Schwannoma of external auditory canal

Schwannomas of the external auditory canal are extremely rare and only a few cases have been reported in the literature. Herein, we report a case of schwannoma of the external ear canal in a 41-year male. Clinicians should consider the possibility that the schwannoma may originate in the external auditory canal mimicking other more frequently observed lesions.     

外耳道癌的根治性手术治疗

外耳道癌是一种具有高度复发倾向的侵袭性疾病,主张在早期施行根治性手术治疗。自1968年以来我们曾收治10例外耳道原发肿瘤,其中5例曾在早期接受过局部小范围切除,术后复发并向周围扩展,而行补充根治手术,术后除1例尚在观察外,其余4例均在3年内再次复发死亡;另5例首诊便施行根治性切除及术后放射治疗,3例已存活10年以上,2例已分别存活4年及5年无复发。以上资料表明,对外耳道癌只有早期诊断与彻底治疗始能获得良好疗效。局部切除容易复发,不宜采用。     

Diagnosis and treatment of carcinoma in external auditory canal

ObjectivesTo evaluate outcomes in treating carcinoma of external auditory canal (EAC) and to analysis factors which effect the prognosis of this disease.MethodsA retrospectively review of 16 patients treated for carcinoma of EAC at our department between April 2000 and April 2014 was conducted. All patients underwent surgical treatment and the diagnosis confirmed by pathological examination.ResultsThere were adenoid cystic carcinoma (ACC) in 8 patients, squamous cell carcinoma (SCC) in 5 patients, adenocarcinoma (AC) in 2 patients, and verrucous carcinoma (VC) in 1 patient. The tumors were classified as Stage I in 4 cases, Stage II in 2 cases, Stage III in 3 cases, and Stage IV in 7 cases. Five patients underwent extensive tumor resection (ETR), 2 patients underwent lateral temporal bone resection (LTBR), 5 patients underwent modified LTBR, 2 patients underwent subtotal temporal bone resection (STBR), and 2 patients underwent only open biopsy. Besides, adjunctive procedures, including neck dissection, parotidectomy and pinna resection were performed when indicated. Ten patients received postoperative radiotherapy. By the end of follow up, two patients had died of their disease, 2 lost to follow up, 2 survived with the disease, and the rest survived disease-free. The median follow-up period was 24 months.ConclusionComplete tumor resection appears to be an effective treatment for carcinoma of the EAC. Patients with SCC seem to have worse prognosis than those with ACC. Radiation therapy seems less effective for the disease than surgical treatment.     

Tick bites in the external auditory canal

We report a case of Ixodes ovatus tick in the external auditory canal. Chief complaints of earfullness and pruritis appeared after the contact with dog. Using a removal method consisting of excising the abdomen of the tick and suctioning its body fluids, followed by removal of the tick body 3 days later, the patient was successfully treated without the development of complications.     

Classification of the external auditory canal cholesteatoma

OBJECTIVES/HYPOTHESIS: The external auditory canal cholesteatoma (EACC) is a rare disease in the field of otolaryngology. Only 1 in 1,000 new otologic patients present with this entity, which was first described by Toynbee. The aim of this article is to classify EACC by different histopathologic and clinical findings of patients presenting to the Department of Otolaryngology at the University of Mannheim, Germany. METHODS: From 2000 to 2004, 17 patients presented to our clinic with EACC. The cholesteatoma were treated surgically, and the specimens were investigated histologically. Clinical findings were also recorded. We classified four stages: stage I with hyperplasia of the canal epithelium, stage II including periosteitis, Stage III including a defective bony canal, and stage IV showing an erosion of adjacent anatomic structure. RESULTS: Eight patients presented with stage II, five patients with stage III, three with stage I, and only one patient presented with erosion of the mastoid cells, which was determined as stage IV. CONCLUSION: In summary, our classification serves to describe the different histopathologic and clinical stages of EACC.     

外耳道胆脂瘤的诊断和治疗

目的探讨外耳道胆脂瘤的临床特征和治疗方法。方法回顾性分析1990年1月至2005年1月期间共42例（44耳）外耳道胆脂瘤的临床资料。结果本组因外耳道骨性狭窄所致2耳，骨瘤阻塞所致2耳，其余主要与炎症、耵聍、挖耳损伤等有关。按Holt分期，Ⅰ期7耳．Ⅱ期22耳，Ⅲ期15耳。单纯外耳道胆脂瘤清除术25耳（门诊20耳）中．随访1-5年，外耳道胆脂瘤复发3耳，1耳上鼓室侵犯行改良乳突根治术；9耳伴有外耳道肉芽者，行外耳道肉芽切除术及外耳道胆脂瘤清除术后恢复良好，2耳伴有外耳道狭窄行外耳道成形术；改良乳突根治术5耳．乳突根治术2耳，随访6月～11年，无胆脂瘤复发，1耳术后外耳道口狭窄；先天性外耳道狭窄行外耳道成形术1耳，外耳道骨瘤切除及鼓膜成形术1耳，乳突骨瘤切除并外耳道成形术1耳。结论外耳道胆脂瘤多为自发性．具有破坏性，治疗原则是早期彻底清除胆脂瘤。     

