[Measurement of surfactant in-irrigating fluid from the nasopharynx of patients with secretory otitis media].

OBJECTIVE: Dysfunction of the eustachian tube is believed to play a role in the pathogenesis of secretory otitis media (SOM). In the animal model, previous investigators have found that surfactant in the eustachian tube could decrease the eustachian tube opening pressure and improve eustachian tube functions. Because the nasopharynx is anatomically adjacent to the eustachian tube and the membrane of the nasopharynx continues to the middle ear via the eustachian tube, we hypothesized that the surfactant could also present in the nasopharynx and then designed the following experiment to confirm this hypothesis. METHODS: The concentrations of surfactants in the nasopharyngeal irrigating fluid were measured in normal control and SOM patients. RESULTS: (1) The surfactant from the SOM patients were significantly lower than that from the normal control (8.637 +/- 2.730) mg/L vs. (39.212 +/- 2.437) mg/L. (2) The concentration of surfactant from child SOM was also significantly lower than that of the normal control (8.062 +/- 2.925) mg/L vs. (39.787 +/- 2.557) mg/L. (3) The concentration of surfactant of SOM was not associated with the course of SOM. CONCLUSION: Surfactant reduction in the nasopharynx could indirectly reflect the level of the surfactant in the eustachian tube and the middle ear and influence the eustachian tube function. So surfactant reduction is one of the causative factors in SOM. The strategy of increasing surfactant in the nasopharynx and eustachian tube should be beneficial to reducing persistent secretory otitis media.