IL-4及IgE在分泌性中耳炎患者中耳积液中的表达

分泌性中耳炎（OME）是以中耳积液及听力下降为主要特征的中耳炎性疾病，其发病机制至今尚未完全明了。部分研究认为工型变态反应是引起该病的因素之一。本研究通过测定46例伴有呼吸道变应性炎症的OME患者和38例对照组其血浆和中耳积液中IL-4及IgE含量，探讨工型变态反应在OME发病中的作用，报告如下。     

分泌性中耳炎的相关发病机制及治疗研究

分泌性中耳炎(otitis media with effusion,OME)是以中耳积液及听力下降为主要特征的疾病,同中耳的化脓性炎症不同的是其通常不伴有耳部急性感染症状。本病发病机制复杂,与咽鼓管功能障碍、感染及颅面部畸形等多种因素相关,治疗手段也因病因不同而方式多样。本文就分泌性中耳炎的发病机制及其治疗方式的新进展作一综述。     

分泌性中耳炎动物模型建立方法及研究进展

<正>分泌性中耳炎(otitis media with effusion,OME)是以中耳积液及听力下降为主要特征的中耳非化脓性炎性疾病,是耳科的常见病。80%的儿童3岁前曾出现过急性中耳炎的表现,以OME为主[1]。然而,一部分患者可以自愈,并且不再复发,另外一部分的患者则迁延不愈。OME的病因与发病机制复杂,目前学者普遍认为,OME病因有咽鼓管阻塞、感染、变应性反应,通常涉及多因素,最新的研究表明基因易感性也是一个重要的发病因素。OME的病因和发病因     

儿童鼓膜置管的相关问题

分泌性中耳炎(otitis media with effusion,OME)是以中耳鼓室积液及听力下降为主要特征的中耳非化脓性炎性疾病,是儿童常见的疾病之一。约80%的儿童8岁前患过1次OME,多数在6个月～4岁,约55%的患者有轻度波动性听力损失[1]。OME主要的     

儿童分泌性中耳炎诊疗规范化的探讨

分泌性中耳炎(OME)是以鼓室积液、传导性耳聋为主要特征的中耳非化脓性疾病,为儿童常见病之一,年龄越小发病率越高.儿童OME在病因、病程及临床表现等方面有其特殊性,如不合理诊治,可能会转化成粘连性中耳炎、鼓室硬化、胆固醇性肉芽肿等疾病,造成永久性听力损失,严重时会影响言语、智力的正常发育,造成严重不良后果.我们参考国内外此方面的研究进展,就儿童分泌性中耳炎的病因、发病机制、临床特点、诊治原则等进行深入探讨,同时推荐“个性化”的规范治疗方案,供临床参考.     

分泌性中耳炎及鼓室置管治疗的并发症

分泌性中耳炎(OME)是以中耳积液和听力下降为主要特征的中耳非化脓性炎症性疾病。急性OME一般预后良好,但对慢性或反复发作性的OME,若不及时正确地治疗,会导致一些并发症的发生;另外在临床工作中,OME的手术治疗———鼓室置管术,也存在多种并发症。这些并发症在治疗上较OME本身更加困难,且效果不佳,给患者造成极大痛苦,因此深入地认识这些并发症,了解各种并发症的原因及转归,有重要的临床意义。1 OME的并发症OME是耳鼻咽喉科的常见病、多发病,儿童发病率较高,大约80%的儿童曾患过OME,是儿童听力下降和语言障碍的重要原因。大部分O…     

耳内镜下鼓膜置管术治疗分泌性中耳炎

分泌性中耳炎(otitis media with effusion.OME)是以鼓室积液及传导性耳聋为主要特征的中耳非化脓性炎性疾病.对于反复发作、保守治疗无效的分泌性中耳炎患者,鼓膜切开置管术是有效治疗方法,我科2006年6月-2007年5月在耳内镜下行鼓膜置管术42例(75耳),取得良好疗效.报道如下.     

分泌性中耳炎的治疗近况

分泌性中耳炎是以中耳积液及听力下降为主要特征的中耳非化脓性炎性疾病,病因复杂,发病机制尚未明确。本文总结分泌性中耳炎治疗近况,以期探讨提高分泌性中耳炎的治疗效果。     

分泌性中耳炎的临床诊治进展

分泌性中耳炎是一种以中耳积液和听力下降为主要特征的中耳非化脓性炎性疾病,以儿童多见,可导致患儿语言发育障碍、平衡功能障碍等,故而了解其病因和发病机制和诊疗方法,对于改善患者症状和生活质量具有重要意义,本文综述了近些年分泌性中耳炎的临床诊治进展。     

儿童分泌性中耳炎的诊疗进展

分泌性中耳炎（otitis media with effusion,OME）是指以中耳积液（包括浆液、黏液、浆一黏液）及听力下降为主要特征的中耳非化脓性炎性疾病,不伴有鼓室和乳突急性感染症状及体征[1,2]。中耳腔的持续积液影响鼓膜动度,形成对声音传导的屏障,从而引起听力下降。     

