慢性中耳炎患者における骨損傷のパターン

Patterns of Bone Damage in Patients With Chronic Middle Ear Inflammation.

• Agnieszka Wiatr
• Pawel Strek
• Maciej Wiatr

抄録

背景:

異なる病因にもかかわらず、慢性中耳炎は骨組織の損傷と再構築を伴う。炎症性のプロセスは骨の鎖の要素を破壊し、骨病変が現れて耳介性合併症の発症を可能にすることがあります。

BACKGROUND: Despite different etiologies, chronic otitis media involves the damaging and restructuring of bone tissue. The inflammatory process destroys elements of the ossicular chain, and bone lesions may appear that allow the development of otogenous complications.

研究の目的:

中耳の骨壁や骨嚢鎖の損傷の程度と慢性炎症性病変の種類との間に相関関係があることを明らかにした。走査型顕微鏡を用いて骨の破壊的変化を観察した。

AIMS/OBJECTIVES: A correlation between the degree of damage to the ossicular chain as well as the bony walls of the middle ear and the type of chronic inflammatory lesions was sought. Destructive changes to bones were observed using scanning microscopy.

材料と方法:

除去された小骨の損傷片を走査型顕微鏡で評価するために調製した。試料は金の薄い層でスパッタコーティングし、その後評価した。

MATERIAL AND METHODS: The removed damaged fragments of the ossicles were prepared for evaluation with a scanning microscope. Preparations were sputter-coated with a thin layer of gold and subsequently evaluated.

結果:

この期間に行われた220件の手術のうち、中耳の骨壁の破壊が頭蓋内合併症の原因となっていたのは27例であった。そのほとんどが肉芽を伴う慢性中耳炎を継続していました。

RESULTS: Of 220 surgeries carried out in the discussed period, destruction of the middle ear bone walls, opening the way for the development of intracranial complications, was found in 27 patients. Most of them had ongoing chronic otitis media with granulation.

結論:

(1)肉芽腫を伴う慢性中耳炎では，胆汁腺腫よりも頭蓋骨基部の骨喪失が高頻度に認められた．(2)胆汁腺腫を伴う慢性中耳炎では、肉芽形成を伴う慢性中耳炎に比べて、骨棘鎖の損傷が有意に高頻度に認められた。

CONCLUSIONS: (1) Bone loss of the skull base was observed more frequently in patients with chronic otitis media with granulation than with cholesteatoma. (2) In chronic otitis media with cholesteatoma, damage to the ossicular chain was observed significantly more frequently than in the case of otitis media with granulation.