Department of Otolaryngology, Jagiellonian University Medical College, Kraków, Poland.
Ear Nose Throat J. 2021 Dec;100(10):NP438-NP443. doi: 10.1177/0145561320924144. Epub 2020 May 13.
Despite different etiologies, chronic otitis media involves the damaging and restructuring of bone tissue. The inflammatory process destroys elements of the ossicular chain, and bone lesions may appear that allow the development of otogenous complications.
AIMS/OBJECTIVES: A correlation between the degree of damage to the ossicular chain as well as the bony walls of the middle ear and the type of chronic inflammatory lesions was sought. Destructive changes to bones were observed using scanning microscopy.
The removed damaged fragments of the ossicles were prepared for evaluation with a scanning microscope. Preparations were sputter-coated with a thin layer of gold and subsequently evaluated.
Of 220 surgeries carried out in the discussed period, destruction of the middle ear bone walls, opening the way for the development of intracranial complications, was found in 27 patients. Most of them had ongoing chronic otitis media with granulation.
(1) Bone loss of the skull base was observed more frequently in patients with chronic otitis media with granulation than with cholesteatoma. (2) In chronic otitis media with cholesteatoma, damage to the ossicular chain was observed significantly more frequently than in the case of otitis media with granulation.
尽管病因不同,但慢性中耳炎涉及骨组织的破坏和重构。炎症过程会破坏听小骨链的元素,可能会出现骨损伤,从而导致耳源性并发症的发展。
寻求中耳骨壁和听小骨链损伤程度与慢性炎症病变类型之间的相关性。使用扫描显微镜观察骨的破坏变化。
对切除的受损听小骨碎片进行扫描显微镜评估。制备物用薄金层进行溅射涂层,然后进行评估。
在所讨论的时间段内进行的 220 例手术中,发现 27 例患者的中耳骨壁被破坏,为颅内并发症的发展开辟了道路。他们大多数患有持续存在的肉芽性慢性中耳炎。
(1)与胆脂瘤型中耳炎相比,基底颅骨的骨质流失在肉芽性慢性中耳炎患者中更为常见。(2)在胆脂瘤型中耳炎中,听小骨链损伤的发生率明显高于肉芽性中耳炎。