小児滲出性中耳炎の長期経過観察—アデノイド切除・口蓋扁桃摘出・鼓膜チューブ挿入術後

A Long-term Follow-up of Secretory Otitis Media in Children

I．はじめに

　小児の滲出性中耳炎の反復性，遷延性がしばしば強調される^3,9）。

　一方，滲出性中耳炎に対する治療方針は，各臨床医の経験に基づいて様々に選択されているのが現状であろう。具体的な療法としては，抗生物質，抗ヒスタミン剤などの薬物治療や，通気治療や，鼓膜切開および貯留液の吸引，アデノイド切除，口蓋扁桃摘出，経鼓膜的換気チューブ挿入などの観血的治療などが一般に行われている。ところで，このような様々な治療を組合わせて実施しても，治療効果が必ずしも持続しない例が少なくない印象がある^4,6）。

　Follow-up results of treatment with ventilation tube and adenotonsillectomy for chronic secretory otitis media were studied in 78 children. The period of post-operative follow-up was 4 years and 6 months. The tympanic membrane was examined under an operative microscope and puretone audiometry was recorded in all cases.

　The treatment was very effective in improvement of hearing impairment. However, some abnormalities of the tympanic membrane were still remained in certain cases (35%). This result suggested that more long-term observation should be needed.