Pleomorphic adenoma of the external auditory canal

Pleomorphic adenoma of the external auditory canal is a rare disease. It is considered to derive from the ceruminous glands. The objective of this study is to familiarize the clinician with the clinical presentation and treatment of this disease. We report the case of a 58-year-old woman. Complete resection should be applied for cases in which magnetic resonanace imaging (MRI) and computerize tomography (CT) examination indicate no erosion in the bone and cartilage tissue. The patient should be seen regularly for recurrence.     

后天性外耳道狭窄的手术治疗

目的探讨后天性外耳道狭窄的手术治疗方法及效果。方法对26例（27耳）外耳道狭窄行外耳道成形术或厢乳突根治鼓室成型术，取大腿内侧自体游离中厚皮片植皮，碘仿纱条压迫并扩张耳道。结果26例病人27耳随访6个月至8年，24耳外耳道宽敞，无再狭窄；3耳出现轻度狭窄，发生率11．1％（3／27），效果满意。结论对后天性外耳道狭窄的治疗可根据狭窄的原因、部位及程度等不同情况采用外耳道成形、游离中厚皮片移植或同时进行乳突根治鼓室成型术等手术治疗，术后局部换药，即能取得较好效果。     

Five cases of chondroma involving the external auditory canal

A cartilaginous tumor located in the external auditory canal is a rare finding. Only 48 cases of chondromas of the external auditory canal have been documented in the literature. The natural course of these tumors as well as the diagnosis and management has not been well established.We have encountered five cases of external auditory canal chondroma. The patients consisted of three males, ages 12, 14, and 29, and two females, ages 2 and 3, respectively. Otoscopic examination demonstrated a tiny firm tumor protruding from the anterior wall of the bony external auditory canal. Surgery was performed all cases, and the tumor proved to be a chondroma histologically. All cases could be approached through the ear canal. The postoperative courses were uneventful and no recurrences were found during the follow-up periods.From our experiences, it is important to recognize that chondromas are in the differential of small exophytic tumors on the anterior or superior wall of the external auditory canal and can be removed safely and effectively through the transcanal approach.     

外耳道胆脂瘤的临床特征及疗效评估

目的 探讨外耳道胆脂瘤(EACC)的临床特点,并评估其治疗效果。 方法 回顾性分析2015年1月至2016年12月47例(47耳)EACC的临床资料,所有患者术前接受听力学检查,耳内镜及颞骨CT检查。 结果 所有患者外耳道均可见黄白色鳞状或肉芽样物阻塞。耳闷胀感、耳痛及耳流脓是EACC常见症状。CT显示41耳有骨破坏。按Holt分期:47耳中,Ⅰ期6耳,Ⅱ期29耳,Ⅲ期12耳。对Ⅰ期6耳及Ⅱ期5例儿童患者行EACC和/或肉芽去除术;对24例Ⅱ期成人患者联合行胆脂瘤清除及外耳道成形术;12例Ⅲ期患者中,9例行乳突改良根治术和/或鼓室成型术,3例行乳突根治术。所有患者术后2周干耳,3个月内术腔完全上皮化。除3例行乳突根治术的患者术后听力无改善,其余44耳都有不同程度的提高。所有患者术后随访3~24个月,未见EACC复发者。 结论 EACC可被误诊,骨质破坏是其最重要的特征。颞骨CT有助于EACC的分期及制定治疗方案,应根据疾病分期、患者年龄及听力水平选择手术方法。彻底清除胆脂瘤及保持外耳道宽敞是治愈该疾病及预防复发的关键。     

Keratinic amyloidosis of the external auditory canal

Objective

We present a rare case of keratinic amyloidosis of the external auditory canal. This is only the seventh case reported of localized cutaneous amyloidosis of the external auditory canal with no systemic symptoms.

Patient

A 62-year-old man, who had complained of an itchy external auditory canal and left-side hearing loss, was referred to our hospital because of a bilateral external auditory canal mass.

Intervention

Biopsy of the external auditory canal mass suggested a diagnosis of amyloidosis. However, total systemic examination failed to identify any disease due to systemic amyloidosis. This led us to diagnose him with localized cutaneous amyloidosis of the external auditory canal.

Main outcome measure

We follow up periodically with systemic examination and local observation.

Results

Thirty months after the initial diagnosis, he remains in follow-up and has not shown any significant aggravation of the disease.

