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胆固醇肉芽肿(CG)是中耳的少见病变,又称特发性血鼓室。CG 是肉芽性炎性产物。绝大多数学者将胆固醇、血红素和出血联系在一起,其中包括炎症所致出血,故认为胆固醇来源于血浆和血红素。作者观察的83例慢性化脓性中耳炎中,经组织学检查有11例发生 CG。10例为中上鼓室炎,1例为中鼓室炎。9例病史在10年以上。6例咽鼓管严重通气不良。乳突 X 线相9例呈硬化型、2例呈气化型。术中3例鼓窦粘膜有轻度炎症,1例有疤痕及角化物,7例增大的鼓窦有松软的淡黄褐色疤痕组织。所有病人鼓窦入口被疤痕样组织堵塞。4例上鼓室发现有上皮样囊肿型胆脂瘤,4例附有表皮化的粘膜,3例粘膜有轻度改变。只1例听骨链完整。充满鼓窦和堵塞鼓窦入口的松软疤痕组织经检查有 CG 结构。疤痕组织
Cholesterol granuloma (CG) is a rare lesion in the middle ear, also known as idiopathic hematocele. CG is a granulomatous inflammatory product. The vast majority of scholars associate cholesterol, heme and hemorrhage, including inflammation-induced bleeding, so that cholesterol is derived from plasma and heme. The authors observed in 83 cases of chronic suppurative otitis media, histological examination occurred in 11 cases of CG. 10 cases of tympanitis in the upper, 1 case of tympanitis. Nine cases had a history of more than 10 years. 6 cases of eustachian tube bad ventilation. Nine cases of mastoid X-ray sclerosis type, 2 were gasification type. Three cases had slight inflammation of the sinonasal mucosa, one had scar and keratosis, and the other seven had enlarged soft pale yellowish brown scar tissue. The entrance of all patients’ sinuses was blocked by scar-like tissue. 4 cases of epithelial cyst type cholesteatoma found in the tympanic cavity, 4 cases with epidermal mucosa, 3 cases mucosal mild changes. Only 1 case of ossicular chain integrity. The soft scar tissue, filled with the sinuses and plugging the drum’s sinuses, was examined for CG structure. Scar tissue