鼓膜硬化研究现状_West China Medical Journal

Authors：

董晓 ,  赵宇

四川大学华西医院耳鼻咽喉头颈外科（成都 610041）;

Corresponding author：

赵宇, Email: yutzhao@163.com

Keywords：

鼓膜硬化; 鼓室硬化; 中耳炎

DOI：

10.7507/1002-0179.201603100

Video：

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Abstract Full text Figures/Tables Video References Cited by

鼓室硬化是长期慢性炎症刺激下产生的一种不可逆的病理改变。在鼓室硬化中，单独发生于鼓膜的，称为鼓膜硬化，组织学检查以血管和细胞数量减少为特征，在耳内镜下鼓膜硬化主要表现为鼓膜增厚、浑浊、萎缩性瘢痕以及片状或岛状钙化斑沉着，常继发于急、慢性化脓性中耳炎，分泌性中耳炎鼓膜切开及置管术后。无自愈倾向，除手术切除外，目前尚无根治方法，且手术切除复发率高。其发病机制目前尚不明确，随着耳外科手术的发展，鼓膜硬化的病因、发病机制及治疗已引起临床医生的重视。该文就其可能的病因及治疗的最新研究进展进行了综述。

Citation： 董晓, 赵宇. 鼓膜硬化研究现状. West China Medical Journal, 2017, 32(9): 1455-1458. doi: 10.7507/1002-0179.201603100 Copy

