粘连性中耳炎的颞骨组织病理学

Histopathologyofthetemporalboneinadhesiveotitismedia

为了解粘连性中耳炎的组织病理学变化，通过颞骨火棉胶切片，对３３８例颞骨切片中有粘连性中耳炎病理特征的２０例（２６耳）作了全面观察。结果显示，粘连性中耳炎病变范围非常广泛，涉及中耳的各部分结构，包括鼓室肌、圆窗及卵圆窗；其病理变化多种多样，包括炎症发生、发展和修复过程的各个阶段。根据２６耳颞骨切片的组织病理学变化的特点可分为４期：即渗出期、炎性肉芽组织期、组织细胞反应期和胶原纤维增生期。从渗出期到胶原纤维增生期，中耳病变组织中炎细胞逐渐减少，炎性渗出物逐渐消散，而纤维母细胞始终增生明显。根据以上病理特征，分析了粘连性中耳炎疗效差的原因。

Tounderstandthehistopathologicalchangesofadhesiveotitismedia(AOM)inhu-man,temporalbonesectionsprocessedwiththeceloidin-embeddingtechniquewerereviewed.Inthe338pairsoftemporalbonespecimens,20cases(26ears)showedcharacteristicsofAOM.There-sultsshowedthatthelesionsofAOMwereextensive,involvingalmiddleearstructuresincludingtympanicmuscles,roundandovalwindows.Therewerevariouspathologicalchanges,ineverystageofinflammationandtissuerepair.Accordingtothemainpathologicalcharacteristics,histopatholo-gicalchangesofthe26earswerestagedasexudation,inflammatorygrannlationformation,histocyteresponseandcolegenproliferation.Astheprocessprogressed,theamountofinflammatorycelsandexudatedecreasedwiththeincreaseoffibroblasts.Certainfactorswerespeculatedtoplayanimpor-tantroleintheprocessoffibrosis.TheauthorsanalysedthedificultiesinthemanagementofAOMandcausesoftheunsatisfactorytherapeuticresults.Possiblemeasurestoimprovetreatmentresultwereproposed.