Chronic Suppurative Otitis Media 慢性化脓性中耳炎Zhong Shixun Ph.D.Department of OtolaryngologyThe First Affiliated HospitalChongqing Medical UniversityDefinition 定义• Long period of time infection of mucous membrane of middle ear, characterized by otorrhea (>8 wk) through a perforated tympanic membrane(TM) and hearing loss 长时间的中耳粘膜感染, 表现为耳漏(> 8 周) 通过鼓膜穿孔(TM) 和听力损失Pathology 病理学• Edematous mucosa with submucosal fibrosis and infiltration by chronic inflammatory cells. 粘膜水肿并发粘膜下纤维化及慢性炎症细胞浸润• Polyps 息肉• Bone erosion 骨侵蚀: – The inflammatory process is thought to lead to infiltration and activation of osteoclasts and mononuclear cells containing various proteolytic enzymes 炎症过程被认为是导致破骨细胞和含有各种蛋白水解酶的单核细胞浸润和激活的原因• Granulation tissue 肉芽组织:– In over 95% of the temporal bones studied from individuals with a history of CSOM 在对有CSOM 病史的人的颞骨研究中超过95%存在Clinical Findings 临床表现• Symptoms 症状：– Otorrhea 耳漏: • Either intermittent or continuous, usually mucopurulent 间歇的或连续的，通常为脓性• Blood-stained drainage is often noted with granulation tissue or polyps 血性分泌物通常提示肉芽组织或息肉Clinical Findings 临床表现• Symptoms 症状：– hearing loss 听力损害• Degree depends on the size and location of the TM perforation and the status of the middle ear 程度取决于TM 穿孔的大小和位置– Size 尺寸– Ossicular chain involvement 听骨链牵涉– fibrosis or inflammatory granulation tissue 纤维化或炎性肉芽组织– Tinnitus 耳鸣Signs 体征•Signs 体征:– Perforation of TM, edematous mucosa, granulation tissue or polyp ；TM 穿孔、粘膜水肿、肉芽组织及息肉– Hearing loss, conductive 听力损害，传导subtotalCentral Total Marginal conductivemixedsensorineuralnormalRadiographic stud...
