Tekin Muhammet, Schachern Patricia A, Mutlu Cemil, Jaisinghani Vikram J, Paparella Michael M, Le Chap T
The Otitis Media Research Center, Department of Otolaryngology, University of Minnesota Medical School, Minneapolis, USA.
Eur Arch Otorhinolaryngol. 2002 Feb;259(2):67-72. doi: 10.1007/s00405-001-0423-0.
This study was designed to compare tympanic membrane (TM) and middle ear (ME) pathologies of temporal bones from children and adults with purulent otitis media (POM). Thirty-four temporal bones were used from 22 subjects ages 2 days to 76 years with histopathologic evidence of POM. There were 55 age-matched controls. Histopathologic findings of the TM and ME in children and adults with POM were compared. Clinical histories and the presence of complications were recorded. The incidence of POM was more common in male children than in females. There was a significant increase in the thickness of the posterosuperior and posteroinferior quadrants in children with POM compared to non-OM children. In adults with POM, there was a significant decrease in the thickness of the posteroinferior and anteroinferior quadrants compared to non-OM adults. Children with POM showed a significant increase in the anterioinferior and posteroinferior quadrants and the umbo compared to adults with POM. Pathology of the TM and ME occurred in adults and children, but severity was greater in children. Residual mesenchyme was frequently observed in temporal bones of children. Serious complications such as labyrinthtis and meningitis were observed more frequently in children. All cases with meningitis had labyrinthitis, previous histories of otitis media and had been treated with antibiotics. Although POM occurs in both children and adults, pathologic changes of the middle ear are more severe, and complications (labyrinthitis and meningitis) occur more often in children. Our findings suggest the need to monitor children carefully under the age of 2 years who have POM.
本研究旨在比较患有化脓性中耳炎（POM）的儿童和成人颞骨的鼓膜（TM）及中耳（ME）病变情况。使用了来自22名年龄在2天至76岁之间、具有POM组织病理学证据的受试者的34块颞骨。有55名年龄匹配的对照者。对患有POM的儿童和成人的TM及ME的组织病理学发现进行了比较。记录了临床病史和并发症情况。POM在男童中比女童中更常见。与非中耳炎儿童相比，患有POM的儿童的后上象限和后下象限厚度显著增加。与非中耳炎成人相比，患有POM的成人的后下象限和前下象限厚度显著降低。与患有POM的成人相比，患有POM的儿童的前下象限、后下象限及鼓膜脐显著增厚。TM和ME的病变在成人和儿童中均有发生，但儿童中的严重程度更高。在儿童颞骨中经常观察到残留间充质。儿童中更频繁地观察到诸如迷路炎和脑膜炎等严重并发症。所有患有脑膜炎的病例均有迷路炎、中耳炎既往史且曾接受过抗生素治疗。尽管POM在儿童和成人中均有发生，但中耳的病理变化在儿童中更严重，并且并发症（迷路炎和脑膜炎）在儿童中更常出现。我们的研究结果表明，需要对患有POM的2岁以下儿童进行仔细监测。
