一般认为包括细菌性脑膜炎在内的颅内感染常与急性中耳炎有关,但从婴儿和幼儿的颞骨组织病理学研究并不能完全证实。本文资料以8例死于原发性细菌性脑膜炎儿童的16块颞骨作组织病理学评价:1例双侧中耳组织学检查正常;中耳炎的表现是在炎性渗出液中有多核白细胞聚集和粘膜下炎性增厚,4耳属轻度,7耳中度,3耳为重度。所有16耳在内耳道蛛网膜下腔均见炎细胞,并以多核白细胞为主,可以明确脑膜炎的诊断。4例双耳的外淋巴间隙中出现炎细胞,提示存在早期双侧化脓性迷路炎;例1的双耳发现听觉感受器以及耳蜗、前庭和面神经严重萎缩。可以设想感染的理论性途径为淋巴系统、骨炎和直接扩散,但已知并无淋巴管自鼓室乳突进入颅腔;中耳炎急性期也不存在骨炎,本文16块颞骨没有骨炎证据,也未见到经软组织延续、迷路侵蚀或血管性分布的直接扩展通道。现在由急 It is generally accepted that intracranial infections, including bacterial meningitis, are often associated with acute otitis media, but histopathological studies in the temporal bone of infants and young children are not fully validated. In this paper, 8 cases of children with primary bacterial meningitis died of temporal bone for histopathological evaluation: 1 case of bilateral middle ear histological examination; the performance of otitis media in inflammatory exudate in the presence of polymorphonuclear leukocytes Aggregation and submucosal inflammatory thickening, 4 ears are mild, 7 ears moderate, 3 ears are severe. All 16 ears in the ear canal subarachnoid see inflammatory cells, and the main multi-nucleated white blood cells, can confirm the diagnosis of meningitis. Inflammatory cells were seen in the peripaphylaxis of the four ears, suggesting the presence of early bilateral suppurative labyrinthitis; the binaural auditory receptors of Example 1 and severe atrophy of the cochlea, vestibular, and facial nerves. It is conceivable that the theoretical pathways of infection are lymphatic system, osteitis, and direct spread, but no lymphatic vessels are known to enter the cranial cavity from the tympanic mastoid; there is also no evidence of osteitis in the acute stage of otitis media and there is no evidence of osteitis for the 16 temporal bones No direct extension of the soft tissue extension, labyrinthine erosion or vascularity was observed. Now by the urgent