小児副鼻腔炎と中耳炎

PEDIATRIC OTITIS MEDIA AND SINUSITIS

　I．緒言

　小児副鼻腔炎の病態の変遷とその対策に関し，小児副鼻腔炎と中耳炎というテーマからは，二つの問題が考えられる。

　第一には，小児副鼻腔炎の変遷と対比して，小児における中耳炎の変遷はどうかという，小児中耳炎病態の今昔を比較検討することである。抗生物質の出現により中耳炎も軽症化したと言われて久しいが，一方，難聴児の問題として滲出性中耳炎が問題視されている現状から，ここに至る時代的背景を調べる必要があろう。

　In order to investigate the changes in the frequency and severity of pediatric otitis media under the age of 16 years, 201 ears undergoing surgery for mastoiditis in patient treated between May, 1940 and March, 1961 were chronologically examined. The study revealed that since 1948 the frequency and the severity of otitis media decreased remakably, while the frequency of secretory otitis media increased. The use of antibiotics are consider to be the major factor for the changes.

　In order to study the frequency ratio between rhinosinusitis and pediatric otitis media, one hundred cases of secretory otitis media in patients between age of five and twelve years were examined.

　In the lower age group, the ratio was high and gradually decrease with age until the age of ten, when the ratio of 30% in the 9-10 years group increased to 35% in the 11-12 years group. The increase is considered to be due to the developmental disturbance of the nose and paranasal sinus in this age. The increase of chronic inflammation cases with postnasal drip and the disturbance of the insufflation of nose may support this fact.