| Co-Investigator(Kenkyū-buntansha) |
SHIMIZU Sawamichi The Jikei University School of Medicine,, 医学部, 助手 (10147324)
YAMAGUCHI Nobumasa The Jikei University School of Medicine,, 医学部, 助手 (60130209)
MORIYAMA Hiroshi The Jikei University School of Medicine,, 医学部, 講師 (60125036)
SANO Shinichi The Jikei University School of Medicine,, 医学部, 講師 (80057059)
UMEZAWA Yuji The Jikei University School of Medicine,, 医学部, 助教授 (90056945)
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| Research Abstract |
The acquired cholesteatoma originats from sequela of chronic infant secretory otitis media(SOM) and is diveded into two categories, that is flaccida type and tenza type. The purpose of the studies are that elucidate the factors which promote or prevent the development of cholesteatoma
Next studies were performed to accomplish this aim. Detailed observation for the advance of cholesteatoma matrix during surgeries, long term following up to the patients with SOM, morphological study of inflammatory temporal bone especially of sclerotic mastoid.
Prosperity and decay of secretory glands of mucose membrane of the middle ear and mastoid, culture study of epedermal cells and matrix of cholesteatoma, besides study of prowth factors to the epidermal cell, ultrastructure of the ear drum of SOM.
As the results of these studies, the promoters of progression from secretory otitis media(SOM) to cholesteatoma can be explained as follows. Deficiency of tubal function, suppressed air cell system of mastoid and blockage of aeration to the mastoid. Besides, continuance of slight inflammation, negative pressure, growth factors to the epidermis of tympanic membrane in the attic are promoting factors to cholesteatoma. Further, disappearance of fibers in pars tneza and adhesion of tympanic membrane are important mechanism to promote the developmnet of tenza cholesteatoma.
On the other hand, the essential conditions for arresting the development to cholesteatoma are as follows, early improvement of tubal function especially at the age of childhood, re-pneumatization of suppressed mastoid, occurrence of tympanic perforation and prevention of adhesion. From these consequences insertion of ventilation tube to the chronic secretory otitis media is ideal procedure.
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