幼稚園検診におけるAcoustic Otoscopeの使用経験

Efficacy of Acoustic Otoscope in Screening for Children with Otitis Media with Effusion

はじめに

　Acoustic Otoscopeは中耳貯留液の検出を目的に開発されたもので，その臨床応用についてはすでにいくつかの報告がある^1,2）。われわれは以前から主として滲出性中耳炎の検出を目的とした耳鼻咽喉科検診を幼稚園児を対象に行っているが^3），今回Acoustic Otoscopeをこの検診に使用する機会を得たので，その集団検診における有用性について検討した。

Using acoustic otoscopes (ENDECO MEDI-CAL), screening tests were performed on 479 children aged 4 to 5 years. The children were examined by pure tone audiometry, tympanome-try, otoscopy and with acoustic otoscope.

Abnormal findings were noted in 96 (20%) of the children. These were reexamined in our cli-nic, and in 42 of them (8.8% of the total num-ber) otitis media with effusion was diagnosed.

By using acoustic otoscopes reflectivity units 4 through 9 indicated otitis media with effusion and false-positive and false-negative diagnoses were found 22.3% and 28.4% respectively. These findings led to the conclusion that the acoustic otoscope should be used not only solely but also with other screening tests for detection of otitis media with effusion.