小児難治性反復性中耳炎に対する短期鼓膜換気チューブ留置術の有効性について [in Japanese] Effects of short-term tympanostomy tube on intractable recurrent otitis media in children [in Japanese]
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We evaluated the effectiveness of short-term tympanostomy tube in children with intractable recurrent otitis media. The subjects were 370 children (682 ears) who were diagnosed as having intractable recurrent otitis media. These children underwent insertion of a grommet-type tympanostomy tube, and were followed until the removal of the tube at our clinic between July 2002 and June 2006. The following results were obtained.<BR>1. The patients developed acute otitis media in a mean of 3.6 times/year preoperatively. Postoperatively, the mean number of episodes after removal of the tube per year decreased to 0.47. More than 69.0% of the patients had no further episodes of acute otitis media, and they were classified as a good result.<BR>2. The mean number of days of antimicrobial administration /month was 18.3 preoperatively but markedly decreased to 2.1 in patients with a satisfactory course and to 7.2 in those with a unsatisfactory course. In particular, in patients showing a satisfactory course, the number of antimicrobial administration/month days significantly decreased because of a decreased risk of acute otitis media in the presence of purulent otorrhea.<BR>3. Concerning complications, there were no cases showing perforation of the tympanic membrane. Tympanic sclerotic lesions were observed in 1. 2% of all patients.<BR>4. A tympanostomy tube was re-inserted in 1.3% of all patients and all of these had persistent otorrhea postoperatively. All cases of re-insertion of the tube showed a good course in the first tympanostomy tube insertion.<BR>5. The biggest problem of the short-term tympanostomy tubes was that the tube could be dislodged easily if the otorrhea was mucoid. In this study, we recognized the dislodged grommet-type tube in 68 cases and after all we needed the long- term tympanostomy tube insertion in 55 cases. Therefore, we should make the incision as small as possible when we inserted a grommet-type tympanostomy tube.
- Ear Research Japan
Ear Research Japan 17(3), 194-202, 2007-07-25
THE JAPAN OTOLOGICAL SOCIETY