難治性滲出性中耳炎の病態-特に性差に着目して-

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In this study of the pathogenesis of refractory otitis media with effusion (OME), we evaluated eustachian tube function, the condition of the upper respiratory tract and sex differences.One hundred and thirty ears of 98 patients with refractory OME were examined. A study of the passive function of the eustachian tube showed higher than normal tubal opening pressure in 34% of the ears, and lower than normal pressure in 14%, indicating that in approximately one half of the patients with refractory OME, there was an organic abnormality of the tube. In 46% of the patients, paranasal sinusitis was identified. Thus, eustachian tube dysfunction and upper respiratory tract inflammation (URI) appear to be the most important factors in the pathogenesis of refractory OME.The incidence of URI showed an unequal sex distribution, being present in 60% of the males but only 30% of the females. However, tubal organic disorders showed no significant sex difference.When we treat refractory OME in adolescents, persistent URI represented by nasal sinusitis should be taken into account more in males than in females. On the other hand, in females eustachian tube dysfunction is considered to be a more important factor than upper respiratory tract inflammation.
耳鼻咽喉科臨床学会の論文