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。

Erosion of the mastoid caused by the external auditory canal cholesteatoma (with 3 cases reported)

Objective:To improve the diagnosis and treatment of the external auditory canal cholesteatoma (EACC) with erosin into the mastoid. Method: The data of 3 patients with erosin of the mastoid caused by EACC were analysed retrospectively and recent literatures were reviewed. Result:In all cases,the cholesteatomas were found in the external auditory canal and the mastoid cavity.The disease eroded the posterior aspect of the canal wall,and fistulas between the canal and the mastoid were found.The fallopian canal was eroded but the facial never and labyrinth were intact.All patients were treated with canal wall down mastoidectomy.There was no recurrence after 6 moths to 9 years follow up.Conclusion: EACC was easily misdiagnosed as keratosis obturans(KO).EACC with posterior canal wall mastoid cavity fistula is an extremely rare occurrence. Treatment consists of the removal of the cholesteatoma sac and bony sequestra. Surgical treatment options can be taken depending on the stage of disease.