小児滲出性中耳炎の誘因に関する一考察

抄録

A review of 122 chronic cases of otitis media with effusion in children in an attempt to study the predisposing factors to the disease revealed the following: 1) the incidence of the disease is much greater during winter time than in other seasons, 2) 155 ears or 64% of the series showed a history of acute otitis media within one year prior to the initial visit with hearing impairment, 3) of the 155 ears 81 ears or 52% had received paracentesis, which suggests that the failure in the practice of paracentesis cannot be blamed for as the major cause of the disease, 4) 106 children or 87% had prolonged upper respiratory infections within one year prior to the onset of hearing defect, 5) nasal symptoms e. g. nasal obstruction, nasal discharge and snoring were seen in 50 to 60% of the series, 6) 74 children (61%) developed the disease during or right after a swimming course at the pool where chlorine is used as disinfectant, which may be one of the causes of the acute rhinitis, nasopharyngitis or salpingitis and subsequent otitis media with effusion. Based on the above findings and 1. above most cases are bilateral, 2. the incidence is centered at a specific age group, 3. its clinical picture suggesting an abortive infection, 4. antibiotic treatment is usually ineffective, 5. frequent occurrence of spontaneous healing, 6. most cases heal or have a fixed disease at a certain age; it is inferred that otits media with effusion may be a result of abortive infection in children of certain age group with temporary local immune dysfunction against infections.