Palatal muscles and the eustacian tube.
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Biomedical subjects
Publications and source records attributed to S R Rood.
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A prospective clinical study of secondary phase nystagmus (SPN) is presented. The tracings of 200 patients referred for ENG evaluation and eight normal control subjects were anlyzed under all caloric conditions, within a prolonged postirrigation tracing time frame. The spontaneous direction reversal (SPN) was observed in a majority of the control subjects under all four conditions. The occurrence of post-caloric SPN in the patient group varied considerably among various diagnostic categories. However, SPN was observed far less frequently in the total patient group as compared to the control group. Thus, the absence of SPN may be taken to be a general indication of vestibular pathology.
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The relationships among the paratubal muscles were studied in human fetal and adult Eustachian tubes. That which has, in recent years, been labeled the tensor veli palatini muscle actually consists of two distinct groups of muscle fibers: a medial group, henceforth termed dilatator tubae, and a lateral group, called tensor veli palatini. The latter was found to have no Eustachian tube origin, but was continuous superiorly with the tensor tympani muscle. The dilatator tubae muscle was found to have a tubal attachment. The participation of this muscle system in the normal functioning of the Eustachian tube-middle ear system in man, and the problems inherent in the development of animal models simulating the physiology of the physiology of the human system, are discussed.
The primate nasopharynx-eustachian tube-middle ear complex is being used to model both the normal and pathologic functions of the human eustachian tube by several researchers. An extensive search of the literature has indicated little detailed information on the primate eustachian tube/middle ear system. This study was undertaken to define the anatomical characteristic of the system in the Rhesus monkey (Macaca mulatta) and to determine the limits on the use of the monkey as a model of human eustachian tube function. Although the direct application of morphologic data to explain the function of a system is tenuous, the data on the Rhesus monkey eustachian tube appears to be consistent with that published for other mammals. The tensor veli palatni muscle appears to be the only muscle to act directly on the tube and effect tubal dilation. The muscle is attached to the lateral membranous tubal wall along its extrabullar extension. The muscle has an inferior attachment to the posterior hard palate and thus possesses a vector directed inferolaterally; contraction would appear to pull the membranous wall inferiorly and laterally, resulting in the tubal dilation. The eustachian tube relationships of the salpingopharyngeus, levator veli palatini, and internal pterygoid muscles are described. Their possible role in primate tubal function is minimal at best.
A prospective study was carried out which tested three hypotheses: 1) certain tumors of the head and neck that originate in sites other than the nasopharynx may cause middle ear effusion; 2) middle ear effusion is a predictable sequela of radical maxillectomy as well as total or partial resection of the soft palate; and 3) middle ear effusions that follow surgery to remove head and neck lesions are due to disturbances in palatal function, specifically to tensor veli palatini muscle dysfunction. Our results indicate that one fourth of all subjects had some evidence of middle ear abnormality prior to entering into treatment although they were asymptomatic. The treatment process influenced the function of the middle ear, as 79% of the subjects experienced middle ear-eustachian tube dysfunction following treatment, and 23% were found to have developed a perforation of the tympanic membrane or required myringotomy and tube insertion to relieve middle ear effusion. The results of these studies indicate that surgery that is adequate to remove cancer of the maxilla, tonsil, or palate in most cases interferes with the function of the tensor veli palatini muscle, resulting in functional eustachian tube obstruction. The need for attention to and the treatment of middle ear effusion in such patients is emphasized in light of other sensory deficits in this patient population.
Androgen-induced changes in laryngeal growth patterns were studied using a sheep animal model. Forty-eight lambs were divided into eight treatment groups. Lambs in seven of the groups were castrated at birth, while lambs in the eighth group served as an intact (noncastrated) control. Six groups were then treated with varying doses of testosterone and dihydrotestosterone, while the seventh served as a castrated, nontreated control. All animals were killed and gross dissections of the larynges were performed. Thirty-four linear and angular measurements were obtained from each larynx. The mean superior thyroid horn separation showed the most dramatic androgen-induced effect (p = 0.023). Laryngeal anterior-posterior diameter, superior thyroid horn height, posterior thyroid cartilage width, thyroid cartilage angle, and vocal process to arytenoid base distances all demonstrated positive dose-response relationships. Hypoandrogenic levels appeared to have an inhibitory effect upon laryngeal growth when compared to castrated controls.
Electromyographic recordings of the activity of the tensor veli palatini, tensor tympani, and stapedius muscles were obtained from several adult human subjects. Muscle responses were recorded under four stimulus conditions, ie, contralateral intense wide-band noise, air jet to the eye, swallow, and electrical stimulation of the tongue. The results indicated that the two tensor muscles responded to the same stimuli in similar patterns. The latter muscle differed from the response of the stapedius.
A study was designed to investigate the muscular relations to the tonsil and tonsillar bed in man. Twenty-one histologically prepared human fetal specimens were examined. Muscle bundles from the palatopharyngeus and stylopharyngeus muscles and the amygdaloglossus muscle were found to relate to the tonsillar capsule in such a way as to suggest that during swallow, the tonsils may be moved laterally to permit a wide and unobstructed pharyngeal port.
Lesions in the substance of the cheek--the buccal space--may present diagnostic and management difficulties. The buccal space, that potential fascia space lying within the bulk of the cheek, is anatomically described. While the history and physical characteristics of the buccal mass and selected radiographic and special procedures may suggest a specific cause, the diagnosis is often elusive and requires removal of the mass for histologic evaluation. The surgical approach to a mass in the cheek is governed by its location within the buccal space and by the index of suspicion of malignancy. The preauricular, submandibular approach is the authors' choice for most buccal space lesions. Five case reports are presented to illustrate features in the diagnosis and management of a buccal space mass.
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