耳気圧外傷を生じたスクーバダイバー患者の耳管機能不全に対する上咽頭擦過療法（EAT）の効果

抄録

Recently, the usefulness of epipharyngeal abrasive therapy (EAT) as an effective treatment method for chronic nasopharyngitis, long COVID, etc., has been reported by otolaryngologists. We employed EAT for tubal stenosis caused by scuba diving-related accidents in scuba divers. We divided the patients enrolled in this study into the following two groups: 1) the EAT group, consisting of patients who received EAT: n = 83; 34 men and 49 women; mean ± SD: 43.2 ± 14.0 years; and 2) the non-EAT group, consisting of patients who did not receive EAT: n = 85; 32 men and 53 women; mean ± SD: 40.5 ± 12.5 years. These included the patients who had been under follow-up at our clinic for 2 years prior to this study, or the ones who refused undergoing ENT. At the first visit, both patient groups received treatment with the same antiallergic agents for 1 month, and the EAT group patients received EAT in addition. All patients underwent Eustachian tube function tests (impedance tests) at the first visit and at the 1-month follow-up examination. Significant improvement of the opening pressure was observed in the EAT group as compared with the non-EAT group. However, the improvements in the compliance curve were not adequate, and we speculated the low number of treatments as the possible reason. We propose the following as the mechanisms underlying the efficacy of EAT for tubal stenosis: 1) improvement of cerebral metabolite excretion tract function by local bloodletting at the epipharyngeal mucosa; 2) anti-inflammatory effects; and 3) the therapeutic effect of EAT on epipharyngeal allergies.