鼓室分泌物涂片阴性的嗜酸粒细胞性中耳炎1例及文献复习  

A case of eosinophil otitis media with smear-negative middle ear effusion and literature review

作　　者：王鹏军 周月 王慧[1] 陈正侬[1] 吴雅琴[1] 时海波[1] 殷善开[1] WANG Pengjun;ZHOU Yue;WANG Hui

机构地区：[1]上海交通大学附属第六人民医院耳鼻咽喉头颈外科,上海交通大学耳鼻咽喉头颈外科研究所,上海市睡眠呼吸障碍疾病重点实验室,上海200233

出　　处：《临床耳鼻咽喉头颈外科杂志》2020年第5期465-467,共3页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：上海市领军人才培养计划(No:2017062)。

摘　　要：1病例报告患者,女,58岁,因右耳闷伴听力下降20余年于2018年11月6日来我院门诊就诊。患者诉伴有无臭性右耳流脓,持续性中调耳鸣,无头痛、眩晕、恶心呕吐等症状。既往有哮喘病史29年,以"布地奈德福莫特罗粉吸入剂"每次1吸,2次/d治疗;2010年于外院行鼻窦炎鼻息肉手术。耳内镜检查(图1):右外耳道黄色脓性分泌物,耳道皮肤及皮下软组织充血肿胀伴局部坏死,耳道内可见淡红色肉芽样新生物,表面充血、光滑、呈分叶状,边界清楚,蒂部窥不及。We report a case of eosinophil otitis media with smear-negative middle ear effusion.This case is a special type of otitis media characterized by highly viscous middle ear effusion associated with bronchial asthma and nasal polyposis.However,unlike the classical cases that tested positive for eosinophils,smear examination of middle ear effusion in this case showed unusual presence of neutrophils.The diagnosis was validated by pathological biopsy of granulation tissue in the tympanic cavity,showing predominantly eosinophils in the mucosa of the middle ear.Surgery,focal applications of corticosteroid and antibiotics to control inflammation and bacterial infection were effective to ameliorate the middle ear condition in this case.

关 键 词：嗜酸粒细胞性中耳炎 鼓室 涂片 

分 类 号：R764.21[医药卫生—耳鼻咽喉科]