TRIAL STAGING OF TYMPANIC FINDINGS IN JUVENILE ACUTE OTITIS MEDIA AND AN EVALUATION OF RESULTS 2

In cases of juvenile acute otitis media, sequential changes occurring in the tympanic membrane should be recorded in image databases. Based on images of tympanic membranes recorded over the last 5 years, we classified acute otitis media into 5 stages, proposed the utility of this classification, and...

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Published inJIBI INKOKA TEMBO Vol. 47; no. 1; pp. 31 - 42
Main Author Kamide, Yosuke
Format Journal Article
LanguageJapanese
Published Society of Oto-rhino-laryngology Tokyo 2004
耳鼻咽喉科展望会
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ISSN0386-9687
1883-6429
DOI10.11453/orltokyo1958.47.31

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Abstract In cases of juvenile acute otitis media, sequential changes occurring in the tympanic membrane should be recorded in image databases. Based on images of tympanic membranes recorded over the last 5 years, we classified acute otitis media into 5 stages, proposed the utility of this classification, and evaluated the clinical course. Subjects were 811 infants and children ranging from under 1 years to 6 years of age were treated at our clinic, under the diagnosis of acute otitis media. These included 168 under one year old, 148 one year old, 81 two years old, 147 three years old, 134 four years old, 78 five years old and 55 six years old. They were observed on days 5, 10, 14 and 20 following initial examination. At initial examination, about half of infants age 1 year or younger were stage 4 or 5 (exacerbated), while only 25% of those between 2 and 6 years were thus classified. We concluded that once inflammation develops in acute otitis media, most cases progress at least to stage 3 regardless of age. Among infants 1 year of age or younger, 50 to 60% recovered within 20 days, while about 25% required 2 months or more. Of those in stage 5, about 90% recovered after 2 months. Of children between 2 and 3 years in stage 1, 90% recovered within 20 days ; and even those who had progressed an advanced stage almost all recovered within 2 months.
AbstractList In cases of juvenile acute otitis media, sequential changes occurring in the tympanic membrane should be recorded in image databases. Based on images of tympanic membranes recorded over the last 5 years, we classified acute otitis media into 5 stages, proposed the utility of this classification, and evaluated the clinical course. Subjects were 811 infants and children ranging from under 1 years to 6 years of age were treated at our clinic, under the diagnosis of acute otitis media. These included 168 under one year old, 148 one year old, 81 two years old, 147 three years old, 134 four years old, 78 five years old and 55 six years old. They were observed on days 5, 10, 14 and 20 following initial examination. At initial examination, about half of infants age 1 year or younger were stage 4 or 5 (exacerbated), while only 25% of those between 2 and 6 years were thus classified. We concluded that once inflammation develops in acute otitis media, most cases progress at least to stage 3 regardless of age. Among infants 1 year of age or younger, 50 to 60% recovered within 20 days, while about 25% required 2 months or more. Of those in stage 5, about 90% recovered after 2 months. Of children between 2 and 3 years in stage 1, 90% recovered within 20 days ; and even those who had progressed an advanced stage almost all recovered within 2 months.
In cases of juvenile acute otitis media, sequential changes occurring in the tympanic membrane should be recorded in image databases. Based on images of tympanic membranes recorded over the last 5 years, we classified acute otitis media into 5 stages, proposed the utility of this classification, and evaluated the clinical course. Subjects were 811 infants and children ranging from under 1 years to 6 years of age were treated at our clinic, under the diagnosis of acute otitis media. These included 168 under one year old, 148 one year old, 81 two years old, 147 three years old, 134 four years old, 78 five years old and 55 six years old. They were observed on days 5, 10, 14 and 20 following initial examination.At initial examination, about half of infants age 1 year or younger were stage 4 or 5 (exacerbated), while only 25% of those between 2 and 6 years were thus classified. We concluded that once inflammation develops in acute otitis media, most cases progress at least to stage 3 regardless of age.Among infants 1 year of age or younger, 50 to 60% recovered within 20 days, while about 25% required 2 months or more. Of those in stage 5, about 90% recovered after 2 months. Of children between 2 and 3 years in stage 1, 90% recovered within 20 days ; and even those who had progressed an advanced stage almost all recovered within 2 months. 