摘要
目的探讨外耳道胆脂瘤的临床特点与外科处理方法。方法对42例(44耳)手术治疗的外耳道胆脂瘤患者的临床资料进行回顾性研究,分析其病因、病史及影像学特点,并采取相应的手术治疗。结果根据病变范围将本组病例分为4型,分别采用不同的手术方法。Ⅰ型21耳,病变局限于外耳道内,采用耳内镜下胆脂瘤清除术;Ⅱ型4耳,病变侵犯上鼓室,乳突正常,采用上鼓室入路;Ⅲ型6耳,病变侵犯乳突、鼓室,采用乳突入路;Ⅳ型13耳,合并外耳道狭窄闭锁,处理原发病变加外耳道成形术。手术均能完全切除胆脂瘤。术后随访6个月～6年,1耳复发。结论根据外耳道胆脂瘤的病变范围和分型,采用不同的手术方式,耳内镜下治疗外耳道胆脂瘤,具有创伤小、暴露清晰等优点,值得临床应用。
Objective To sum up the clinical features of external auditory canal cholesteatoma （EACC） to explore more appropriated treating procedures for such a lesion based on a clinical trial. Methods A retrospective study was carried out among 42 patients （44 ears） with EACC treated in our Hospital during the recent years, with their clinical data carefully analyzed to explore the associated pathogenesis factors on the etiology, ill history and image features like that of CT scans. Then, the attention was focused on the summation on the experience with the surgical management for the lesion. Results According to the extending range of lesion, these cases were divided into 4 types, with 21 ears in type Ⅰ, 4 ears in type Ⅱ, 6 ears in type Ⅲ and 13 ears in type Ⅳ and they were treated with different surgical procedures based on their lesion types respectively, all with their lesion of EACC cleared up thoroughly. The cases with type I lesion, with EACC limited only in the external auditory canal, were treated with the operation of focus clearance under endotoscope, the cases with type II lesion extended into attic but not into mastoid cavity yet were treated with the surgery through attic approach, those with type III lesion invaded into both of tympanic cavity and mastoid cells were treated with the surgical procedures via mastoid approach, and the ones with type IV lesion, complicated with external auditory canal stenosis due to the basis of EACC, were treated with the program of focus clearance combined with canaloplasty. There was only one case seen with the lesion reoccurred in this group of cases by the end of following up period lasted for 6 moths to 6 years after the therapy. Conclusions EACC can be ideally treated by various kinds of surgical procedures, mainly depending upon the types and extension range of the lesion. The procedures performed under endotoscope are valuable to be promoted into a wider range of usage in clinical practice to treat this kind of lesion because of its advantages such as minimal invasion to and better illumination in the surgical field.
出处
《中国中西医结合耳鼻咽喉科杂志》
2010年第2期75-77,共3页
Chinese Journal of Otorhinolaryngology in Integrative Medicine
关键词
外耳道胆脂瘤
耳内镜
外科手术
External auditory canal
Ear endoscope
Surgery
