Chao W Y, Shen C L
Department of Otolaryngology, National Cheng Kung University College of Medicine, Tainan, Taiwan.
Eur Arch Otorhinolaryngol. 1996;253(1-2):56-61. doi: 10.1007/BF00176705.
Mucosa of the middle ear was obtained from the promontory wall in each of 20 patients during cholesteatoma surgery. Specimens were processed for both scanning and transmission electron microscopy. Non-ciliated mucosal cells were commonly found, with most being secretory cells with secretory droplets and microvilli. The patterns of distribution of microvilli on the surface of these cells were variable. The interciliary spaces were stagnated with secretion. Bacilli were present in five cases. Falloff of mucosal cells was common and intercellular spaces were widened. Compound cilia were observed sporadically. Polymorphic nuclear inflammatory cells, macrophages and fibroblasts appeared in the submucosal area. These findings indicate that although remaining adjacent mucosa after removal of cholesteatoma looks free of disease under the operating microscope, it is actually in a diseased condition with impaired mucociliary function. The cells and bacteria seen microscopically may account for postoperative inflammation, thus warranting continued postoperative antimicrobial medication.
在20例胆脂瘤手术患者中，每例均从岬壁获取中耳黏膜。标本进行了扫描电子显微镜和透射电子显微镜检查。常见非纤毛黏膜细胞，其中大多数为具有分泌小滴和微绒毛的分泌细胞。这些细胞表面微绒毛的分布模式各不相同。纤毛间间隙被分泌物阻塞。5例中发现有杆菌。黏膜细胞脱落常见，细胞间隙增宽。偶尔可见复合纤毛。黏膜下区域出现多形核炎性细胞、巨噬细胞和成纤维细胞。这些发现表明，尽管在手术显微镜下，胆脂瘤切除后残留的相邻黏膜看起来没有病变，但实际上处于疾病状态，其黏液纤毛功能受损。显微镜下所见的细胞和细菌可能是术后炎症的原因，因此术后需要持续使用抗菌药物。
