小児急性中耳炎における乳突蜂巣の臨床的意義

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  • Clinical Importance of Mastoid Lesions in Acute Otitis Media of Children.

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There are some cases of acute otitis media (AOM) in children which have repetitive courses and finally develop intractable chronic otitis media with effusion (COME). In these cases, infection could be one of the major background factors. What kinds of infectious lesions in the tympanic cavity, mastoid and Eustachian tube will lead these sequelae? Microscopic findings of the tympanic membrane and the findings at paracenthesis procedure were evaluated with the findings of CT scan.<BR>There were two groups of AOM that showed bulging of the tympanic membrane.<BR>The one was without infectious lesions and the other was with infectious lesions of the mastoid air cells found on CT scan. The former showed a mixture of air and fluid in the tympanic cavity only and were treated by administration of antibiotics. The latter showed partial absorption of effusion in the mastoid and as a result developed retraction of the tympanic membrane with residual effusion in the tympanic cavity.<BR>Even in the aerated mastoid after resolution of the initial COME, if there was repeating infections, severe inflammation developed in the total mastoid, and the case resulted in intractable COME.<BR>I concluded that mastoid lesions influenced tubal function and were important to determine the prognosis of AOM in children.

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