lateral) mastoid radiography. Main Outcome Measures: A hyperinflated tympanic membrane indicates a middle ear pressure that is higher than atmospheric pressure. The ballooned tympanic membrane returns to its physiological level after being punctured. This pressure situation is the reverse or opposite of atelectasis and is therefore termed hyperectasis. Hyperectasis, like atelectasis, is associated with a poorly pneumatized mastoid. Results: Fifty-nine hyperectatic ears persisted in their hyperinflated state for weeks, months, or even years. The hyperectasis was preceded by atelectasis, and both conditions occasionally changed one into the other. The ballooned part of the tympanic membrane is usually thin and "scarred. " Hyperectasis is not a rare situation and, once recognized, can be readily encountered in an otologic clinic. Conclusions: Like most biologic systems (e.g., blood pressure, temperature), the middle ear's central feature, i.e., pressure, also has a dynamic character vacillating up and down. It is conceivable that middle ear pressure is also actively regulated and controlled with the aid of a feedback mechanism. Passage of gas through the eustachian tube or absorption by diffusion-perfusion is also at least partly an active process. The up and down middleear pressure vacillations are usually clinically benign and do not lead toany pathologic features as long as they are buffered by an accompanying normal mastoid pneumatization. It is the ear with a nonpneumatized mastoid that has limited ability to buffer pressure changes and that will present as an atelectasis, a retraction pocket, or (eventually a cholesteatoma) or their reverse, a hyperectatic tympanic membrane.

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Documento generato il 28/02/20 alle ore 23:16:18