Department of Otorhinolaryngology, Head and Neck Surgery, Ruhr-University Bochum, Bochum, Germany.
Eur Arch Otorhinolaryngol. 2009 Dec;266(12):1865-70. doi: 10.1007/s00405-009-0984-x. Epub 2009 Apr 23.
The chronic secretory otitis media (CSOM) is a common disease in children. Its cardinal symptoms are recurrent middle ear effusions and conductive hearing loss. Until today, the pathophysiological mechanism of this disease remains unknown. The correlation with adenoids and tubal dysfunction during childhood seems to be obvious, but the origin of middle ear effusions still has to be clarified. It is known that the CSOM affects the mucociliary system in several ways. In order to find out more about these correlations, the ciliary beat frequency was examined in 123 samples of infantile middle ear mucosa suffering from CSOM. Samples were surveyed using a stroboscopic microscopy method. The results of this study showed a significant decrease of ciliary beat frequency (CBF) to an average of 7.4 s(-1) in children with a CSOM. The healthy group of control showed a frequency of 10.1 s(-1). The measured CBF dataset was correlated with microbiological findings. We found a typical bacterial profile in nearly all the cases that were examined but were unable to find a specific bacterium decreasing CBF. This study provides evidence for the diminution of CBF in cases of CSOM in comparison to a healthy control group. Our findings emphasize the importance of stopping the vicious circle of recurrent effusions by paracentesis or grommet insertion.
慢性分泌性中耳炎(CSOM)是儿童的一种常见疾病。其主要症状是反复发作的中耳积液和传导性听力损失。直到今天,这种疾病的病理生理机制仍然未知。与儿童时期腺样体和咽鼓管功能障碍的相关性似乎很明显,但中耳积液的起源仍有待阐明。已知 CSOM 以多种方式影响黏液纤毛系统。为了进一步了解这些相关性,我们使用频闪显微镜法检查了 123 例患有 CSOM 的婴儿中耳黏膜样本中的纤毛摆动频率。研究结果显示,患有 CSOM 的儿童的纤毛摆动频率(CBF)显著下降,平均为 7.4 s(-1)。健康对照组的频率为 10.1 s(-1)。测量的 CBF 数据集与微生物学发现相关。我们发现,在几乎所有检查的病例中都存在典型的细菌谱,但未能发现降低 CBF 的特定细菌。本研究提供了 CSOM 病例中 CBF 减少的证据,与健康对照组相比。我们的研究结果强调了通过穿刺或鼓膜置管来阻止反复积液恶性循环的重要性。