側頭骨炎（所謂中耳炎）に際する骨病攣の發生機序に就いて

　緒言

　所謂急性中耳炎に際し，炎症は單に鼓室のみならず，側頭骨の全含氣蜂窩に殆んど同時に波及する事が多く，從つて從來の急性乳嘴突起炎，錐体炎等は之の分身に過ぎないと云う考は，O. Mayer, Lange, Krainz, Schlittler, Linck西端，山下等の研究以來，耳鼻科医の常識とならうとしている現状である．而して，その蔓延機轉に関しては，Scheibeの蓄膿説，及びKrainzの血管周囲説の対立以來，種々の報告が見られるが，未だ意見の一致を見ない．

　抑々，急性中耳炎の治療にあたつては，先ず化学療法等の保存的治療を行い，ある程度経過を観察する事が多いので，早期例の病理組織学的研究は甚だ少ない．

　In making observations on pathological changes that occur in the osseous tissues of the temporal bone, M. Niho and Nagai noted that, in their 4 cases of otitis media, in whom surgical operations were performed relatively early (3-10 days) in the course of disease, effects of inflammatory processes, such a, trophic changes, elargementof haversian canals and absorption of cellular structures, were comonly present in all cases alike. In cases 2, 3, and 4 of the report, are shown areas of bone in which beginning necrosis and sequestration and hypertrophic processes are taking place.

　As a barrier against infectious invasions, osseous seems to offer the least amount of resistance or even, to aid such phenomenon by means of haversian canals as the pathway of entrance. The fact remains that infections do spread in bones with rapidity and, it might be safely assumed that incidences of. they temporal bone infections are found in much greater number than they have ever been suspected to occur, in the past. And again, in face with presenting osteitis that may have advanced to the stage of sequestrum formation, a cure in such cases might be attained only under a great difficultywith constant fear of re-infections, if the treatment thereto were limited to a conservative method by use of chemotherapy and anti-biotics.