Conclusion

In previous cases, the chief complaints were itching sensations and pain in the external auditory canal as well as a sense of discomfort when wearing a hearing aid. This suggests that chronic stimulation and inflammation of the skin lining the external auditory canal induced amyloidosis.     

An immunohistochemical study of adenoid cystic carcinoma of the external auditory canal

Summary Specimens from five cases of adenoid cystic carcinoma of the external auditory canal were studied by immunohistochemical staining, and findings were compared with those from adjacent non-neoplastic tissues containing ceruminous glands. In the ceruminous gland, cytokeratin showed diffuse positive staining, while myoepithelial cells were stained for smooth muscle actin, desmin, S-100 protein and vimentin. The epithelial markers used were cytokeratin, carcinoembryonic antigen and secretory component and stained at various densities the inner cells of the tubular component and ductlining cells in the cibriform component of tumor tissues. In contrast, the muscular markers, smooth muscle actin and desmin, and the mesenchymal marker, vimentin, were positive in the outer cells of the tubular component and in the cyst-lining cells of the cribriform component. S-100 protein immunoreactivity showed pradoxical results; positive findings occurred in the myoepithelial cells of the ceruminous glands and in the inner cells of the tubular component and duct-lining cells of the cribriform component of the tumor. Present findings demonstrate that adenoid cystic carcinoma of the external auditory canal had dual epithelial and myoepithelial differentiation and can mimic the ceruminous glands of the auditory canal.     

Syringocystadenoma papilliferum of external auditory canal and pinna: A rare presentation

Syringocystadenoma papilliferum (SCAP) is a rare benign skin tumour characterized by extensive papillary epithelial elements growing into the dermis. SCAP often presents at birth and most commonly in the head and neck. However, it rarely involves ear. Here, we present a case of SCAP involving external auditory canal and pinna and its surgical management involving excision and split skin grafting.     

自制幼儿外耳道异物取出器

异物取出难易程度取决于异物形状、大小以及在外耳道的深浅,对于成人和年龄较大的儿童容易配合,但几乎所有的幼儿不能配合.特别是比较深在、卡在外耳道狭窄部的圆形异物,我们针对这种难取的外耳道异物,自制了幼儿外耳道异物取出器.     

右侧外耳道耵聍腺瘤1例

<正>耵聍腺瘤起源于外耳道软骨部耵聍腺导管上皮和肌上皮,其组织结构与汗腺相似,病因可能与腺体发育异常、腺体增生有关。也有人认为系胚胎性汗腺或汗腺管的异位生长。虽然为良性肿瘤,但易复发,有恶变倾向。多发于耳道外1/3,王保华等[1]报道的12例外耳道腺样囊性癌中有4例手术前曾确诊为耵聍腺瘤。我们分析研究了临床中对于治疗这一类似病例的措施,利用手术根治性切除肿瘤,疗效确切。现介绍1例外耳道耵聍腺瘤的有效治疗案例,报告如下。     

A case of hemodialysis-associated amyloidosis localized to the external auditory canal

Amyloidosis of the external auditory canal is extremely rare. Only 12 cases, including the present case, have been reported, and this is the second reported case attributed to dialysis. This case involved a 56-year-old man who had been on dialysis for 12 years. A tumor was visible in the right external auditory canal and caused pain. The tumor was resected at another hospital, but subsequently recurred with rapid increase in size due to infection. We therefore performed further resection at our hospital. We report our experiences herein, together with a discussion of the literature.     

外耳道阻塞性角化病的临床特点

目的总结外耳道阻塞性角化病的临床特点。方法对30例外耳道阻塞性角化病患者的临床资料进行回顾性分析。结果外耳道阻塞性角化病的临床主要特点有：剧烈的耳痛;嵌塞物有较硬的核心;嵌塞物呈灰白色或者污灰色;嵌塞物和耳道皮肤粘连紧密;外耳道皮肤炎症较重。结论外耳道阻塞性角化病的5个特点可以作为诊断外耳道阻塞性角化病以及与外耳道胆脂瘤区别的参考。     

外耳道胆脂瘤侵蚀乳突(附3例报告)

目的 :提高临床对外耳道胆脂瘤 (EACC)侵蚀乳突的认识。方法 :回顾性分析 3例EACC侵蚀乳突患者的临床资料。结果 :3例外耳道后壁破坏 ,并有外耳道后壁 乳突腔瘘形成 ;2例面神经骨管破坏 ,面神经及迷路完整 ;经手术治疗 ,随访 6个月～ 9年 ,无复发迹象。结论 :临床上易将外耳道栓塞性角化病 (KO)误诊为EACC ;EACC侵蚀乳突者临床并不多见 ;治疗原则是彻底清除胆脂瘤和死骨 ,并根据病变程度决定手术方式。