耳鼻咽喉科・頭頸部外科93巻10号

2021年09月発行

Review Article

好酸球性中耳炎—四半世紀の軌跡

著者： 飯野ゆき子¹

所属機関： ¹東京北医療センター耳鼻咽喉科／難聴・中耳手術センター

ページ範囲：P.842 - P.855

Summary

●診断は貯留液から好酸球を証明し，診断基準小項目のうち2項目を満たすこと。

●治療の目標は耳漏の停止，貯留液の消失，骨導閾値を保つこと。

●骨導閾値上昇の危険因子は高度の粘膜病変と細菌感染であり，これらをコントロールする必要がある。

●長期管理療法の基本はトリアムシノロンの鼓室内投与で，高度病変耳や急性増悪時は集約的治療が有効である。コントロール不良例には生物学的製剤の投与も考慮する。

●各症例の重症度や治療効果の判定には重症度スコアリングが有用である。

●コントロール良好な鼓膜穿孔耳には鼓膜形成術が予後の点からも有効である。

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