小型および大型チューブ使用による小児滲出性中耳炎の治療成績

Results of Treatment with Large Ventilating Tubes and Grommet Tubes in Children with Middle Ear Effusion

I．はじめに

　小児の滲出性中耳炎に対するチューブ留置術は，その優れた治療効果により本疾患に不可欠な治療方法となっている。しかしチューブ留置術を施行した例の中には，十分な留置期間が得られないために再発を繰り返す例も多い。当科では昭和48年よりチューブ留置術を施行しているが，難治が予想される症例に対しては昭和55年より従来の小型チューブに替えて，つば広の大型チューブを使用してきた。今回は術後経過を観察できた症例について両チューブの治療成績を比較したので報告する。

　We compared the results of two different ventilating tubes of a wide frange type and a grommet type in 206 ears of 118 children with middle ear effusion who had been treated during the past 5 years.

　1) The average time of intubation to extubation was 9.8 months in large ventilating tubes and 4.0 months in grommet tubes. Although grommet tubes showed recurrence in 28.5 percent of the treated ears, recurrence was negligible in large tubes.

　2) Regarding postoperative hearing levels and complications, there was no difference among the patients treated with two different tubes.

　3) In children treated with grommet tubes, patients with upper respiratory infections showed higher recurrence than those without such involvements. However, a treatment by large tubes markedly decreased recurrence of the disease.

　From the present study, an intubation of wide frange tubes seems to be the most successful treatment of middle ear effusion in children with upper respiratory infections.