急性乳様突起炎の臨床的検討

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Thirty nine cases of acute mastoiditis admitted to Kitasato University Hospital over the past 30 years (1971-2001) were reviewed. Twenty six of the patients were younger than five years old. Twenty eight cases required surgery for control of inflammation. The clinical features were compared between those cases required mastoid surgery and those treated without surgery. Those cases treated surgically, visited our hospital over 10 days after the onset of symptoms, and clinical findings were a retro-auricular swelling and erythema in 25 cases, protrusion of the auricle in 15, and a swelling in the posterior wall of the external audiotory canal in 8. In the 28 cases treated surgically, simple mastoidectomy was performed in 24 cases, radical mastoidectomy in 2 cases, and atticotomy and simple mastoidectomy in 1 case, and exploratory mastoidectomy in 1 case. During surgery, cholesteatoma was recognized in 3 cases out of the 28. Eleven patients treated with antibiotic therapy without mastoid surgery, and myringotomy followed by insertion of a ventlation tube was necessary in 4 cases out of the 11. In those cases treated without mastiodectomy, subperiosteal abcess was found in only 3 of the 11 cases, while it was found in 25 of the 28 cases treated with mastoid surgery. When subperiosteal abcess was absent, the initial treatment was antibiotic therapy. When there were 3 findings of a swelling in the retro-auricular region and the posterior wall of the external auditory canal, and protrusion of the auricle existed, mastoid surgery was considered to be the initial treatment.
日本耳科学会の論文
2001-12-25

急性乳様突起炎の臨床的検討

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