鼓膜緊張部の菲薄化、陥凹、癒着化 : 上皮の増殖・分化、緊張部真珠腫の発症機序

概要

論文の詳細を見る
Histopathological and molecular biology studies were performed in relation to otitis media with effusion, atelectasis and adhesive otitis media as nonperforative lesions of the tense tympanic membrane. In otitis media with effusion, thinning of the lamina propria of the tympanic membrane was observed to have occurred as a result of absorption of the inner and outer fibrous layers. Eustachian tube insufficiency and damage to the middle ear mucosa can be postulated as causes of adhesive otitis media, and it was surmised that the difference between complete and partial adhesion of the tympanic membrane arises from differences in the time of occurrence or duration of eustachian tube insufficiency or differences in the intensity of reaction of the middle ear mucosa to inflammation. In addition, the posterosuperior region of the tympanic membrane is anatomically complicated, and retraction of the PSQ region leads to ready closure of the tympanic isthmus. Experimental findings also indicated that there was impairment of migration of the retracted and fused epithelium, which resulted in accumulation of debris, infection and activation of epithelial proliferation, with possible eventual progression to tension-type cholesteatoma.However, it is surmised that chaotic proliferation of the epithelium does not occur because of preservation of a normal balance between differentiation and apoptosis of the epithelial cells.
日本耳科学会の論文
1999-07-25