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以及粘连性中耳炎与胆脂瘤的关系，进行了以下研究。临床检查2.实验性中耳炎动物鼓膜的形态观察3.粘连性中耳炎和胆脂瘤患者鼓膜的形态观察4.人颞骨的研究5.粘连性中耳炎感觉性耳聋的机制6.实验性中耳炎。研究结果如下：1.粘连性中耳炎是婴儿持续性分泌性中耳炎的后遗症。鼓膜的纤维层在最初阶段被溶解，然后鼓膜在中耳的负压下逐渐被压低。对于粘连现象的发生，一些细菌感染被认为是必要的。分泌性中耳炎向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胆脂瘤的转化也被认为是在儿童时期发生的。除部分病例外，咽鼓管鼓室口情况严重。即使咽鼓管完全闭合，鼓膜也不仅仅附着在海角上。中层极厚的鼓膜太难附着。粘连性中耳炎引起的感觉性耳聋是通过圆窗膜发生的。圆窗龛肉芽组织被认为是对内耳功能的损伤。制作粘连性中耳炎的动物模型是相当困难的，这件事将是未来的问题。

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.