慢性中耳炎の最近の治療法に就て

　慢性中耳炎の最新治療法及び臨床講義を書けとの事だが，私は其の任ではない．唯現在私が本症の治療に関してどんな考え方を持ち，從つてどんな方法で之を処理せんとしているかを書いて見る事は，読者諸賢に多少参考になるかも知れない．敢て私見を記述する所以である．

　元來慢性中耳炎は單純な疾患ではない．從つて其の治療も一律に決定は出來ない．耳管，鼓室，側頭骨含氣蜂窠等を含む一連の系列の慢性炎症であるから，病変の主在する部位と程度で処置が異る．即ち(ⅰ)病変が耳管，鼓室等の表在軟組織に主在し，仮令骨変化を伴うもそれが機に應じ自ら治癒し得る場合と，(ⅱ)自らは治癒し得ぬ程度の骨変化を伴う場合とに別けられる．前者には保存療法が講ぜられ，後者には手術療法が施行されるのは当然であるが，臨床上前者が大多数を占める爲，保存療法が問題の大きな部分と成ると共に，屡々手術すべき骨変化のある症例迄此の内に混入論議され易い．扨保存療法適應例中，特殊の原因が中耳炎を慢性化している場合がある．即ちアデノイド，鼻咽頭炎，腎炎，糖尿病，副鼻洞炎等の外，梅毒，結核，或は淋巴性，滲出性体質等が之である．是等を整理すると慢性中耳炎の療法は下記の分類が出來る．

Shiroiwa classified the method of treatment of chronic otitis media into (A) conservative, which aimed at (1) elimination of cause and (2) localized treatment or alleviation of symptoms, and (B) operative ones. In localized treatment the step of prime importance is the management whereby secondary inflammatory changes in the middle ear and the tuba acustica may be eliminated so that functional activities of these organs may be restored to the state of normalcy. Considerations for attacks on causative organisms should then be made with the aid of chemotherapy anti-biotics. To facilitate application of these therapeutic agents directly to the areas which are pathologically involved, they were introduced, besides those which were given parenterally, through the external ear canal under a certain amount of pressure to ,ensure their proper flow within those structures and, obtained thereby, favorable results. In the operative treatment the usual method of operation was employed excepting for making a plastic skin flap from the posterior wall of the external canal-a process which was purposely avoidedand, the wound was thoroughly sterilized and closed by primary sutres, whereby, its complete healing was accomplished in relatively short period of time.