同种异体脱细胞真皮在外耳道胆脂瘤治疗中的应用

 目的 探讨同种异体脱细胞真皮在外耳道胆脂瘤治疗中的应用。 方法 回顾我科2006-02至2010-12收治的18例（18耳）外耳道胆脂瘤患者，根据Holt分期Ⅱ期12例、Ⅲ期6例。所有病例均在完全清除胆脂瘤病变的术腔缺损处放置同种异体脱细胞真皮（2 cm×3 cm），并定期门诊复诊。 结果 18例术后均达到干耳，无外耳道狭窄及真菌感染的发生，随诊6个月以上无复发。 结论 对于Ⅱ、Ⅲ期的外耳道胆脂瘤患者，术腔放置脱细胞异体真皮能达到良好的治疗效果。

Experience in the treatment of external acoustic meatus cholesteatoma

Objective To study the therapeutic principle and prognosis of external acoustic meatus eholesteatoma of different phases according to Holt standard. Methods A retrospective study was carried out on 18 patients with external acoustic meatus chol- esteatoma during the recent five years. The selected subjects included 12 cases of phase II patients treated by expansion of the external auditory canal opening and formation of the cavity of auricular coneha, and 6 cases of phase ffi patients treated by mastoidotympanecto- my combined with the formation of the cavity of auricular eoneha. Their pathological tissues in the antrum mastoideum and mastoid air cells were removed to ensure smooth auris media. All the phase Ⅲ patrents were implanted with 2 cm×3 em acellular deimal matrix in the mastoid cavity to accelerate epithelial repair. Results In the 18 patients, iodoform gauze was removed from their external auditory canals and conventional change of dressings was made. After two weeks of treatment, all the patients were able to keep their ears dry without suffering from any stenosis of the external auditory canal or infection by mycetes. Conclusions During the diagnos, Jis and treat- ment of external acoustic meatus cholesteatoma, a suitable method should be chosen according to the scope of pathological change. When treating patients with phase Ⅱ and Ⅲ external acoustic meatus cholesteatoma, we should remove the eholesteatolna epithelium and place the acellular dermal matrix to obtain the optimal effect.