耳廓慢性结节性软骨皮炎认识的进展：软骨膜血管炎理论
Advances in the understanding of chondrodermatitis nodularis chronica helices: the perichondrial vasculitis theory.
作者信息
Upile T, Patel N N, Jerjes W, Singh N U, Sandison A, Michaels L
机构信息
Head and Neck Department, University College London Hospital, London, UK.
出版信息
Clin Otolaryngol. 2009 Apr;34(2):147-50. doi: 10.1111/j.1749-4486.2008.01851.x.
OBJECTIVES
Chondrodermatitis nodularis chronica helicis (CNCH) usually presents as a painful nodule affecting the pinna. The aetiology of the disease is unknown. Several theories have been suggested. We suggest a possible explanation based upon pathophysiological treatment correlations to new histopathological evidence.
DESIGN
A detailed histopathological review of 16 confirmed cases of CNCH was undertaken by two pathologists, independently and together, using a qualitative grading of arteriolar narrowing.
RESULTS
Review of cases revealed arteriolar narrowing in perichondrium region of pinna most remote from arterial blood supply, i.e. helix. This has lead to ischaemic changes and death of the metabolically active underlying cartilage with necrosis and extrusion.
CONCLUSION
This is the first report of specific perichondrial arteriolar changes as the possible cause of underlying cartilage necrosis resulting in CNCH.
目的
慢性结节性耳轮软骨皮炎（CNCH）通常表现为累及耳廓的疼痛性结节。该病病因不明，已有多种理论提出。我们基于病理生理治疗相关性及新的组织病理学证据提出一种可能的解释。
设计
两位病理学家独立并共同对16例确诊的CNCH病例进行了详细的组织病理学检查，采用小动脉狭窄的定性分级。
结果
病例回顾显示，在耳廓最远离动脉血供的区域即耳轮的软骨膜区域存在小动脉狭窄。这导致了缺血性改变以及代谢活跃的深层软骨坏死和挤压后死亡。
结论
这是首篇报道特定的软骨膜小动脉改变可能是导致软骨坏死进而引起CNCH的原因。
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