颞骨先天性胆脂瘤的误诊分析(附5例报告)

The misdiagnosis of congenital cholesteatoma of the temporal bone (5 case report)

目的:通过对5例颞骨先天性胆脂瘤的资料分析,探讨其误诊原因。方法:5例术前均经影像学检查确诊而行手术治疗。结果:5例均手术治愈,分别随访2～5年,患者全身情况良好。结论:在鼓膜完整情况下,虽有面瘫、外耳道溢液或耳闷痛等主诉,但先天性胆脂瘤常易漏诊和误治。影像学和仔细的局部检查可提高诊疗水平,从而避免严重的并发症发生。

Objective：The congenital cholesteatoma of the temporal bone is a rarer disease which might easily be misdiagnosed and wrongly treated. The clinical material and management of five cases are hereby introduced in order to call common attention. Method.. There were 4 males and 1 female with age rage 10-48 years old. All cases revealed intact drum membrane. The complaints of these 5 cases are;2 cases suffered from facial palsy; 2 cases from purulent bloody otorrhea;1 case from otalgia. Among these five congenital cholesteatomas, four cases were originated from petromastoid region and 1 case from undeveloped, external ear canal. Surgical managements were performed after preoperative radiological examination in these five cases. Result.. In each case, the diagnosis was confirmed by pathological examination and the disease was cured by operation. Conclusion： If a patient is suffered from facial palsy or otorrhea or otolgia, but the eardrum is intact, the correct diagnosis and suitable treatment of the congenital choleateatoma are easily to be delayed and failed. Radiological evaluation, carefully topical examination and paying attention to this disease play important role in the early diagnosis and surgical management, thus the serious complications might be avoided.