Iino Y, Nakamura Y, Koizumi T, Toriyama M
Department of Otolaryngology, Teikyo University School of Medicine, Tokyo, Japan.
Acta Otolaryngol. 1993 Nov;113(6):761-5. doi: 10.3109/00016489309135897.
The present study was carried out to determine the clinical course of acute otitis media (AOM) in children and to analyze the risk factors that lead to persistent effusion. One hundred and twenty children aged 9 months to 10 years diagnosed as having AOM were included in this study. Sixty-two children (52%) recovered from AOM without middle ear effusions within a month. In 26 cases (22%), middle ear effusions resolved after 1 to 3 months, while 32 children (26%) had persistent effusions for more than 3 months after the onset of acute inflammation. Statistical analysis between the group showing quick recovery and that with persistent effusion was carried out in relation to various clinical factors at the onset. The significant risk factors were: younger age, bilateral AOM, presence of otorrhea, tympanogram type B or C2 on an AOM ear. Moreover, the most significant prognostic factor was a tympanogram type B or C2 on an opposite ear at the acute onset. On the other hand, factors such as sex, fever, history of otitis media, season at onset or complications did not correlate with the duration of persistent effusion. From these results we conclude that careful examination should be performed not only on the ear with AOM but also on the opposite ear in order to predict the course of otitis media.
本研究旨在确定儿童急性中耳炎（AOM）的临床病程，并分析导致持续性中耳积液的危险因素。本研究纳入了120名年龄在9个月至10岁之间、被诊断为患有AOM的儿童。62名儿童（52%）在1个月内从中耳炎中康复且无中耳积液。26例（22%）中耳积液在1至3个月后消退，而32名儿童（26%）在急性炎症发作后3个月以上仍有持续性积液。针对起病时的各种临床因素，对恢复迅速组和有持续性积液组进行了统计学分析。显著的危险因素包括：年龄较小、双侧AOM、耳漏的存在、AOM耳的鼓室图为B型或C2型。此外，最显著的预后因素是急性起病时对侧耳的鼓室图为B型或C2型。另一方面，性别、发热、中耳炎病史、起病季节或并发症等因素与持续性积液的持续时间无关。从这些结果我们得出结论，为了预测中耳炎的病程，不仅应对患有AOM的耳朵进行仔细检查，还应对对侧耳进行仔细检查。
