小児急性中耳炎の鼓膜所見に対する病期分類の試みとその検証

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  • Classification of Tympanic Membrane Findings on Acute Otitis Media in Children and Their Verification.

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Based on imaging data for pediatric acute otitis media (AOM), we followed up 0-to 1-year-old children with otitis media retrospectively and propose a pathological classification of tympanic membrane (TM) findings on AOM into 5 stages, then assessed results for consistency and validity.<BR>Subjects were 2, 137 children between 0 and 6 years of age who visited our clinic during the 39-month study and were treated for AOM diagnosed on first visit.<BR>Results : Age-specific AOM incidence was 85.5% under 1 year of age and 88.4% at 1 year. The incidence of AOM decreased with each additional year of age.<BR>Classification results showed that children with AOM stages 4 and 5 accounted for half of all cases in the groups aged 0 and 1 year, consistent with previous reports of frequent cases in infants whose symptoms had worsened. Of groups aged 2 and 3, 25% had AOM stage 4 or 5, and the number of severe cases decreased with each additional year of age.<BR>In recovery, 80% of those aged 0 and 1 year was cured of AOM stage 1 within 1 month, and the rate decreased to 55-60% in cases of AOM stage 5. Of bilateral cases 48.6% were cured within 1 month in the group aged 0, as were 80.5% of unilateral cases, suggesting that unilateral cases have more favorable results in healing than bilateral, and that recovery improved with each additional year of age.<BR>Conclusion : We found that our classification meets requirements for consistency and validity.

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