Takahashi H, Sando I
Elizabeth McCullough Knowles Otopathology Laboratory Dedicated to Hearing Research, Department of Otolaryngology, University of Pittsburgh School of Medicine, Pennsylvania.
Ann Otol Rhinol Laryngol. 1992 Oct;101(10):841-7. doi: 10.1177/000348949210101007.
We studied histopathologically the middle ear (ME) and eustachian tube (ET) in 12 temporal bones from eight children who had had otitis media with effusion that had been treated with ventilation tubes (VTs) for 3 weeks to 11 months. In the ME, 1) only a minimal amount of effusion was seen in most of the ears treated for 3 months or longer, 2) the severity of submucosal inflammation almost paralleled the amount of effusion, 3) the amount of granulation tissue on the tympanic membrane at the site of VT insertion also seemed to parallel the degree of ME inflammation, and 4) epidermal ingrowth was seen in both of the two ears treated with VTs for 10 and 11 months. Pathologic findings in the ET were generally more severe than those in the ME, but tended to decrease with longer VT therapy. In two ears with VTs obstructed by inflammatory granulomatous tissue, the entire ME cavity was filled with effusion, and dense effusion plugged the bony portion of the ET. The results of this study indicate that 3 to 11 months of treatment with a VT is effective for reversing the ME effusion and for reducing inflammation in the ME. Some inflammation may be left in the ET, however, even with 11 months of VT therapy, and epithelial ingrowth should be watched for when VT therapy lasts 10 months or longer. Despite the fact that most of our temporal bones were from infants and children who had a variety of systemic diseases or disorders and in whom their terminal event might have contributed to our findings, we consider these temporal bones to be informative.
我们对8名儿童的12块颞骨进行了组织病理学研究，这些儿童患有中耳积液性中耳炎，已通过通气管（VT）治疗3周至11个月。在中耳，1）在大多数接受3个月或更长时间治疗的耳朵中，仅可见少量积液；2）黏膜下炎症的严重程度几乎与积液量平行；3）鼓膜上通气管插入部位的肉芽组织量似乎也与中耳炎症程度平行；4）在接受10个月和11个月通气管治疗的两只耳朵中均可见表皮向内生长。咽鼓管的病理表现一般比中耳更严重，但随着通气管治疗时间延长有减轻趋势。在两只通气管被炎性肉芽肿组织阻塞的耳朵中，整个中耳腔充满积液，致密的积液堵塞了咽鼓管的骨质部分。本研究结果表明，通气管治疗3至11个月可有效逆转中耳积液并减轻中耳炎症。然而，即使进行11个月的通气管治疗，咽鼓管仍可能残留一些炎症，通气管治疗持续10个月或更长时间时应注意观察表皮向内生长情况。尽管我们的大多数颞骨来自患有各种全身性疾病或病症的婴儿和儿童，他们的终末事件可能对我们的研究结果有影响，但我们认为这些颞骨具有参考价值。
