Rhys Evans P H, Cameron M
Lister Hospital , London UK.
East Sussex Healthcare NHS Trust , UK.
Ann R Coll Surg Engl. 2017 Nov;99(8):594-601. doi: 10.1308/rcsann.2017.0162. Epub 2017 Sep 15.
For over a century, otolaryngologists have recognised the condition of aural exostoses, but their significance and aetiology remains obscure, although they tend to be associated with frequent swimming and cold water immersion of the auditory canal. The fact that this condition is usually bilateral is predictable since both ears are immersed in water. However, why do exostoses only grow in swimmers and why do they grow in the deep bony meatus at two or three constant sites? Furthermore, from an evolutionary point of view, what is or was the purpose and function of these rather incongruous protrusions? In recent decades, paleoanthropological evidence has challenged ideas about early hominid evolution. In 1992 the senior author suggested that aural exostoses were evolved in early hominid Man for protection of the delicate tympanic membrane during swimming and diving by narrowing the ear canal in a similar fashion to other semiaquatic species. We now provide evidence for this theory and propose an aetiological explanation for the formation of exostoses.
一个多世纪以来,耳鼻喉科医生已经认识到外耳道骨瘤这种病症,但其重要性和病因仍不清楚,尽管它们往往与频繁游泳和耳道冷水浸泡有关。由于双耳都浸在水中,这种病症通常是双侧的,这是可以预见的。然而,为什么骨瘤只在游泳者中生长,为什么它们会在深部骨性耳道的两三个固定部位生长?此外,从进化的角度来看,这些相当不协调的突出物的目的和功能是什么?近几十年来,古人类学证据对早期人类进化的观点提出了挑战。1992年,资深作者提出,外耳道骨瘤是早期人类在游泳和潜水时进化而来的,通过像其他半水生物种一样使耳道变窄来保护脆弱的鼓膜。我们现在为这一理论提供证据,并对外耳道骨瘤的形成提出病因学解释。