[Normal middle ear ventilation: a new theory]. 2007

Mihály Fücsek
Petz Aladár Megyei Oktató Kórház, Csecsemo- és Gyermekgyógyászati Központ Gyermek Fül-orr-gége Részleg Gyor. drfucsek@t-online.hu

According to our present knowledge, mainly due to O2 absorption the pressure continuously decreases in the normal middle ear, which is equalized by time to time opening of the Eustachian tube, so that air flows across the tube. OBJECTIVE The aim of the author is to revise this classic theory on the basis of his own research and the results of the last decades. The basic question is whether the pressure increases or decreases in the normal middle ear between two swallowings? METHODS Middle ear pressure change was examined in 32 ears of 16 healthy children in the swallowing pause (between two swallowings) with tympanometry. The patients were 14 +/- 5.2 years old. RESULTS According to the results of the examinations, the middle ear pressure increases between two swallowings in healthy individuals, which is statistically significant (p = 0.028). CONCLUSIONS In his opinion this can only be explained by one factor, and that is CO2 diffusion. The pressure gradient of CO2 that is directed towards the middle ear cavity is upheld by the Eustachian tube - every time the tube opens the middle ear loses CO2 (the partial pressure of CO2 in the middle ear is higher, in the atmospheric air is very low), so after tube is closed, CO2 diffuses from surrounding tissue to the middle ear and the pressure increases. This CO2 loss can take place if we consider that gases not only flow according to their composition percent, but also diffuse according to their partial pressure difference through the tube.

UI MeSH Term Description Entries
D008297 Male Males
D010100 Oxygen An element with atomic symbol O, atomic number 8, and atomic weight [15.99903; 15.99977]. It is the most abundant element on earth and essential for respiration. Dioxygen,Oxygen-16,Oxygen 16
D010313 Partial Pressure The pressure that would be exerted by one component of a mixture of gases if it were present alone in a container. (From McGraw-Hill Dictionary of Scientific and Technical Terms, 6th ed) Partial Pressures,Pressure, Partial,Pressures, Partial
D012016 Reference Values The range or frequency distribution of a measurement in a population (of organisms, organs or things) that has not been selected for the presence of disease or abnormality. Normal Range,Normal Values,Reference Ranges,Normal Ranges,Normal Value,Range, Normal,Range, Reference,Ranges, Normal,Ranges, Reference,Reference Range,Reference Value,Value, Normal,Value, Reference,Values, Normal,Values, Reference
D002245 Carbon Dioxide A colorless, odorless gas that can be formed by the body and is necessary for the respiration cycle of plants and animals. Carbonic Anhydride,Anhydride, Carbonic,Dioxide, Carbon
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D003679 Deglutition The act of taking solids and liquids into the GASTROINTESTINAL TRACT through the mouth and throat. Swallowing,Deglutitions,Swallowings
D004432 Ear, Middle The space and structures directly internal to the TYMPANIC MEMBRANE and external to the inner ear (LABYRINTH). Its major components include the AUDITORY OSSICLES and the EUSTACHIAN TUBE that connects the cavity of middle ear (tympanic cavity) to the upper part of the throat. Tympanic Cavity,Tympanum,Middle Ear,Cavities, Tympanic,Cavity, Tympanic,Ears, Middle,Middle Ears,Tympanic Cavities,Tympanums
D005064 Eustachian Tube A narrow passageway that connects the upper part of the throat to the TYMPANIC CAVITY. Auditory Tube,Pharyngotympanic Tube,Auditory Tubes,Eustachian Tubes,Pharyngotympanic Tubes,Tube, Auditory,Tube, Eustachian,Tube, Pharyngotympanic,Tubes, Auditory,Tubes, Eustachian,Tubes, Pharyngotympanic
D005260 Female Females

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