만성중이염 환자에서 술전 이루에서의 세균학적 검색의 임상적 의의

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The clinical significances of the preoperative bacteriologie study from otorrhea in patients with chronic otitis media were evaluated by review of 396 cases who underwent the middle ear surgery in Chonnam University Hospital from Jan. 1992 to Dec. 1994. During that period 480 operations were performed and 159 bacterial cases in 125 patients were cultured. Among the 159 bacterial cases, the 139 bacterial cases which ranked 1st to 5th grade were included for analysis of the clinical significances of the preoperative bacteriologie study. The clinical significances were obtained according to the age, sex, duration of disease, eustachian tube (E- tube) patency, status of middle ear mucosa, status of ossicular chain at the time of surgery, and postoperative resuks based on review of the patient’s charts and operation records. The results are as follows: Overall operation success rate was 87% in cholesteatoma group and 90% in noncholesteatoma group. In non-cholesteatoma group, the operation failure rate was high in the Staphylococcus aureus group. There were no significant relations between operation failure and both of E-tube patency and status of middle ear mucosa. But there were high relations between operation failure and both of age distribution especially in 2nd decade group and duration of disease especially in 1∼5 year duration group. In cholesteatoma group, the operation failure rate was high in the Proteus mirabilis group. And significant relations between operation failure and both of duration of disease especially over 10 year duration group and pathologic middle ear mucosal status were present. These results suggested that when Staphylococcus aureus in non-cholesteatomatous patient and Proteus mirabilis in cholesteatomatous patient is cultured, otolarygologists should be cautious and provide meticulous preoperative, operative, and postoperative care for the higher success rate of surgery.