小児滲出性中耳炎の後遺症の分類と発現頻度

Seguelae of Otitis Media with Effusion and its Classification

I．はじめに

　小児滲出性中耳炎は一般に良性の疾患と考えられ，それに伴う後遺症は比較的軽度で永続的難聴を合併することは少ないと考えられている。しかし，最近急激に増加しつつある本症が将来患者が成長した後，いかなる後遺症をどの程度の頻度で起こすことになるかはいまだ明らかではない。実際には，このことが本症の病態の木質を決定づける最も重大な鍵になると思われる。

　ここでは，過去10年間に聖路加国際病院で手術的治療を必要とした230例の慢性の経過を示した症例を対象に本症の後遺症の種類，その分類，頻度に関する調査結果を報告したい。

　The results of our observation of the course of otitis media with effusion in 230 children who had been necessitated tube insertions during the ten years from 1972 to 1982 revealed that, in most instances, early complications from OME of the tympanic membrane and the middle ear can be reversible by ventilation of the middle ear.

　Hearing defect of worse than 40dB occurred in two ears, one in the ear with cholesteatoma and the other with ossicular disruption, which consisted 0.4% of all the ears in this series.

　It has been shown that early complications from the disease of OME e.g. atelectasis, atrophy and blue eardrum are usually benign and reversible, while severe complications with hearing defect can develop from secondary infections of OME ears. The influence of OME sequelae on hearing in adult or advanced aged remains to be clarified.