両側性滲出性中耳炎に対する一側換気チューブ, 他側保存的治療による比較検討

抄録

79 patients with bilateral chronic otitis media with effusion (C. O. M. E) who had continuous middle ear effusion more than 6 Mos., were treated uni-laterally with insertion of a long-term ventlation tube (V. T.).
After first 12 Mos., the ventilated side had been remarkablly improved compared with nontube side. However, towards the time of 36 Mos., when the tube was gone, final cure-ratio of each side was likely to converge to the same point of 70-80%.
There was no significant difference between two sides on complications.
Non-tube sides were classified into two groups“B”and “C” according to preoperative tympanogram. “B”-group responded rather poorly to conservative treatment and revealed final cure-ratio of 54-71% in contrast with “C”-group of 71-100%.
If hypothetical conclusion that the final cure-ratio of tube-inserted side and conservatively treated side are converging to the same ponint is true and there is minimum difference on complication-occurrance rate between two sides, ventilatin tube still has benefitial values for treatment of C. O. M. E. especially for hearing disturbances. Preoperative tympanogram also helps making decision of this procedure.