岩骨胆脂瘤诊断治疗初探

目的总结岩骨胆脂瘤诊断和治疗的经验。方法结合文献对2例岩骨胆脂瘤患者术中术后的情况进行分析。结果1耳经迷路上径路切除病变,术中行面神经减压,采取开放术腔术式,术后面瘫由Ⅵ级恢复至Ⅴ级,听力无改善;1耳经迷路径路全切病变,术中行面神经移植,采取闭封术腔术式,面瘫无恢复,听力完全丧失。术后至今分别4年、2年,2耳均无复发。结论手术入路应根据病变情况而定,开放术腔和闭封术腔各有优点,也应根据手术情况灵活采用。

Initial exploration on the diagnosis and treatment of the petrous bone cholesteatoma

Objective To summarize the experience on the diagnosis and treatment of the petrous bone cholesteatoma. Methods Based on the relative literatures, the findings during the operation and postoperation of two cases with petrous bone cholesteatoma were analyzed. Results One case was treated with a supralabyrinthine approach accompaning with facial nerve decompression,and left the petrous cavity exposed,the function of facial nerve was recovered from VI to V of House-Brackmann grading and the hearing result had not been improved; Another case was treated with a translabyrinthine approach accompaining with facial nerve anastomosis,closed the petrous cavity,the function of the facial nerve had not been improved and the hearing had been lost.There had been no evidence of recurrence in two cases up to now. Conclusion The surgical approach must be chosen according to the place of the lesions,exposing and closing of the petrous cavity can be used in proper patients because of their own advantages.