滲出性中耳炎に伴う感音難聴の臨床統計的検討

抄録

It is pointed out that sensorineural hearing loss sometimes accompanies otitis media with effusion. In order to clarify the incidence and clinical features of sensorineural hearing loss associated with otitis media with effusion, the cases over the past ten years were reviewed. During the period from January 1979 through December 1988, 1338 patients were diagnosed to have otitis media with effusion and showed reliable audiograms in our clinic. Among these patients, 237 patients (17.7%) showed sensorineural hearing loss, defined as a bone conduction loss of 25 dB or more at any one of the frequencies of 500 through 4 kHz. The incidence of sensorineural hearing loss increased as the age of the patients increased. By analyzing their clinical course, these 237 patients were classified into 3 groups according to the etiological relationship of sensorineural hearing loss and otitis media with effusion. In Group A which comprises 14 patients (1.0%), a strong causal relationship was suspected. This group was further divided into 2 subgroups. In one subgroup of 4 patients, sensorineural hearing loss developed rather rapidly during the course of otitis media with effusion and recovered gradually. In the other subgroup of 10 patients, sensorineural hearing loss progressed and did not recover. The clinical features of these 2 subgroups were quite different. In Group B which comprises 50 patients (3.7%), causal relationship was suspected but was not confirmed. Many of the patients in this group showed unilateral otitis media with effusion and the sensorineural hearing loss in the same ear, which was characteristically demonstrated as bone conduction loss at 2 and 4 kHz. In Group C which comprises the rest of the patients (173; 12.9%), the cause of the sensorineural hearing loss was considered to be unrelated with otitis media with effusion.