外耳道胆脂瘤的诊断与治疗

目的:探讨外耳道胆脂瘤(external auditory canal cholesteatoma,EACC)的临床特征和治疗方法。方法:回顾性分析1995年1月~2005年6月期间经手术治疗的46例(48耳)EACC患者的临床资料。结果:24例行单纯EACC清除术的患者听力恢复正常19例,5例改善;10例伴外耳道肉芽者行外耳道肉芽切除术和EACC清除术后恢复良好;3例行乳突根治术,6例行改良乳突根治术的患者,其中2例术后发生外耳道狭窄。随访2~12年,4例复发,再次清理治愈。结论:EACC对周围软组织及骨组织具有破坏性,治疗原则宜采用手术彻底清除胆脂瘤。

Diagnosis and Treatment of External Auditory Canal Cholesteatoma

Objective:To investigate the clinical characteristics and treatment of external auditory canal cholesteatoma(EACC).Methods:The clinical data of 46 cases(48 ears)with EACC treated with surgery from January 1995 to June 2005 were retrospectively analyzed.Results:Among the 24 cases of EACC patients who were only given clearing surgery of EACC,19 cases recovered and 5 cases turned better.As to the 10 EACC patients combined with external auditory canal granulation who were given surgery of granulation resection and cholesteatoma clearing.And 3 EACC patients combined with external auditory canal stenosis received external auditory canal plasty.3 cases performed radical mastoidectomy and 6 cases performed modified radical mastoidectomy,2 cases had external auditory canal stenosis after operation.With a follow-up from 2 to 12 years,4 cases had EACC recurrence and recovered by another surgery.1 case with erosions of middle ear and atticus was cured by modified radical mastoidectomy 1 year and 6 months later.Conclusions:EACC has erosive effects on the soft and bone tissue around.The therapeutic principle is completely removing cholesteatomas in early stage.