外耳道胆脂瘤的影像学特征和处理方法的选择

目的：探讨外耳道胆脂瘤（EACC）的表现特征和处理方法。方法：对17例（21耳）入院手术治疗的EACC患者的临床资料进行回顾性研究,分析其病因、病史、临床表现和影像学特点,探讨这些特点对临床处理方法的影响。结果：8耳行外耳道成形和EACC切除;1耳术中仅行外耳道成形和EACC切除,待二期行鼓室成形手术;3耳清理鼓室内病变后将颞肌筋膜内植,行鼓膜修补。9耳采用耳后切口,行开放式乳突根治。结论：EACC的病因学特点和病变的范围决定其处理方式,颞骨CT有助于了解病变的范围,制定手术计划。

Imaging features and surgical approach of external auditory canal cholesteatoma

Objective:To define the clinical and imaging features of external auditory canal cholesteatoma(EACC) and determine the characteristics most important to its clinical management.Method:Seventeen cases(21 ears) of EACC were retrospectively reviewed.Clinical data were collected for the history,presentation,physical examination findings and CT scans.The surgical management approaches were reviewed.Result:Patients presented with otalgia(n=21),otorrhea(n=16),ear-canal stenosis(n=11),facical nerve dysfunction(n=4).CT scans showed a soft tissue mass with adjacent bone erosion(n=21).Middle ear and mastoid involvement(n=9),facial canal erosion(n=4),sigmoid sinus erosion(n=1) and jugular bulb dehiscence(n=1) were observed.EACC excision and canaloplasty through transcanal approaches were performed in 12 ears,while postauricular incision and canal wall down mastoidectomy were used in 9 ears.Conclusion:The possible causes of EACC and its possible extension may influence clinical management.Preoperative high-resolution temporal bone CT scans can be helpful in the diagnosis and management of EACC.