中耳炎乳突根治术后乳突腔内上皮组织的病理学研究

Histopathological study of skin tissue obtained from mastoid cavities following mastoidectomy

目的 :探讨慢性中耳炎行乳突根治术后乳突腔内覆盖的上皮组织的病理结构和改变 ,为中耳炎乳突根治术后再手术时处理乳突腔内的上皮组织提供病理学基础资料。方法 :对慢性中耳炎 11例行乳突根治术后的乳突腔内覆盖的上皮组织进行病理学检查 ,并与乳突根治术后再手术的 14例肉芽组织的病理改变进行比较。结果 :慢性中耳炎行乳突根治术后耳漏患者的乳突腔内覆盖上皮组织的改变为非特异性的慢性炎症表现 ,肉芽组织也表现为慢性炎症改变 ,但是部分肉芽组织内有急性炎症表现及腺管结构、胆固醇结晶、巨噬细胞等。结论 :慢性中耳炎行乳突根治术后耳漏患者再手术时应切除乳突腔内覆盖的上皮组织 。

Objective:To investigate the pathological changes of the skin tissue obtained from mastoid cavities,which covered the bone surface of the mastoid cavity following classical radical mastoidectomy or modified radical mastoidectomy for chronic otitis media.Methods:Surgical speciment of the skin tissue were taken from 11 mastoid cavities and were investigated histologically.In addition,granulation tissue taken from 14 mastoid cavities were examined.Result:Skin tissue mainly presented chronic inflammation.Granulation tissue presented a mixture of acute and chronic inflammation,and signs of acute inflammation such as infiltration of neutrophils were seen,in addition,some granulation tissue presented particular findings not observed in skin tissue such as cholesterol cleft,multinucleated giant cells.Conclusion:The skin tissue,which taken from mastoid cavities following mastoidectomy for chronic otitis media,consists of stratified flattened epithelium and underlying connective tissue.Histological observation suggests that removal of the skin tissue is necessary to terminate infection in the postoperative mastoid cavity.