The origin and pathology of the adhesive otitis media and relation with middle ear cholesteatoma

为了探讨粘连性中耳炎的发病机制及与胆脂瘤的关系，我们进行了以下研究。2.临床检查实验性中耳炎动物鼓膜的形态学观察粘连性中耳炎和胆脂瘤的鼓膜形态学研究人类颞骨的研究粘连性中耳炎感觉耳聋的发病机制实验耳炎。结果如下：粘连性中耳炎是婴儿持续性分泌性中耳炎的后遗症。鼓膜纤维层在初始阶段溶解，然后鼓膜在中耳负压作用下逐渐凹陷。对于附着现象的发生，一些细菌感染被认为是必要的。从分泌性中耳炎到粘连性中耳炎的转变发生在儿童早期。从粘连性中耳炎到张力性胆脂瘤的转变也被认为是在儿童时期发生的。除部分病例外，耳咽管鼓室口的情况不仅对鼓室成形术严重。即使在耳咽管完全闭合的情况下，鼓膜也不只是附着在耳咽管岬上。中间层极厚的鼓膜难以粘附。粘连性中耳炎引起的感觉性耳聋是通过圆窗膜发生的。圆窗壁龛的肉芽组织被认为对内耳功能有损害。粘连性中耳炎动物模型的制作是相当困难的，这将是今后的课题。

In order to examine the pathogenesis of adhesive otitis and the relationship between adhesive otitis and cholesteatoma, following researches were conducted.1. clinical examinations 2. morphological observations of the animal tympanic membrane on the experimental otitis 3. morphology of the tympanic membrane in cases of adhesive otitis and cholesteatoma 4. study of human temporal bone 5. mechanism of sensory deafness in adhesive otitis 6. experimental otitis. Results are follows.1. Adhesive otitis occurs as a sequela of infant persistent secretory otitis. Fibrous layers of the tympanic membrane are dissolved at the initial stage, then the tympanic membrane is gradually depressed by negative pressure in the middle ear. For the occurrence of the adherent phenomenon, some bacterial infection is considered to be necessary.2. The transition from secretory otitis to adhesive otitis is made at early stage of childhood.3. The transformation from adhesive otitis to tensa cholesteatoma is considered to be made in childhood too.4. The situation of the tympanic orifice of the Eustachian tube is not only serious for the tympanoplasty except some partial cases.5. Even in case of complete closure on the Eustachian tube, the tympanic membrane is not only adhered to the promontory. The tympanic membrane that the middle layer is extremely thick is too hard to adherent.6. Perceptive deafness from adhesive otitis occurs through the round window membrane. The granulation tissure of the round window niche are considered to injure the inner ear function.7. To make the animal model of the adhesive otitis is quite difficult, this matter will be future problem.