日本耳鼻咽喉科学会会報
Online ISSN : 1883-0854
Print ISSN : 0030-6622
ISSN-L : 0030-6622
滲出性中耳炎の遷延化に影響を与える因子
特に貯留液中の細菌との関係について
飯野 ゆき子石戸谷 淳一池田 美智子伊藤 由紀子宇佐神 正海川城 信子高橋 健一永浜 武彦永原 國彦渡辺 貴和子
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1989 年 92 巻 8 号 p. 1183-1191

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The resolution of middle ear effusions(MEE)of children with otitis media with effusion (OME)who underwent myringotomy for the bacteriological examination was analyzed in terms of the culture results and the clinical features. The present study consisted of 193 children(258 ears), and the MEE from 77 ears(30%)were culture positive and the respiratory pathogens were detected from 44 ears(17%). Each child was then assigned to receive either a more than two-week course of antibiotics, cefaclor(CCL)or not. At one month following entry, 53(55%)out of 97 ears in CCL-treated group were effusion-free compared with 31(40%)out of 78 ears in the control group (P<0.05), In the control group, the resolution of MEE was significantly poor in the recurrent cases and the cases with pathogen positive-MEE. The presence of accompanying diseases such as adenoid vegetation, chronic sinusitis and allergy, however, was not related to the resolution of MEE. On the other hand, the cure rate of the cases with pathogen positive-MEE and recurrent cases in the CCL-treated group showed significant improvement. Furthermore, the cases accompanying adenoid vegetation and chronic sinusitis tended to become effusion-free after the antibiotic treat. ment. Therefore, the persistent bacterial infection in the middle ear and/or surrounding organs such as adenoid plays possibly an important role in the delayed recovery of OME. Antibiotics treatment could increase, to some extent, the resolution of MEE in cases with OME.

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