難治性しん出性中耳炎と中耳真珠腫

Abstract

The relationship between refractory otitis media with effusion (OME) and acquired aural cholesteatoma was examined from the aspects of eustachian tube function and concurrent upper respiratory tract inflammatory conditions.Eustachian tube function was compared in 106 ears with refractory OME which did not heal before the age of ten and 133 ears with cholesteatoma (attic type 85 ears, sinus type 48 ears). Abnormally high, normal and abnormally low tubal opening pressures were seen in 31%, 56% and 13% cases of refractory OME, respectively, and in 27%, 53% and 20% of those of cholesteatoma. The percentages of abnormal opening pressures were significantly higher than those seen in OME children younger than ten years of age. The sniff-test was positive in 24% and 33% of cases of refractory OME and of cholesteatoma, respectively, but in only 8% of children with OME. On the other hand, less than half of the patients with refractory OME or cholesteatoma had sinusitis significantly fewer than OME children. These results suggest a pathologic relationship between refractory OME and cholesteatoma.