外耳道胆脂瘤的临床特点及误诊分析

目的：分析外耳道胆脂瘤（EACC）的临床特点及误诊原因。方法：对1993～2003年收治的经临床和病理确诊的18例EACC患者，根据病变的范围和程度，采取不同的治疗方法，其治疗原则是彻底清除EACC和肉芽组织，促进创面愈合。结果：外耳道骨质破坏13例，外耳道深部为白色或黄色上皮角化物或耵聍样团块阻塞18例，外耳道口肉芽阻塞、皮肤红肿或外耳道狭窄15例，EACC侵犯乳突和上鼓室4例，鼓膜穿孔2例。随访1～6年，无复发。结论：EACC是以疼痛、间歇耳漏和骨质破坏为其特征的外耳道疾患，其治疗原则是彻底清除胆脂瘤囊袋、肉芽组织，促进创面愈合。

The preliminary analysis of the clinical characteristics and misdiagnosis of external auditory canal cholesteatoma

Objective:To analyze the clinical characteristics of external auditory canal cholesteatoma (EACC) and investigate the causes of misdiagnosis.Method:A retrospective study was carried out in 18 cases (18 ears) of EACC diagnosed on pathological and clinical process during 1993~ 2003 in our department.Result:Bony erosion was found in 13 cases, yellow and white keratotic substances or cerumen-like conglomerations blocked in the deep external auditory canal was found in 18 cases, external auditory canal stenosis or granulation tissue formation was found in 15 cases, epitympanum and mastoid antrum invasion was in found 4 cases, perforation of tympanic membrane was found in 2 cases. All were treated with thoroughly cleaning of the cholesteatoma,degeneration tissue and sequestrum and the application of antibiotics. All cases were followed up for 1-6 years, and no recurrent cases were found.Conclusion:EACC shows to be an external auditory disease with characteristics of chronic dull pain, intermission otorrhea and bony erosion that is definitely different from keratosis obturans (KO), its therapeutic principle should be a thoroughly clearance of cholesteatoma sac, degeneration tissues and sequestrum and the improvement of healing of lesions.