小児急性中耳炎の臨床的観察

抄録

This report presents the results of the clinical observation of 96 children under ten years of age with acute otitis media (107ears) who visited our out-patient clinic from May 1986 to August 1987.
The patients were classified into the following three groups according to clinical course: Group 1:25 cases (26.0%) in which acute inflammatory findings rapidly disappeared and otitis media was cured within two weeks with no evidence of effusion; Group 2:62 cases (64.6%) in which acute inflammatory findings rapidly disappeared but obvious accumulation of effusion which resolved gradually was observed and in which otitis media was cured from two weeks to three months after onset; Group 3:9 cases (9.4%) in which persistent accumulation of effusion for more than three months was observed and which required myringotomy and insertion of a ventilation tube and in which a diagnosis of otitis media with effusion was made.
The presence or absence of allergic diseases, adenoid symptoms, and otorrhea, or history of tonsillitis had no affect on the prognosis of acute otitis media. However, patients with a history of acute otitis media were at a significantly higher risk of developing the disease chronically.
At the time of the resolution of the tympanic redness, abnormal findings in the tympanic membrane and tympanogram (TG), suggestive of the presence of middle ear effusion, were observed in approximately 80% of the patients. Approximately 20% of the patients who showed Type Cs or B in TG at that time developed otitis media with effusion.
Therefore, children with acute otitis media who are not cured promptly and who tend to take a chronic course are at risk of developing otitis media with effusion. We believe that myringotomy should be performed on such patients without delay.