Perrin A, Despreaux G, Candau P, Bré M, Zerbib R, Saliba N, Basset J M, Fleury P
Ann Otolaryngol Chir Cervicofac. 1985;102(4):229-37.
44 cases of tympanic involvement in the context of chronic otitis are described. 34 occurred during active chronic otitis. This is a rare possibility (approximately 4% of our own cases of chronic otitis). The following may be mentioned amongst them: 21 cases of osteitis, for which the following concepts should be borne in mind: the extreme severity of the chronic otitis responsible, in most instances, ears which had undergone multiple surgery (17/21), lesions exclusively of osteitis, but very extensive in 2/3 of cases (14/21). 7 cases of osteolytic disease, occurring severe or atypical cholesteatomatous chronic otitis and quite often involving associated osteolysis affecting the main VII, the promontory, the bulb of the internal jugular vein, or even the carotid canal. 4 cases of diffuse sub-obstructive osteomatous disease of the walls of the E.A.M., "progressive" development of which over several months was noted in 3 cases. Finally, 2 cases of mixed disease: (osteitis--osteomatoma and osteitis--osteolysis). 8 cases occurred following myringoplasty: this is a rare eventuality (approximately 1%), 1 case only of osteolysis due to iatrogenic cholesteatoma, 7 cases of osteitis, either highly localized and not preventing further myringoplasty (4 cases), or very extensive, finally resulting in a vast evacuation cavity. In 2 cases, a malformation is the origin of involvement of the tympanic at the origin of chronic otitis was felt probable, without it being possible to reach any definite conclusion concerning auriculobranchial fistula or Huschke foramen.
本文描述了44例慢性中耳炎累及鼓膜的病例。其中34例发生于慢性中耳炎活动期。这是一种罕见情况(约占我们自身慢性中耳炎病例的4%)。其中包括以下情况:21例骨炎,对于此类情况应牢记以下要点:引发骨炎的慢性中耳炎病情极为严重,多数情况下,患病耳朵都经历过多次手术(21例中有17例);病变仅为骨炎,但2/3的病例(21例中有14例)病变范围非常广泛。7例骨质溶解疾病,发生于重度或非典型胆脂瘤型慢性中耳炎,常伴有累及面神经主干、岬、颈内静脉球甚至颈动脉管的骨质溶解。4例外耳道壁弥漫性亚梗阻性骨瘤病,其中3例在数月内呈“进行性”发展。最后,2例混合性疾病(骨炎 - 骨瘤和骨炎 - 骨质溶解)。8例发生于鼓膜成形术后:这是一种罕见情况(约1%),仅1例因医源性胆脂瘤导致骨质溶解,7例为骨炎,其中4例骨炎局限程度高,不妨碍进一步进行鼓膜成形术,另外3例骨炎范围非常广泛,最终形成一个大的引流腔。2例中,畸形被认为可能是慢性中耳炎发病时鼓膜受累的原因,但无法就耳鳃瘘或胡施克孔得出明确结论。