2012 年 105 巻 8 号 p. 721-727
Patulous Eustachian tubes (PETs) have been thought to be relatively rare, but the morbidity rate seems to be increasing due to the growing interest in this disease. The symptoms of PET improve when the patients lower their head. The reason is speculated to be due to tightening of the Eustachian tube because of an increase in blood flow around the tube. In terms of this mechanism, we hypothesized that adenosin-5′-triphospahte (ATP) administration might have some effect in improving PET symptoms, because it could enhance blood flow of the tissue around the Eustachian tube. The study design was retrospective. The subjects comprised patients seen in our department from April 2004 to April 2009 and who were diagnosed as having PET. The diagnosis was made based on their symptoms and objective examinations of the Eustachian tube functions tests including sonotubometry and tubotympanoaerodynamography (TTAG). A total of 139 ears with PET from 104 patients were involved in the present study. All patients were given 300 mg/day ATP orally for an average of 3.1 months. To evaluate the effect, changes in the symptoms and the results of Eustachian tube function tests were compared between before and after the treatment. Symptoms were classified into 4 groups, complete remission, partial remission, no change and worse. Complete or partial remission was achieved in 106 ears (76.3% of the total). Durations in sonotubometry showed statistically significant improvement from an average of 316.9±204.9 daPa to 410.9±226.0 daPa (p<0.01, paired t-test). These results suggest that ATP was useful for the treatment of PET.