Zhang Quan-An, Zhang Qing, Zheng Guo-Xi, Fan Meng-Yun
Department of Otorhinolaryngology, Second Hospital of Xi'an, Jiaotong University, Xi'an, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2005 Jan;40(1):6-9.
To explore the deep pathogenesis of acquired cholesteatoma.
The temporal bone slides of 12 ears with retraction pocket were histopathologically studied under microscope, especially focusing on the location of retraction pocket and inflammatory pathology in the local middle ear cavity next to retraction pockets. The temporal bone slides of 11 ears with acquired cholesteatoma were histopathologically observed and 33 cases diagnosed as acquired cholesteatoma were clinically observed observed in the local middle ear cavity next to the part without retraction pocket of eardrum. The results of pathological observation of the temporal bone slides with acquired cholesteatoma and clinical observation during operation for acquired cholesteatoma show that cholesteatoma invade mainly and occupied the ossicular chain eara of the middle ear cleft.
In the pathological process of otitis media, the intractable pathological changes in the ossicular chain area can inward adhere posterosuperior quadrant or pars flaccida of the eardrum to form retraction pocket and permanently infiltrate the external squamous epithelial layer of retraction pocket to excessively proliferate and keratinize, leading to formation of acquired cholesteatoma.
探讨获得性胆脂瘤的深层发病机制。
对12例存在内陷袋的颞骨切片进行显微镜下组织病理学研究，特别关注内陷袋的位置以及内陷袋旁局部中耳腔的炎症病理情况。对11例获得性胆脂瘤的颞骨切片进行组织病理学观察，并对33例诊断为获得性胆脂瘤的患者在鼓膜无内陷袋部位旁的局部中耳腔进行临床观察。获得性胆脂瘤颞骨切片的病理观察结果及获得性胆脂瘤手术中的临床观察结果显示，胆脂瘤主要侵犯并占据中耳裂的听骨链区域。
在中耳炎的病理过程中，听骨链区域顽固性病理改变可向内粘连鼓膜后上象限或松弛部，形成内陷袋，并使内陷袋的外耳道鳞状上皮层永久浸润，过度增殖和角化，导致获得性胆脂瘤形成。
