评论
打印
CHRONIC SUPPURATIVE OTITIS MEDIA put simply: CSOM, is a perforated tympanic membrane with persistent drainage from the middle ear lasting more than 12 weeks.
慢性化脓性中耳炎，简称CSOM，表现为持续12周以上的耳内持续性流脓和鼓膜穿孔。
CSOM is initiated by episode of acute infections.
慢性化脓性中耳炎是由急性感染引起的。
The path of physiology of CSOM begins with irritation and subsequent inflammation of the middle ear mucosa.
CSOM的生理学途径始于中耳粘膜的刺激和随后的炎症。
The inflammatory response creates mucosal oedema and increase middle ear discharge, eventually leading to tympanic membrane perforation.
炎症反应导致粘膜水肿，中耳分泌物增多，最终导致鼓膜穿孔。
A perforation becomes permanent when its edges are covered by squamous epithelium and it doesnot heal spontaneously.
当穿孔的边缘被鳞状上皮覆盖且不能自动愈合时，穿孔就成为永久性的。
Types of CSOM Clinically, it is divided into 2 types.
CSOM的类型在临床上分为两种。
One: Tubotympanic, also called the safe or benign type.
一种是管鼓型，也被称为安全型或良性。
It involves ante-inferior part of middle ear cleft and is associated with a central perforation.
它累及中耳前下部，并伴有中耳穿孔。
There is little risk of serious complications.
几乎没有严重并发症的风险。
Two: Atticoantral, also called unsafe or dangerous type.
二：上鼓窦型，又称不安全或危险型。
It involves postero-superior part of the cleft, i.E. Attic, Antrum and Mastiod, and is associated with an attic or marginal perforation.
它包括后上裂部分，即鼓室上隐窝、鼓窦和乳突，并与鼓室或边缘穿孔有关。
The disease is often associated with a bone-eroding process Risk of complications is high in this type.
这种疾病常伴有骨侵蚀，如胆脂瘤中耳炎，这种类型的患者并发症风险很高。
Investigations One: Examination under microscope.
调查一：耳镜检查。
Two: Audiogram. It gives an assessment of degree of hearing loss and its type.
第二种：听力图，可以对听力损失的程度和类型进行评估。
Three: Culture and sensitivity of ear discharge.
耳液培养及敏感性测试。
It helps us select proper antibiotic ear drops.
它能帮助我们选择合适的抗生素滴耳液。
Treatment
治疗
The aim is to control infection and eliminate ear discharge and at a later stage, to correct the hearing loss by surgical means.
治疗的目的是控制感染，消除耳内分泌物，并在后期通过手术手段纠正听力损失。
One: Aural Toilet. Remove all discharge and debris from the ear.
第一：耳内清理，清除耳内所有分泌物和碎片。
Two: Ear Drops. Antibiotic ear drops are used.
二：滴耳液，使用抗生素滴耳液。
They're combined with steroids which have local anti-inflammatory effect.
它们与类固醇结合，具有局部消炎作用。
Three: Systemic Antibiotics.
三：全身应用抗生素。
Four: Precautions for patient. Patients are instructed to keep water out of the ear during bathing, swimming and hair wash.
四：病人的预防措施，告知患者，在洗澡、游泳和洗头时不要让水进入耳朵。
Five: Treatment of Contributory Causes.
第五：其他病因的治疗
Attention should be paid to treat causes contributing to disease for example, adenoids and nasal allergy.
应注意其他致病原因的治疗，例如腺样体和鼻部过敏。
Six: Surgical Treatment.
第六：手术治疗
Once ear is dry, myringoplasty can be done to restore hearing.
一旦耳内干燥，可以做鼓膜成形术来恢复听力。
