乳突气房发育类型与梅尼埃病发病的关系

Development of the mastoid air cells and its relationship to Meniere＇s disease

目的通过观察梅尼埃病（M6nibre’s disease，MD）患者乳突气房发育情况，并与对照组进行比较，探讨MD的病理解剖学基础及可能的发病因素。方法以行内淋巴囊减压术治疗的100例MD患者（113耳）作为研究对象，选取同期无耳科疾患的100例成年人（100耳）作为对照组。每个研究对象均行颞骨CT扫描，根据影像学资料（MD组同时参考术中所见）将其乳突气房分为气化型、板障型及硬化型。统计两组乳突发育不同类型所占比例，并进行统计学分析。结果MD组板障型乳突占51．4％（57／113），明显高于对照组的18．0％（18／100），差异具有统计学意义（X2=24．476，P〈0．001）；MD组气化型乳突占43．4％（49／113），明显低于对照组的77．0％（77／100），差异具有统计学意义（X2=24．843，P〈0．001）；MD组硬化型乳突占6．2％（7／113），对照组硬化型乳突占5．0％（5／100），二者差异无统计学意义（X2=0．142，P〉0．05）。结论MD组患者乳突发育不良，板障型乳突所占比例较对照组明显增加，这可能是MD的病理解剖基础之一，长期的通气引流障碍及其所导致的反复炎性反应发作等因素可能在MD的发生、发展及转归中起重要作用。

Objective To investigate the fundamental pathological anatomy and possible pathogentic factors of Meniere＇s disease（MD） , we compared the types of mastoid air ceils between the MD group and the control group. Methods The MD group had 113 ears and the control group had 100 ears. Temoral bone CT scanning was performed in all the subjects. The types of mastoid air ceils were determined by surgical findings and imaging data. All the mastoid air cells were divided into diploetic type, gasified type and sclerosis type. Analysis of the proportion of different types and the statistical analysis were performed between the two groups. Results 51.4% （57/113）in the MD group and 18.0% （18/100） in the control group were diploetic type mastoid, the difference was significant （ X2 = 24. 476 ,P 〈 0. 001 ）. The gasified type was 43.4% （49/113） in the MD group and 77.0% （77/100） in the control group, the difference was significant（ X2 = 24. 843,P 〈 0. 001 ）. The sclerosis type was 6.2% in the MD group and 5.0% （5/100） in the control group, and there was no statistical significance （ X2 = 0. 142, P 〉 0.05）. Conclusions The mastoid air cells are dysplasia in MD patients, and it may be one of the fundamental pathological anatomy. The long-term ventilation and drainage disorder and recurrent inflammation attack may play an important role in occurrence, development and prognosis of MD.