Sensorineural hearing loss in experimental purulent otitis media due to Streptococcus pneumoniae

Sensorineural hearing loss (SNHL) has been described clinically following chronic otitis media with effusion, but to the best of our knowledge, no studies have demonstrated SNHL in an animal model of otitis media. Using the chinchilla model of pneumococcal otitis media, significant SNHL was demonstrated after purulent otitis media, especially at higher frequencies. Animals with otitis media received penicillin G procaine treatment for five days after otitis media with effusion (OME) was first documented; resolution of middle ear infection was confirmed by middle ear effusion culture in all animals. Both the inoculated and uninoculated ears were examined by tone burst-elicited compound action potential at threshold. The inoculated ear showed a marked hearing loss of 13 to 36 dB three to four days after OME was first documented; a hearing loss up to 24 dB persisted two to five weeks after inoculation. The change in the compound action potential was highly significant at all frequencies studied. Conductive losses were largely ruled out because there was no middle ear effusion at death and the tympanogram was normal. Purulent labyrinthitis was ruled out by histopathological study. These results indicate that purulent pneumococcal otitis media in the chinchilla model causes significant SNHL and suggest that the pathogenesis of SNHL associated with chronic OME in humans may be studied in this model.     

Otitis media with effusion in children with congenital or early-onset hearing impairment

OBJECTIVE: The purpose of this study was to examine the incidence of otitis media with effusion (OME) among children with bilateral congenital or early-onset hearing impairment (CEHI) and to assess whether the diagnosis of OME had any effect on the detection of CEHI. METHODS: The study population consisted of all patients diagnosed in a Finnish university hospital between 1976 and 1995 as having CEHI (> 25 dB, 0.5-4 kHz, in the better hearing ear). Early-onset hearing impairments were defined as losses attributed to perinatal or neonatal complications. Otitis media with effusion was assigned when asymptomatic middle ear effusion had lasted at least 2 months and tympanocentesis had yielded mucous effusion. RESULTS: A total of 184 child patients with CEHI were identified. Of these, OME was diagnosed and treated in 28 (15%) patients. Of the patients with OME, diagnosis of CEHI was made before the occurrence of OME in 7 (25%) and at the same time in 10 (36%) but was delayed at least 6 months after the treatment of OME in 11 (39%) patients. CONCLUSION: It is suggested that all children undergoing ventilation tube placement should have age-appropriate hearing examination to exclude coexisting sensorineural hearing loss.     

Impaired Binaural Hearing in Children Produced by a Threshold Level of Middle Ear Disease

Otitis media with effusion (OME), a form of middle ear disease, is the most common reason for young children both to visit their family doctor and to have surgery. Almost all children have at least a single episode of OME before their first birthday and annual incidence rates exceed 50% in each of the first five years. For most children, OME occurs infrequently, but about 10–15% of children have OME during more than half of their first six years. Middle ear effusions attenuate and delay sound, causing conductive sound distortion during the crucial years for language acquisition. The many studies of OME effects on language and other indices of development have produced mixed results. However, a consensus is emerging of mild language impairment in the preschool years, with subsequent performance, emotional, and behavioral difficulties. In addition to the peripheral hearing loss produced directly by the disease, binaural and other central auditory deficits can outlive the OME. It has been unclear which children are at risk of central impairment following OME, since the children studied have generally been recruited from otolaryngology clinics. Consequently, a detailed prospective history of the middle ear status of participants has not been available. By studying six-year-old children with a lifetime known history of OME, we show in this study that only those children with a cumulative OME experience of more than about half the time during the first five years consistently have residual impaired binaural hearing.     

感音神经性聋与分泌性中耳炎的相关性研究

目的：探讨感音神经性聋与分泌性中耳炎的关系。方法：对治疗后骨导听力下降仍未恢复的38例分泌性中耳炎患者进行分析，观察健耳和患耳在不同频率的骨导听阈情况，并分别就其发病年龄、病程、积液性质和积液量与骨导听阈的关系进行观察。结果：患耳在不同频率的骨导听阈均大于健耳（均P＜0．01）；年龄愈大、病程愈长，感音神经性聋发生率愈高；积液为黏液者发生率高于浆液者；但与积液量无明显关系。结论：分泌性中耳炎可导致感音神经性聋，其发病原因和机制是多方面的，年龄大、病程长、积液为黏液者更易导致感音神经性聋的发生；应提高认识，早诊断，早治疗。     

儿童分泌性中耳炎致骨导听力下降的临床特征分析

目的 探讨儿童分泌性中耳炎致骨导听力下降的特点、病因和预后.方法 回顾性分析75例(82耳)分泌性中耳炎患儿骨导听力下降的临床资料,并对其发病年龄、病程、积液性质和积液量与骨导听阈的关系进行观察.结果 75例患儿(82耳)骨导听力下降,平均骨导阈值在2.0 kHz和4.0kHz处增高最明显.骨导听阈与病程和积液性质显著相关(P＜0.01或P＜0.05),与年龄、积液量无关.75例患儿均采取鼓膜切开置管术和(或)腺样体切除术,术后给予药物治疗.随访6月,听力恢复正常者76耳,气导听阈下降但骨导听阈无改善者6耳.结论 分泌性中耳炎可导致儿童骨导阈值增高,是导致儿童耳聋的危险因素之一,及早干预可避免病情发展.     

