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作者们近年观察了4例继发于慢性中耳炎的顽固性坏死性颞骨炎。本病或称坏死性耳炎、坏死性乳突炎。病例的共同点是:①从小患有慢性化脓性中耳炎,反复流脓。②急性发作时,外耳道、中耳腔有大量肉芽并伴有骨质破坏的乳突炎。③抗生素及外科搔刮处理不能控制坏死病变的进行。本文4例中,1例治愈,3例死亡。一例尸体解剖发现坏死病变由颞骨开始,侵及枕骨、颈椎,其中并有过度角化变性,表明为胆脂瘤向颅内广泛浸润而导致死亡。对于伴有骨质破坏、增殖的肉芽组织,曾怀疑为癌肿,经多次组织学检查皆为非特异性肉芽肿。又曾在一例试用小量~(60)钴照射,短期内上皮化过程似有好转,但从全程来看并无效果。本文指出,由于抗生素的问世,中耳炎并发症有明显下降,但自1965年以来又有回升趋势。
In recent years, the authors observed 4 cases of refractory necrotizing temporal bone inflammation secondary to chronic otitis media. The disease or necrotizing otitis media, necrotizing mastoiditis. Common cases are: ① suffering from chronic purulent otitis media, repeated pus. ② acute attack, the external auditory canal, the middle ear cavity has a large number of granulation and bone destruction associated with mastoiditis. ③ antibiotics and surgical scraping treatment can not control the progression of necrotic lesions. Of the 4 cases in this article, 1 was cured and 3 died. One case of autopsy found necrotic lesions started from the temporal bone, invasion of the occipital, cervical vertebrae, with hyperkeratosis and degeneration, indicating that the extensive invasion of cholesteatoma to the brain and cause death. For accompanied by bone destruction, proliferation of granulation tissue, had suspected of cancer, after many histological examination are non-specific granuloma. Also in a trial of a small amount of ~ (60) cobalt irradiation, epithelialization seems to be improving in the short term, but from the whole point of view no effect. This article points out that due to the advent of antibiotics, there has been a significant drop in the incidence of otitis media, but since 1965 there has been an upward trend.