Sadé J, Halevy A
J Laryngol Otol. 1976 Aug;90(8):743-51. doi: 10.1017/s0022215100082645.
A retrospective study was made of 200 chronic otitis media patients. Simple chronic otitis media was observed in 76 per cent of cases; the rest were associated with cholesteatoma. In about one third of the patients, the contralateral ear showed some inflammatory middle ear disease as well. The average time lapse between initial symptoms and hospitalization was about 10 years. The events leading to the tympanic perforation were difficult to ascertain, but included probably acute otitis media, possibly external otitis, trauma, and a rather large group (35-40 per cent) of insidious 'essential perforations'. The aetiology of the 'essential perforations' is so far not known, but might be non-inflammatory in nature but related to insufficient middle ear aeration and hypo-pneumatization as well as to what is termed atelectatic ears. The bacteria isolated from chronic otitis media ears (usually gram negative bacteria and staphylococcus aureus) are usually not the types of micro-organisms found in association with any primary or acute otitis media. It is proposed that the bacterial infection encountered in what is termed 'chronic otitis media' is often a secondary infection of a primary perforated tympanic membrane, the perforation originating or persisting in underventilated ears, and having arisen from various causes--some of them as yet unknown.
对200例慢性中耳炎患者进行了回顾性研究。76%的病例观察到单纯性慢性中耳炎；其余病例伴有胆脂瘤。约三分之一的患者对侧耳也有一些炎性中耳疾病。初始症状与住院之间的平均时间间隔约为10年。导致鼓膜穿孔的事件难以确定，但可能包括急性中耳炎、可能的外耳道炎、外伤以及相当大比例（35%-40%）的隐匿性“原发性穿孔”。“原发性穿孔”的病因目前尚不清楚，但可能本质上是非炎性的，与中耳通气不足和气化不良以及所谓的萎缩性耳有关。从慢性中耳炎耳中分离出的细菌（通常是革兰氏阴性菌和金黄色葡萄球菌）通常不是在任何原发性或急性中耳炎中发现的微生物类型。有人提出，在所谓的“慢性中耳炎”中遇到的细菌感染通常是原发性穿孔鼓膜的继发性感染，穿孔起源于或持续存在于通气不良的耳朵中，并且由各种原因引起——其中一些原因尚不清楚。
