Sadé J, Halevy A, Klajman A, Mualem T
Acta Otolaryngol. 1980 Mar-Apr;89(3-4):233-9. doi: 10.3109/00016488009127133.
The "idiopathic haemotympanum" is in reality a persistent secretory otitis media. Histologically it demonstrates a chronic granular mastoiditis associated with a cholesterol granuloma. This, however, is not a very specific finding and may be frequently found in other types of the 'underaerated middle ear syndrome', wuch as ears with central perforations or indeed with cholesteatoma. In these granulomas, iron deposits are found, as well as the iron-chelating agent--lactoferin, which is known to be part of the defence mechanism of all mucosas. Lactoferrin is specifically secreted by the exocrine glands and it is not surprising to find much of it in the middle ear in a situation where mucus is being abundantly synthesized--as the case may be in any otitis media. There is no real clinical or histological evidence, so far, that neither the iron deposits nor the cholesterol crystals of these granulomas emanate from a previous hemorrhage.
“特发性血鼓室”实际上是一种持续性分泌性中耳炎。组织学上，它表现为与胆固醇肉芽肿相关的慢性颗粒性乳突炎。然而，这并不是一个非常特异的发现，在其他类型的“中耳通气不良综合征”中也经常可以见到，比如伴有中央性穿孔的耳朵，或者实际上患有胆脂瘤的耳朵。在这些肉芽肿中，发现了铁沉积物以及铁螯合剂——乳铁蛋白，乳铁蛋白是已知的所有黏膜防御机制的一部分。乳铁蛋白由外分泌腺特异性分泌，在中耳大量合成黏液的情况下（任何中耳炎都可能如此），在中耳发现大量乳铁蛋白也就不足为奇了。目前尚无实际的临床或组织学证据表明这些肉芽肿中的铁沉积物和胆固醇晶体源自先前的出血。
