삼출성 중이염 환아에서 시럽용 약병을 이용한 폴리처이관통기법에 의한 치료

Otitis media with effusion is one of the most common childhood diseases, but its pathogenesis is obscure. Oral antibiotics, decongestants and antihistamines are used commonly to treat this disease. When the otitis media with effusion is not improved with medical treatment, ventilation tube insertion is considered. But complications which are postoperative infection, permanent perforation of the tympanic membrane, atrophic membrane, cholesteatoma of the middle ear and sensorineural hearing loss, may follow the use of ventilation tube. Especially general anesthesia is necessary in a child.

Therefore we have recently performed the politzerization which was introduced in 1863 by Politzer, in order to reduce surgical complications in 30 patients(48 ears) who had suffered from otitis media with effusion. The patients consisted of 19 males and 11 females and their age distribution ranged from 3 to 10 years with an average 5.4 years. We defined 16 ears which failed from medical therapy in 3 months as group I, 18 ears which failed from medical therapy in 1 month with a history of ventilation tube insertion as group II and 14 ears which recurred over 3 times in 6 months as group III. The politzerization was performed 6 times in a day at home by the parents. Diagnosis was made from otoscopic findings and tympanogram. The ear with normal drum finding and A type in a tympanogram were diagnosed as completely improved case.

The results of this study revealed that completely improved ears were 77%(37 ears). Duration of treatment in the completely improved cases were 32, 21 and 36 days for group I, group II and group III (median 28.3 days). There was no significant difference in the duration of treatment in each group. So we think that politzerization reduces the case of ventilation tube insertion and its complcations.