Isolation of Chlamydia trachomatis from the middle ear aspirates of otitis media

Chlamydia trachomatis was cultured from the middle ear aspirates of patients with acute otitis media and otitis media with effusion (OME) to assess the relationship between the microorganism and middle ear disease. The agent was recovered in 2 of 6 patients with acute otitis media, in 3 of 13 with acute OME and in 9 of 31 with chronic OME. Serum antibody to the agent was detected in 8 of 9 patients with C. trachomatis infection in the middle ear. Chlamydial infection was found, serologically or by isolation of the agent from the genital tract, in the parents of 5 of 6 children with the infection. Therefore perinatal transmission appeared to be the most probable mode of infection in the infants. These studies indicate that C. trachomatis causes middle ear diseases more often than has been suspected.     

A Model of Spontaneous Chronic Otitis Media with Effusion in Mice with ENU Induced Mutations

Background Chronic otitis media (COM) is a significant clinical problem. Understanding the mechanisms of COM is critical for its control and treatment. However, little is known of the processes leading to COM as a result of lack of animal models of N-ethyl-N-nitrosourea (ENU) induced mutations in otitis media with effusion (OME). Methods Otoscopy and auditory brain response(ABR) evaluation were carried out under sedation in Nmf391 nmf/nmf mice of 2, 4, 6 and 8 months of age. The mice were killed for study of middle and inner ear pathology. Results Tympanic membrane visualization and ABR thresholds in 1- to 8-month-old Nmf391 nmf/nmf mice showed spontaneous OME and inner ear diseases in approximately 100% of the animals.The significant elevation of ABR thresholds suggested a sensorineural component in hearing loss in addition to the conductive loss. Middle and inner ear histology showed various degrees of outer hair cells loss and middle ear inflammation in all the mice, but no inflammation cells in the inner ear. The ABR threshold at 32 kHz was significantly elevated. Conclusions This study shows histopathologic changes in the Nmf391 nmf/nmf mouse model of COM with effusion that have not been reported in human COM. This ENU induced mutation model of COM will be valuable for the characterization of middle ear inflammation and inner ear disease processes that are induced by middle ear infections. We propose that COM with effusion in this ENU induced mutation model is the cause of the cochlea hair cells damage.     

Otitis media with effusion in the adult

The etiologic factors associated with serous otitis media or otitis media with effusion (OME) are well described in children. Little has been published with regard to OME and its etiology in adults. Thirty-five adult patients who presented with OME in a referral-based otolaryngologic practice over a five-year period were studied by retrospective chart review with a follow-up telephone interview. OME in adults may be related to previous middle ear surgery in the contralateral ear, a history of middle ear disease in childhood, chronic nasal symptoms of obstruction and nasal fullness, cigarette smoking, and a family history of middle ear disease. The onset is often associated with upper respiratory tract infection. Nasopharyngeal carcinoma was uncommon.     

Assessment of complications of the condition and of the treatment of otitis media with effusion

Persistent otitis media with effusion (OME) may cause long-term changes of the tympanic membrane and middle ear, resulting in some degree of hearing loss. One of the traditional aims of treatment with ventilation tubes is to prevent these complications from developing. Ventilation tubes themselves, however, are also known to induce changes of the tympanic membrane. Several recent studies have addressed the questions: what are the effects of the disease, and what are the result of its treatment? The object of this study was to present the state of the art, by literature review, regarding structural and functional complications of OME and treatment with ventilation tubes. In both observational and experimental studies tympanosclerosis is reported to occur in 39-65% of ears treated with ventilation tubes as opposed to 0-10% of untreated ears. For segmental atrophy these percentages are 16-73 and 5-31, respectively. Regarding the prevalence of atelectasis and attic retraction, the difference between ventilated and untreated ears is less: 10-37% as opposed to 1-20% for atelectasis, and 10-52% as opposed to 29-40% for attic retraction. The average hearing loss associated with these tympanic membrane abnormalities is less than 5 dB. Although ventilation tubes have proven very effective in improving hearing in the short term, they have not proven effective in preventing long-term changes of the tympanic membrane related to OME, nor in keeping some degree of hearing loss from developing.