山东大学耳鼻喉眼学报 ›› 2019, Vol. 33 ›› Issue (5): 6-10.doi: 10.6040/j.issn.1673-3770.1.2019.038

• 专家笔谈 • 上一篇    下一篇

中耳肌肉生理及病理

韩朝1,2,3(),丁娟1,2,3   

  1. 1. 复旦大学附属眼耳鼻咽喉医院耳鼻喉科
    2. 上海听觉医学中心
    3. 国家卫生健康委员会听觉医学重点实验室（复旦大学），上海 200031
  • 收稿日期:2019-06-06 修回日期:2019-08-06 出版日期:2019-09-20 发布日期:2019-10-15
  • 通讯作者: 韩朝 E-mail:sfhanzao@163.com
  • 作者简介:韩朝，复旦大学附属眼耳鼻喉科医院副主任医师，硕士生导师。主要学术任职：中国中西医结合学会第七届耳鼻咽喉科专业委员会委员兼秘书、耳鸣专家学组副主任兼委员，上海中西医结合学会第六届耳鼻咽喉科专业委员会委员兼秘书，上海市听觉与前庭专科委员会委员兼秘书，《中国中西医结合耳鼻喉咽喉科杂志》常务编委。全国第一个耳鸣公益网站——耳鸣之光www.tinnitus-light.org创始人之一。以第一作者及通讯作者发表SCI收录论文12篇（总分29.414），以第一作者及通讯作者发表中文论文30篇，负责国家自然科学基金面上项目1项，上海市科委自然科学基金项目2项。擅长耳鸣、眩晕、耳聋的诊断和治疗。
  • 基金资助:
    国家自然科学基金面上项目(81371093);上海市自然科学基金项目(18ZR1406100)

Physiology and pathology review of the middle ear muscles

Zhao HAN1,2,3(),Juan DING1,2,3   

  1. 1. Department of Otorhinolaryngology, Eye and Nasopharyngeal Hospital, Fudan University
    2. Shanghai Hearing Medicine Center
    3. Key Laboratory of Auditory Medicine, National Health and Wellness Committee (Fudan University), Shanghai 200031, China
  • Received:2019-06-06 Revised:2019-08-06 Online:2019-09-20 Published:2019-10-15
  • Contact: Zhao HAN E-mail:sfhanzao@163.com

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摘要：

中耳肌肉是耳部“降噪系统”中最为关键的部分，其在持续监测声学输入和动态调节听觉灵敏度方面发挥着重要的保护作用。当中耳肌肉收缩时, 它们将镫骨推入卵圆窗, 并增加内耳膜迷路内液体的压力。如果中耳肌肉失去调节内耳压力的能力, 如强直、痉挛或肌张力障碍, 产生的异常压力将对内耳压力产生影响, 并导致许多问题, 如耳鸣、梅尼埃病和感音神经性听力损失等。综述中耳肌肉的生理构造及各自所起的作用，讨论中耳肌肉功能紊乱与耳部疾病的联系。

关键词: 中耳肌肉, 鼓膜张肌, 镫骨肌, 梅尼埃病, 听觉过敏

Abstract:

With the complex anatomy of the human ear, we need to better understand the physiological and pathological characteristics of the “noise reduction system” of the ear, the most critical part being the middle ear muscle (MEM). MEMs play an important protective role by constantly monitoring acoustic input and dynamically adjusting hearing sensitivity, to enhance external sounds and to reduce transmission of loud sound through the middle ear. If the MEMs lose the ability to regulate cramps, spasms, or dystonia in the ear, the resulting abnormal pressure can have a significant impact on internal cellular pressure, which can cause some otologic disorders including tinnitus, Meniere’s disease, and sensorineural hearing loss. This literature review aims to explain the physiological structure and function of MEMs and discuss several otological disorders associated with MEM dysfunction.

Key words: Middle ear muscle, Tensor tympani muscle, Stapedius muscle, Meniere’s disease, Hyperacusis

中图分类号: 

  • R764

图1

中耳内部结构"

图2

中耳肌肉。A图显示附加在锤骨上的鼓膜张肌(红色)和附着于镫骨的镫骨肌(灰色)。当鼓膜张肌收缩时，听骨链被向前拉，迫使镫骨进入耳蜗，并提高内耳膜迷路内液体的压力。B图来自组织病理学的三维重建，中耳肌呈红色，听骨链呈黄色，鼓膜呈绿色。箭头表示由鼓膜张肌收缩引起的运动。图片由R.Pennings和M.Bance，Dalhosie大学提供[20]。"

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