1.	黄选兆, 汪吉宝, 孔维佳. 实用耳鼻咽喉头颈外科学. 北京: 人民卫生出版社, 2013: 866-867.
2.	Wielinga EW, Kerr AG. Tympanosclerosis. Clin Otolaryngol Allied Sci, 1993, 18(5): 341-349.
3.	Asiri S, Hasham A, Al Anazy F, et al. Tympanosclerosis: review of literature and incidence among patients with middle-ear infection. J Laryngol Otol, 1999, 113(12): 1076-1080.
4.	Slack RW, Maw AR, Capper JW, et al. Prospective study of tympanosclerosis developing after grommet insertion. J Laryngol Otol, 1984, 98(8): 771-774.
5.	Yaman H, Guclu E, Yilmaz S, et al. Myringosclerosis after tympanostomy tube insertion: relation with tube retention time and gender. Auris Nasus Larynx, 2010, 37(6): 676-679.
6.	Friedman EM, Sprecher RC, Simon S, et al. Quantitation and prevalence of tympanosclerosis in a pediatric otolaryngology clinic. Int J Pediatr Otorhinolaryngol. 2001. 60(3): 205-211.
7.	Koc A, Uneri C. Sex distribution in children with tympanosclerosis after insertion of a tympanostomy tube. Eur Arch Otorhinolaryngol, 2001, 258(1): 16-19.
8.	Tos M, Bonding P, Poulsen G. Tympanosclerosis of the drum in secretory otitis after insertion of grommets. A prospective, comparative study. J Laryngol Otol, 1983, 97(6): 489-496.
9.	Daly KA, Hunter LL, Lindgren BR, et al. Chronic otitis media with effusion sequelae in children treated with tubes. Arch Otolaryngol Head Neck Surg, 2003, 129(5): 517-522.
10.	Erdurak SC, Coskun BU, Sakalli E, et al. Does the use of radiofrequency myringotomy for insertion of a ventilation tube reduce the incidence of myringosclerosis? Eur Arch Otorhinolaryngol, 2014, 271(3): 459-462.
11.	Kalcioglu MT, Cokkeser Y, Kizilay A, et al. Follow-up of 366 ears after tympanostomy tube insertion: why is it draining? Otolaryngol Head Neck Surg, 2003, 128(4): 560-564.
12.	Cagdas KK. The role of experimental myringosclerosis in interpretation of tympanograms and its possible clinical implications. Med Hypotheses, 2005, 64(6): 1132-1134.
13.	Karlidağ T, Ilhan N, Kaygusuz I, et al. Comparison of free radicals and antioxidant enzymes in chronic otitis media with and without tympanosclerosis. Laryngoscope, 2004, 114(1): 85-89.
14.	Mattsson C, Magnuson K, Hellström S. Myringosclerosis caused by increased Oxygen concentration in traumatized tympanic membranes. Experimental study. Ann Otol Rhinol Laryngol, 1995, 104(8): 625-632.
15.	Mattsson C, Marklund SL, Hellström S. Application of Oxygen free radical scavengers to diminish the occurrence of myringosclerosis. Ann Otol Rhinol Laryngol, 1997, 106(6): 513-518.
16.	Forséni M, Bagger-Sjöbäck D, Hultcrantz M. A study of inflammatory mediators in the human tympanosclerotic middle ear. Arch Otolaryngol Head Neck Surg, 2001, 127(5): 559-564.
17.	Raustyte G, Hermansson A. Development of myringosclerosis during acute otitis media caused by Streptococcus pneumoniae and non-typeable Haemophilus influenzae: a clinical otomicroscopical study using the rat model. Medicina (Kaunas), 2005, 41(8): 661-667.
18.	Mattsson C, Stierna P, Hellström S. Treatment with dexamethasone arrests the development of myringosclerosis after myringotomy. Am J Otol, 2000, 21(6): 804-808.
