滲出性中耳炎の点耳逆通気療法について

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タイトル別名
  • Treatment of Exudative Otitis Media by Ear Instillation and Reverse Politzerisation
  • シンシュツセイ チュウジエン ノ テン ジ ギャク ツウキ リョウホウ ニ ツ

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As one of the local treatments of intractable cases of exudative otitis media, a method consisting of ear instillation and reverse politzerisation was proved to be effective.<br>A total of 297 ears of 200 patients were encountered by the authors. Of them, 248 ears were treated by ear instillation and reverse politzerisation with various drugs at the same time with other local and systemic treatments. As a result, all the treatments were effective in 104 ears and a little effective in 137 ears. In other words, they displayed only a transitional effect and failed to bring about complete healing in about a half of the ears treated.<br>The principle of the proposed method consists of draining and cleaning of the auditory tube and the tympanic cavity. It is supported by the antiphlogistic action of drugs. In this method it is better to use Brünings's anastigmatic otoscope, as well as the pneumatic otoscope, than Politzer's bag. Each otoscope has a rubber or resin ring at the pointed end. When it is attached closely to the external auditory foramen, it is almost always possible to carry out reverse politzerisation through an incised or punctured opening of the tympanic membrane.<br>Of the drugs used, one which dissolves mucus did not exhibit such effect as anticipated. The best effect was displayed by epinephrine added to a solution of dexamethasone or betamethasone. To prevent any disturbance of the internal ear from occurring, it is necessary to avoid the use of any drug which is toxic for the auditory organ. Even in the case of the other drugs, attention must be paid to the kind, concentration, and dose of a given drug and changes induced by a combination with another drug. In addition, cases of tinnitus and dysacousis caused by an excessive dosage of epirenamin and vertigo induced by alcoholism were reported. Discussion was also made on measures to prevent the side effects of drugs from appearing.

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