For proper surgical treatment of otitis media exudative in children: diagnosis of refractory cases and new surgical treatment methods

2022 Fiscal Year Final Research Report

• Project/Area Number: 17K11342
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Otorhinolaryngology
• Research Institution: Jichi Medical University
• Principal Investigator: Ito Makoto 自治医科大学, 医学部, 教授 (50283106)
• Project Period (FY): 2017-04-01 – 2023-03-31
• Keywords: 滲出性中耳炎 / 急性中耳炎 / 光干渉断層撮影

Outline of Final Research Achievements

The purpose of this study was to establish a differential diagnostic method for refractory cases of pediatric exudative otitis media, to clarify the indication criteria for surgical treatment, and to validate a minimally invasive treatment method with fewer sequelae. We investigated the usefulness of various examinations including optical coherence tomography (OCT) of the tympanic membrane in children with otitis media exudative, and since OCT can now be imported, it can provide information on the degree of thickening of the tympanic membrane and biofilm formation on the back surface of the middle ear cavity. OCT provides information on the degree of thickening of the tympanic membrane and biofilm formation on the back surface of the middle ear cavity, making it possible to differentiate not only between acute and chronic otitis media, but also between refractory and prolonged cases of otitis media, congenital otitis media with pearloma, cholesterin otitis media, and other conditions.

Free Research Field

耳鼻咽喉科学

Academic Significance and Societal Importance of the Research Achievements

小児難聴の最大の原因である、滲出性中耳炎の治療適正化を考える上で、実際の臨床において求められているのは、鼓膜チューブ留置術などの外科治療が真に必要な症例を、発症後の比較的早期に鑑別することである。ところが、発症後３カ月ー半年以内にそのような難治・遷延例を推定する試みはなされてこなかった。これまでは、各種治療を行なっても最終的に予後不良な症例を選別して手術症例を選択してきたが、難治例を早期に鑑別可能となれば、積極的な外科治療によって生育期の難聴を改善すべき症例を鑑別することが可能となる。