巨大岩尖胆脂瘤诊治初探（附2例临床分析）

目的：探讨岩尖胆脂瘤的临床特征、手术进路和方法，以提高手术疗效，减少并发症。方法：对2例巨大颞骨岩尖胆脂瘤患者采用迷路进路切除病灶，对其中1例成功施行了耳内镜辅助下迷路进路病灶切除术。结果：2例术后均无脑脊液漏和感染，无眩晕或平衡失调。结论：颞骨CT扫描及MRI对临床诊断及手术进路的选择有重要作用。手术清除病灶为本病治疗的惟一措施，经迷路进路为彻底清除胆脂瘤、处理面神经及脑脊液漏提供了最直接的途径，而彻底清除病变和术后长期严格随访、定期清理术腔是预防复发的关键。

Primary study of diagnosis and treatment of huge petrous apex cholesteatoma( clinical analysis of 2 cases)

Objective:To investigate the clinical features, operative approach and method of petrous apex chol-esteatoma, to improve the effect of operation and to reduce surgical complications. Method:Two cases of patients with giant petrous apex cholesteatoma were treated by trans labyrinth approach,one of which was successfully operated with oto-endoscope-assisted surgery. Result; No cerebrospinal fluid leakage, infection, vertigo or disequilibrium was found in the two cases after operation. Conclusion:Temporal CT and MRI are of great importance in clinical diagnosis and choice of surgical approach. Surgery by trans-labyrinth approach paves way for removing cholesteatoma thoroughly, dealing with facial nerve and repairing cerebrospinal fluid leakage. Surgery is considered to be the only way to cure petrous apex cholesteatoma, while the key procedure to prevent recurrence lies in complete removal of lesion, long-time strict follow up and regular clearance of the surgical field.