19.	Uneri C, Sari M, Akboğa J, et al. Vitamin e-coated tympanostomy tube insertion decreases the quantity of free radicals in tympanic membrane. Laryngoscope, 2006, 116(1): 140-143.
20.	Uneri C, Bağlam T, Yazici M. The effect of Vitamin E treatment on the development of myringosclerosis after ventilation tube insertion. Int J Pediatr Otorhinolaryngol, 2006, 70(6): 1045-1048.
21.	De Carvalho Leal M, Ferreira Bento R, Da Silva Caldas Neto S, et al. Influence of hypercalcemia in the formation of tympanosclerosis in rats. Otol Neurotol, 2006, 27(1): 27-32.
22.	Ozkan M, Yariktas M, Aynaliet G, et al. Effects of Calcium-rich Diet in Experimentally Induced Otitis Media Subtypes in the Formation of Tympanosclerosis in Rats. J Int Adv Otol, 2012, 8(2): 231-238.
23.	Raustyte G, Cayé-Thomasen P, Hermansson A, et al. Calcium deposition and expression of bone modelling markers in the tympanic membrane following acute otitis media. Int J Pediatr Otorhinolaryngol, 2006, 70(3): 529-539.
24.	Koç A, Uneri C. Genetic predisposition for tympanosclerotic degeneration. Eur Arch Otorhinolaryngol, 2002, 259(4): 180-183.
25.	Selcuk A, Ozlu F, Akdogan O, et al. Is there a relationship between myringosclerosis and atherosclerosis?. B-ENT. 2007, 3(3): 127-130.
26.	Konstantinidis I, Malliari H, Tsakiropoulou E, et al. Fat myringoplasty outcome analysis with otoendoscopy: who is the suitable patient? Otol Neurotol, 2013, 34(1): 95-99.
27.	Pinar E, Sadullahoglu K, Calli C, et al. Evaluation of prognostic factors and middle ear risk index in tympanoplasty. Otolaryngol Head Neck Surg, 2008, 139(3): 386-390.
28.	Wielinga EW, Derks AM, Cremers CW. Tympanosclerosis in the tympanic membrane: influence on outcome of myringoplasty. Am J Otol, 1995, 16(6): 811-814.
29.	Kazikdas KC, Serbetcioglu B, Boyraz I, et al. Tympanometric changes in an experimental myringosclerosis model after myringotomy. Otol Neurotol, 2006, 27(3): 303-307.
30.	Vlastarakos PV, Nikolopoulos TP, Korres S, et al. Grommets in otitis media with effusion: the most frequent operation in children. But is it associated with significant complications?. Eur J Pediatr, 2007, 166(5): 385-391.
31.	Kay DJ, Nelson M, Rosenfeld RM. Meta-analysis of tympanostomy tube sequelae. Otolaryngol Head Neck Surg, 2001, 124(4): 374-380.
32.	Arslan N, Tepe D, Taştan E, et al. Evaluation of the effectiveness of topical ciprofloxacin and prednisolone in the prevention of myringosclerosis. Eur Arch Otorhinolaryngol, 2012, 269(11): 2335-2341.
33.	Uneri CS, Akboga JY. Vitamin e-coated tympanostomy tube insertion decreases the quantity of free radicals in tympanic membrane. Laryngoscope, 2006, 116(1): 140-143.
34.	Ozcan C, Polat G, Görür K, et al. The effect of local administration of N-acetylcysteine in perforated rat tympanic membrane: an experimental study in myringosclerosis. Pharmacol Res, 2002, 45(1): 5-9.
35.	Song JJ, Kwon SK, Cho CG, et al. The effect of caffeic acid phenethyl ester on the prevention of experimentally induced myringosclerosis. Int J Pediatr Otorhinolaryngol, 2007, 71(8): 1287-1291.
36.	Selcuk A, Akdogan O, Ozcan I, et al. Topical application of calcium channel blockers to reduce the progression of experimentally induced myringosclerosis and tympanosclerosis. Laryngoscope, 2008, 118(4): 697-705.

