所謂中耳炎（側頭骨炎）に対する化学療法の限界

　最近約5年間に我国の化膿性疾患，耳科領域に於ては所謂中耳炎に対する化学療法は長足の進歩を遂げ，一時は「ペニシリン」を使用すれば凡ゆる中耳炎は忽ち治癒するかの如き錯覚に陥つた．耳科を受持つ我々専門医すらも解熱，疼痛寛解，鼓膜所見の改善等に眩惑せられて，最も大切な側頭骨内の病変の進行を見逃し，或は其の慢性化に依る諸症状の寛解に眩惑せられて，乳樣突起全鑿開術，保存的中耳根治手術の時期を逸する事が多い．

　即ち結果論ではあるから此の樣な議論の成立する場合は極めて稀ではあるが，化学療法の現在程発達しなかつた戦前に於ては疼痛，発熱等の為に患者も耐えきれず医師も亦生命の危険を考慮して乳樣突起全鑿開術を敢行した．是が為に慢性化を予防された症例も或程度はあつたであろうし，又錐体炎が此の減荷手術に依つて減荷せられて，直接的錐体手術を施行せられずに済んだ症例もあつたであろう．

TEZUKA reports a case of otitis media which progressed to mastoiditis and petrositis in spite of institution of antibiotic treatments and chemothe-rapy. The patient was cured only after adoption of operative measures with methods following those advanced by Kopetzky, Almour, Niho and Hirano.Contrary to general expectations antibiotic therapy and chemo-therapy appear to be effective towards infective processes that involve the soft tissues around the temporal bone but not that of the bone per se.Consequently by use of these agents criteria by which mastoidectomy were indicated in the past are, thus, to a large extent obliterated from the picture at present; opportune moment for operative measures at the acute stage of the disease may escape unhe-eded or the affection may be allowed to progress to a chronic state which may necessitate performing an operation more extensive in nature than it might have been otherwise. The author sounds, the warning that it is for the otolaryngologists to heed the limi-tation by which antibiotic treatment and chemo-the-rapy are bound with and to carry out proper surgi-cal measures at the most opportune moment along with the use of these agents.