急性中耳炎鼓膜の経時的変化を画像データベースに保存することは極めて有益である。5年分の保存した鼓膜画像をもとに急性中耳炎を5段階に分類, 提唱し, それを用いて患児の経過をstage分類で評価した。対象は1999年9月1日から2001年8月31日までに, 当院を受診した0歳から6歳の乳幼児で急性中耳炎と診断された811名である。内訳は0歳168名, 1歳148名, 2歳81名, 3歳147名, 4歳134名, 5歳78名, 6歳55名である。初診時以後5日目, 10日目, 2週間目, 20日目に観察した。初診時0, 1歳では増悪した状態であるstage4と5が約半数を占めていた。2~6歳ではstage4と5は25%にまで減少した。急性中耳炎はどの年齢においても炎症が一度始まってしまうとstage3程度にまでは進行することが多いことがわかった。0~1歳では50~60%が20日以内に治癒する一方で25%前後が2ヵ月かそれ以上の治療期間が必要であった。stage5では2ヵ月を経ても約90%しか治癒しなかった。2~3歳ではstage1の場合20日以内に90%が治癒し, stageが進行してもほとんどの例が2ヵ月以内に治癒した。
Author Kamide, Yosuke
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References 12) Little P, Gould C, Williamson I, Moore M, Warner G, Dunleavey J : Pragmatic randamized controlled trial of two prescribing strategies for childhood acute otitis media. BMJ 322 : 336-342, 2001.
8) 杉田麟也 : 耳鼻科領域の耐性菌感染症への対策.平松啓一編 : 耐性菌感染症の理論と実践, 医薬ジャーナル社2002,219-228.
6) 保富宗城 : 中耳炎スコアリングシステム.変貌する急性中耳炎, 山中昇編 : 金原出版, 東京, 2000,160-168.
9) Damoiseaux RAMJ, Baren FAM, Hoes AW, Verheij TJM, Melker RA : Primary care based randamized, double blind trial of amoxicillin versus placebo for acute otitis media in children aged under 2 years. BMJ 320 : 350-354, 2000.
3) 上出洋介 : 耳鼻咽喉科領域におけるデジタル画像と画像データベース.日本写真学会誌66 : 36-41, 2003.
2) 上出洋介 : 医院・診療所における画像ファイリング.JOHNS 19 : 1679-1684, 2003.
4) 上出洋介 : 小児急性中耳炎の鼓膜所見に対する病期分類の試みとその検証.耳展46 : 17-30, 2003.
5) 上出洋介 : 画像データベースを用いた小児急性中耳炎の病期分類の試み.日耳鼻感染症研究会誌21 : 36-43, 2003.
10) Kaleida PH, Casselbrant ML, Rockette HE, Paradise JL, Bluestone CD, et al : Amoxicillin or myringotomy or both for acute otitis media : Results of randamized clinical trial. Pediatrics 87 : 466-474, 1991.
1) 上出洋介 : 情報化時代の画像管理.JOHNS 18 : 1327-1333, 2002.
11) Pradise JL : On classifying otitis media as suppurative or non suppurative, with a suggested clinical schema. J Pediatr 111 : 948-951, 1987
13) Harabuchi Y, Kodama H, Faden H : Outcome of otitis media and its relation to clinical features and nasopharyngeal colonization at the time of diagnosis. Acta Otolaryngol 121 : 908-914, 2001.
7) 山中昇 : 中耳炎, 鼻副鼻腔炎, 扁桃炎.今月の治療9 (臨増) : 323-327, 2001.
References_xml – reference: 8) 杉田麟也 : 耳鼻科領域の耐性菌感染症への対策.平松啓一編 : 耐性菌感染症の理論と実践, 医薬ジャーナル社2002,219-228.
– reference: 7) 山中昇 : 中耳炎, 鼻副鼻腔炎, 扁桃炎.今月の治療9 (臨増) : 323-327, 2001.
– reference: 2) 上出洋介 : 医院・診療所における画像ファイリング.JOHNS 19 : 1679-1684, 2003.
– reference: 13) Harabuchi Y, Kodama H, Faden H : Outcome of otitis media and its relation to clinical features and nasopharyngeal colonization at the time of diagnosis. Acta Otolaryngol 121 : 908-914, 2001.
– reference: 12) Little P, Gould C, Williamson I, Moore M, Warner G, Dunleavey J : Pragmatic randamized controlled trial of two prescribing strategies for childhood acute otitis media. BMJ 322 : 336-342, 2001.
– reference: 3) 上出洋介 : 耳鼻咽喉科領域におけるデジタル画像と画像データベース.日本写真学会誌66 : 36-41, 2003.
– reference: 5) 上出洋介 : 画像データベースを用いた小児急性中耳炎の病期分類の試み.日耳鼻感染症研究会誌21 : 36-43, 2003.
– reference: 11) Pradise JL : On classifying otitis media as suppurative or non suppurative, with a suggested clinical schema. J Pediatr 111 : 948-951, 1987
– reference: 4) 上出洋介 : 小児急性中耳炎の鼓膜所見に対する病期分類の試みとその検証.耳展46 : 17-30, 2003.
– reference: 9) Damoiseaux RAMJ, Baren FAM, Hoes AW, Verheij TJM, Melker RA : Primary care based randamized, double blind trial of amoxicillin versus placebo for acute otitis media in children aged under 2 years. BMJ 320 : 350-354, 2000.
– reference: 10) Kaleida PH, Casselbrant ML, Rockette HE, Paradise JL, Bluestone CD, et al : Amoxicillin or myringotomy or both for acute otitis media : Results of randamized clinical trial. Pediatrics 87 : 466-474, 1991.
– reference: 1) 上出洋介 : 情報化時代の画像管理.JOHNS 18 : 1327-1333, 2002.
– reference: 6) 保富宗城 : 中耳炎スコアリングシステム.変貌する急性中耳炎, 山中昇編 : 金原出版, 東京, 2000,160-168.
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Snippet In cases of juvenile acute otitis media, sequential changes occurring in the tympanic membrane should be recorded in image databases. Based on images of...
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SubjectTerms acute otitis media
image database
staging
急性中耳炎
画像データベース
病期分類
Subtitle 2
Title TRIAL STAGING OF TYMPANIC FINDINGS IN JUVENILE ACUTE OTITIS MEDIA AND AN EVALUATION OF RESULTS
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