1. 黄选兆, 汪吉宝, 孔维佳. 实用耳鼻咽喉头颈外科学. 北京: 人民卫生出版社, 2013: 866-867.
2. Wielinga EW, Kerr AG. Tympanosclerosis. Clin Otolaryngol Allied Sci, 1993, 18(5): 341-349.
3. Asiri S, Hasham A, Al Anazy F, et al. Tympanosclerosis: review of literature and incidence among patients with middle-ear infection. J Laryngol Otol, 1999, 113(12): 1076-1080.
4. Slack RW, Maw AR, Capper JW, et al. Prospective study of tympanosclerosis developing after grommet insertion. J Laryngol Otol, 1984, 98(8): 771-774.
5. Yaman H, Guclu E, Yilmaz S, et al. Myringosclerosis after tympanostomy tube insertion: relation with tube retention time and gender. Auris Nasus Larynx, 2010, 37(6): 676-679.
6. Friedman EM, Sprecher RC, Simon S, et al. Quantitation and prevalence of tympanosclerosis in a pediatric otolaryngology clinic. Int J Pediatr Otorhinolaryngol. 2001. 60(3): 205-211.
7. Koc A, Uneri C. Sex distribution in children with tympanosclerosis after insertion of a tympanostomy tube. Eur Arch Otorhinolaryngol, 2001, 258(1): 16-19.
8. Tos M, Bonding P, Poulsen G. Tympanosclerosis of the drum in secretory otitis after insertion of grommets. A prospective, comparative study. J Laryngol Otol, 1983, 97(6): 489-496.
9. Daly KA, Hunter LL, Lindgren BR, et al. Chronic otitis media with effusion sequelae in children treated with tubes. Arch Otolaryngol Head Neck Surg, 2003, 129(5): 517-522.
10. Erdurak SC, Coskun BU, Sakalli E, et al. Does the use of radiofrequency myringotomy for insertion of a ventilation tube reduce the incidence of myringosclerosis? Eur Arch Otorhinolaryngol, 2014, 271(3): 459-462.
11. Kalcioglu MT, Cokkeser Y, Kizilay A, et al. Follow-up of 366 ears after tympanostomy tube insertion: why is it draining? Otolaryngol Head Neck Surg, 2003, 128(4): 560-564.
12. Cagdas KK. The role of experimental myringosclerosis in interpretation of tympanograms and its possible clinical implications. Med Hypotheses, 2005, 64(6): 1132-1134.
13. Karlidağ T, Ilhan N, Kaygusuz I, et al. Comparison of free radicals and antioxidant enzymes in chronic otitis media with and without tympanosclerosis. Laryngoscope, 2004, 114(1): 85-89.
14. Mattsson C, Magnuson K, Hellström S. Myringosclerosis caused by increased Oxygen concentration in traumatized tympanic membranes. Experimental study. Ann Otol Rhinol Laryngol, 1995, 104(8): 625-632.
15. Mattsson C, Marklund SL, Hellström S. Application of Oxygen free radical scavengers to diminish the occurrence of myringosclerosis. Ann Otol Rhinol Laryngol, 1997, 106(6): 513-518.
16. Forséni M, Bagger-Sjöbäck D, Hultcrantz M. A study of inflammatory mediators in the human tympanosclerotic middle ear. Arch Otolaryngol Head Neck Surg, 2001, 127(5): 559-564.
17. Raustyte G, Hermansson A. Development of myringosclerosis during acute otitis media caused by Streptococcus pneumoniae and non-typeable Haemophilus influenzae: a clinical otomicroscopical study using the rat model. Medicina (Kaunas), 2005, 41(8): 661-667.
18. Mattsson C, Stierna P, Hellström S. Treatment with dexamethasone arrests the development of myringosclerosis after myringotomy. Am J Otol, 2000, 21(6): 804-808.
19. Uneri C, Sari M, Akboğa J, et al. Vitamin e-coated tympanostomy tube insertion decreases the quantity of free radicals in tympanic membrane. Laryngoscope, 2006, 116(1): 140-143.
20. Uneri C, Bağlam T, Yazici M. The effect of Vitamin E treatment on the development of myringosclerosis after ventilation tube insertion. Int J Pediatr Otorhinolaryngol, 2006, 70(6): 1045-1048.
21. De Carvalho Leal M, Ferreira Bento R, Da Silva Caldas Neto S, et al. Influence of hypercalcemia in the formation of tympanosclerosis in rats. Otol Neurotol, 2006, 27(1): 27-32.
22. Ozkan M, Yariktas M, Aynaliet G, et al. Effects of Calcium-rich Diet in Experimentally Induced Otitis Media Subtypes in the Formation of Tympanosclerosis in Rats. J Int Adv Otol, 2012, 8(2): 231-238.
23. Raustyte G, Cayé-Thomasen P, Hermansson A, et al. Calcium deposition and expression of bone modelling markers in the tympanic membrane following acute otitis media. Int J Pediatr Otorhinolaryngol, 2006, 70(3): 529-539.
24. Koç A, Uneri C. Genetic predisposition for tympanosclerotic degeneration. Eur Arch Otorhinolaryngol, 2002, 259(4): 180-183.
25. Selcuk A, Ozlu F, Akdogan O, et al. Is there a relationship between myringosclerosis and atherosclerosis?. B-ENT. 2007, 3(3): 127-130.
26. Konstantinidis I, Malliari H, Tsakiropoulou E, et al. Fat myringoplasty outcome analysis with otoendoscopy: who is the suitable patient? Otol Neurotol, 2013, 34(1): 95-99.
27. Pinar E, Sadullahoglu K, Calli C, et al. Evaluation of prognostic factors and middle ear risk index in tympanoplasty. Otolaryngol Head Neck Surg, 2008, 139(3): 386-390.
28. Wielinga EW, Derks AM, Cremers CW. Tympanosclerosis in the tympanic membrane: influence on outcome of myringoplasty. Am J Otol, 1995, 16(6): 811-814.
29. Kazikdas KC, Serbetcioglu B, Boyraz I, et al. Tympanometric changes in an experimental myringosclerosis model after myringotomy. Otol Neurotol, 2006, 27(3): 303-307.
30. Vlastarakos PV, Nikolopoulos TP, Korres S, et al. Grommets in otitis media with effusion: the most frequent operation in children. But is it associated with significant complications?. Eur J Pediatr, 2007, 166(5): 385-391.
31. Kay DJ, Nelson M, Rosenfeld RM. Meta-analysis of tympanostomy tube sequelae. Otolaryngol Head Neck Surg, 2001, 124(4): 374-380.
32. Arslan N, Tepe D, Taştan E, et al. Evaluation of the effectiveness of topical ciprofloxacin and prednisolone in the prevention of myringosclerosis. Eur Arch Otorhinolaryngol, 2012, 269(11): 2335-2341.
33. Uneri CS, Akboga JY. Vitamin e-coated tympanostomy tube insertion decreases the quantity of free radicals in tympanic membrane. Laryngoscope, 2006, 116(1): 140-143.
34. Ozcan C, Polat G, Görür K, et al. The effect of local administration of N-acetylcysteine in perforated rat tympanic membrane: an experimental study in myringosclerosis. Pharmacol Res, 2002, 45(1): 5-9.
35. Song JJ, Kwon SK, Cho CG, et al. The effect of caffeic acid phenethyl ester on the prevention of experimentally induced myringosclerosis. Int J Pediatr Otorhinolaryngol, 2007, 71(8): 1287-1291.
36. Selcuk A, Akdogan O, Ozcan I, et al. Topical application of calcium channel blockers to reduce the progression of experimentally induced myringosclerosis and tympanosclerosis. Laryngoscope, 2008, 118(4): 697-705.

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鼓膜硬化研究现状

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