Takahashi H, Honjo I, Fujita A, Kurata K
Department of Otolaryngology, Kyoto University, Japan.
Arch Otolaryngol Head Neck Surg. 1990 Oct;116(10):1186-9. doi: 10.1001/archotol.1990.01870100080017.
Using a fine, rigid endoscope (Olympus, SES-1711K), we examined the middle ear, including the tympanic orifice of the eustachian tube, of children with otitis media with effusion (OME) in its active stage (26 ears), in the convalescent stage (13 ears), and during treatment with ventilation tubes for 10 days to 6 months (five ears) through myringotomy with the patients under general anesthesia. Several color photographs of representative ears are shown. In the active stage of OME, edema (73.1%) and hyperemia (23.1%) were characteristic features of the middle ear mucosa, and normal mucosa was seen in only one ear (3.1%). The tympanic orifice of the eustachian tube, which could be examined in 12 ears, were stenosed with edema in four ears (33.3%) or plugged with effusion in three ears (25.0%) in this group. In the convalescent stage of OME, dilated vessels were most often seen (69.2%), but the rest of the patients had normal mucosa (30.8%) in the middle ear, and none of them had edema nor hyperemia. The tympanic orifice of the eustachian tube, which could be examined in five ears, was clearly patent in all the patients in this group. One ear that was treated with a ventilation tube for 1 month showed dilated vessels and less severe inflammation than did ears that were in the active stage of OME, and three ears that were treated for more than 3 months showed almost normal middle ear mucosa.
我们使用一种精细、硬质的内窥镜（奥林巴斯，SES - 1711K），在全身麻醉下通过鼓膜切开术，对处于活动期（26耳）、恢复期（13耳）以及置管治疗10天至6个月（5耳）的分泌性中耳炎（OME）患儿的中耳进行检查，包括咽鼓管的鼓室口。展示了具有代表性耳部的几张彩色照片。在OME活动期，中耳黏膜的特征性表现为水肿（73.1%）和充血（23.1%），仅1耳（3.1%）可见正常黏膜。在该组中，12耳可检查咽鼓管的鼓室口，其中4耳（33.3%）因水肿而狭窄，3耳（25.0%）被积液堵塞。在OME恢复期，最常观察到血管扩张（69.2%），但其余患者中耳黏膜正常（30.8%），且均无水肿和充血。该组5耳可检查咽鼓管的鼓室口，所有患者的鼓室口均通畅。1耳置管治疗1个月，显示血管扩张，炎症程度低于处于OME活动期的耳部，3耳治疗超过3个月，中耳黏膜几乎正常。
