分泌性中耳炎咽鼓管及鼓室黏膜的光镜及电镜观察

Histopathological and ultracytochemical observation of mucosa on the eustachian tube and middle ear with experimental secretory otitis media

目的 :探讨分泌性中耳炎的发病原因 ,为临床治疗提供理论依据。 方法 :通过微波烧灼双侧咽鼓管口 ,建立分泌性中耳炎动物模型。光镜观察比较咽鼓管管腔及黏 软骨膜和鼓室黏膜变化。电镜观察咽鼓管鼓室段暗颗粒分泌细胞及其表面活性物质样板层体的变化。结果 :各组咽鼓管管腔通畅 ,咽鼓管黏 软骨膜不易受炎症浸润及负压影响。鼓室黏膜水肿、增生、炎性细胞浸润明显 ,暗颗粒细胞分泌功能受损 ,表面活性物质板层体结构明显减少或消失。结论 :咽鼓管黏 软骨膜在分泌性中耳炎发病过程中起重要作用。

Objective:To further explore the pathogenesis of the secrectory otitis media and provide basis for its clinical treatment. Method:A model of otitis media with effusion was established by coagulating the pharyngeal orifice of the eustachian tube under an endoscope with microwave.Orifice and its cartilage mucosa of the eustachian tube and the mucosa in the middle ear were observed and compared,dark granulated cells near the middle ear and surfactant like lamellar bodies were observed. Result:Under light microscope,the eustachian tube in all the specimens were unblocked.The thick measurements and pathology observations of the cartilage mucosa on eustachian tube with otitis media revealed that there were no obviously inflammatory change and no significantly difference in comparsion with normal control group.In all the pathologic groups, no surfactant like lamellar bodies were found in the secretory cells, which showed impaired characters with little secertory granules. Conclusion:The cartilage mucosa on eustachian tube is possessed of very strong function of natural defence for inflammatory disease.Surfactant like substance are important in maintaining the physiological function of the eustachian tube.These studies provide a basis for further experimental research and clinical treatment for secretory otitis media.