滲出性中耳炎の耳管咽頭口病変

Pharyngeal Orifice of the Eustachian Tube in Otitis Media with Effusion

　I．はじめに

　滲出性中耳炎の病因としては，耳管障害，アデノイド，アレルギー，感染など，多様な因子が想定されている。うち耳管障害は従来耳管峡部の病変と考えられてきたが，最近の組織学的および生理学的研究の結果，その主病変はむしろ耳管咽頭口にある事が示唆された。耳管咽頭口の観察は従来から内視鏡により行われているが，滲出性中耳炎が高頻度にみられる幼少児の咽頭口観察は困難であった。今回，針状内視鏡により小児滲出性中耳炎例の観察が容易に行えるようになったので，成人例も含め滲出性中耳炎と耳管咽頭口病変との関係を調べてみた。

Endoscopic examination of the pharygeal orifice of the Eustachian tube was carried out in 50 patients with otitis media with effusion (OME). Eighty eight percent of infant patients showed obstruction of the orifice with hypertrophic adenoid tissue. Thus adenotomy seemed to be effective on treatment of OME. Sixty seven percent of adultpatients showed edematous swelling of the oriffice, and 17% of them showed brownish discharge from the orifice. The aged patients, however, showed patent orifice with marked atrophy around it, and this fact indicates that etiology of OME might differ greatly depending on ages. It seemed possible to establish the most beneficial measure for treatment of OME according to the endoscopic findings of the pharyngeal orifice.