Palva T, Northrop C, Ramsay H
Department of Otolaryngology, Helsinki University Central Hospital, Finland.
Int J Pediatr Otorhinolaryngol. 1999 May 5;48(2):143-53. doi: 10.1016/s0165-5876(99)00024-5.
Six full-term neonatal temporal bones, with meconium contaminated amniotic fluid aspiration of varying degrees, were serially sectioned at 20 microm and every tenth section was stained by hematoxylin eosin and mounted on slides. All stained sections were studied, the data recorded and relevant details of all compartments photographed. In addition, four normal neonate temporal bones were studied, one by serial sectioning and three by microdissection. The lateral incudomalleal and tensor folds were present in all, membrane defects in the tensor fold were seen in two normal ears. Three ears in the aspiration group had much fetal tissue present rendering Prussak's space small. Four ears with aspiration had remnants of incus intercrural (medial) folds. The amniotic fluid cellular content (AFCC) was sparse or nonexistent in the supratubal recess, Prussak's space and hypotympanum. It concentrated to the areas around the stapes, to sinus tympani and round window niche, to lower lateral attic and posterior pouch, medial attic and in lesser amounts to superior attic, mastoid antrum and air cells. Massive amounts of AFCC in tympanic isthmus and posterior pouch may lead to formation of granulation tissue and blockage of the aeration pathways to attic proper and to Prussak's space. These changes may initiate the development of chronic secretory otitis media in infants.
选取六例足月新生儿颞骨，其羊水均有不同程度的胎粪污染，将颞骨连续切片，切片厚度为20微米，每隔十张切片进行苏木精-伊红染色并制成载玻片。对所有染色切片进行研究，记录数据，并拍摄所有腔室的相关细节。此外，还研究了四例正常新生儿颞骨，其中一例采用连续切片法，三例采用显微解剖法。所有颞骨均存在外侧砧镫襞和鼓膜张肌襞，两例正常耳的鼓膜张肌襞存在膜性缺损。吸入组中有三只耳朵存在大量胎儿组织，导致普氏间隙变小。四只有吸入情况的耳朵有砧骨脚间（内侧）襞的残余。在鼓室上隐窝、普氏间隙和下鼓室，羊水细胞成分（AFCC）稀少或不存在。它集中在镫骨周围区域、鼓窦隐窝和圆窗龛、下外侧鼓室上隐窝和后袋、内侧鼓室上隐窝，少量集中在上鼓室、乳突窦和气房。鼓室峡部和后袋中大量的AFCC可能导致肉芽组织形成，并阻塞通向鼓室上隐窝和普氏间隙的通气途径。这些变化可能引发婴儿慢性分泌性中耳炎的发展。
