外耳道胆脂瘤CT分期及手术方式

目的 探讨外耳道胆脂瘤(external auditory canal cholesteatoma,EACC)的CT分期方法和手术方式.方法 对66例(66耳)EACC手术病例进行回顾性分析,根据颞骨CT中EACC的侵犯范围进行分期,并对不同分期EACC的手术方式进行分析.结果 66例EACC中,Ⅰ期13例(19.7％),Ⅱ期35例(53.0％),Ⅲ期18例(27.3％).13例Ⅰ期病例中,11例行胆脂瘤清除术,2例行外耳道成形术;35例Ⅱ期病例中,34例行外耳道成形术,1例行乳突切开术+外耳道成形术;18例Ⅲ期病例中,10例行鼓室成形术+外耳道成形术,2例行乳突切开术+外耳道成形术,6例行乳突切开术+鼓室成形术+外耳道成形术.随访6个月～3年,61例无复发,2例复发,3例失访.结论 EACC的CT分期有助于选择正确的EACC手术方式.

External auditory canal cholesteatoma classification by computed tomography and surgical method

OBJECTIVE To determine the classification of external auditory canal cholesteatoma （EACC）by the computed tomography findings and the operation methods of EACC. METHODS A total of 66 patients（66 ears）with EACC who underwent surgical therapy were retrospectively evaluated. According to the results of temporal bone computed tomography, we classified EACC into three stages. We also evaluated the surgical methods of the EACC in different stage. RESULTS Of these 66 EACC cases,the number of stage I, II and III cases was 13（19.7%）, 35（53.0%）, and 16（27.3%）, respectively. Of the 13 cases in stage I, 11cases underwent curettage and 2 cases underwent canaloplasty. Of the 35 cases in stage II,34 cases underwent canaloplasty and 1 case underwent mastoi dectomy＋canaloplasty. Of the 18 cases in stage III, 10 cases underwent tympanoplasty＋canaloplasty, 2cases underwent mastoidectomy＋canaloplasty and 6cases underwent mastoidectomy＋tympanoplasty＋canaloplasty. The following-up ranged from 6 months to 3 years, 61 csaes was free of recurrence, 2 cases was found recurrences and 3 cases was lost. CONCLUSION This staging system of EACC due to the computed tomography findings can be helpful to choose the accurate surgical method of EACC.