Stamm A C, Pinto J A, Cóser P L, Marigo C
Laryngoscope. 1984 Sep;94(9):1218-22. doi: 10.1288/00005537-198409000-00014.
Three cases of an unusual form of suppurative chronic otitis media in children 2 and 3 years old are presented. The clinical feature common to all cases was otorrhea, beginning at the first months of life, with a silent evolution to a complete peripheral facial paralysis. In one case the facial paralysis was bilateral. The treatment applied was surgical: subtotal petrosectomy. The surgical findings were bloody granulation tissue, sequestering completely the otic capsule. The facial nerve was destroyed almost the total length of the Fallopian canal in all cases. The histopathologic examination revealed a destructive and nonspecific chronic inflammatory process. The culture showed Gram-negative organisms, such as Pseudomonas aeruginosa and Proteus mirabilis. Etiologic aspects involved in the process are discussed and the name non-specific necrotizing petrositis is suggested to individualize this rare form of otitis which, with morbidity, leads to severe complications such as facial paralysis and deafness.
本文报告了3例2至3岁儿童的特殊类型化脓性慢性中耳炎。所有病例的共同临床特征为耳漏，始于出生后的头几个月，病情隐匿发展，最终导致完全性周围性面瘫。其中1例为双侧面瘫。治疗方法为手术：岩骨次全切除术。手术所见为血性肉芽组织，完全包绕听骨链。所有病例面神经在面神经管内几乎全程受损。组织病理学检查显示为破坏性非特异性慢性炎症过程。培养结果显示革兰阴性菌，如铜绿假单胞菌和奇异变形杆菌。文中讨论了该疾病的病因，并建议将这种罕见的中耳炎命名为非特异性坏死性岩骨炎，其具有较高的发病率，可导致面瘫和耳聋等严重并发症。
