삼출성 중이염 환자에서 Politzer 이관통기후 중이압력의 변화

Abstract

Background and Objectives: Otitis media with effusion is one of the most common diseases of young children. Impedance audiometry is an accurate method of detecting it. Middle ear inflation such as Politzerization had been used as a conservative method to treat the otitis media with effusion. Recently, the middle ear pressure regulation through gas exchange between the middle ear and blood is known. Several investigators suggest that middle ear inflation may not be useful to treat the otitis media with effusion because middle ear inflation initiates a process of gas exchange and causes an immediate increase in middle ear pressure and follows by rapid decrease to the level before inflation. So, We studied to know changes of middle ear pressure and therapeutic benefits after Politzer inflation. Materials and Methods: We studied to determine the effects of Politzer inflation in 44 ears with otitis media with effusion. The tympanometric peak pressure was used as indirect method to measure the middle ear pressure. The measurements were performed before, immediately, 10 min, 30 min, 1hr after Politzer inflation and every 3 days. Results: The middle ear pressure induced by Politzer inflation was gradually declined to 93.5% within 1hr. 11 ears were more negative pressure at 1hr than pre-inflation level. That of 6 ears with atelectasis was rapidly decreased to 98.2% within 10 min after inflation. The middle ear pressure of 32 ears with good result was shifted toward positive pressure zone after inflation every 3 days and it was restored to normal range. But that of 6 ears with poor result was fluctuated with incerased or decreased change and was not improved to it. Conclusion: Politzer inflation has several benefits to treat the otitis media with effusion such as restoration of negative middle ear pressure and promotion of drainage of fluid. (J Clinical Otolaryngol 2000;11:41–45)