老年外耳道胆脂瘤(附34例报告)

External auditory canal cholesteatoma in senior patients(a report of 34 cases)

目的探讨老年外耳道胆脂瘤临床特征.方法回顾性分析34例老年外耳道胆脂瘤临床表现及诊治方法.结果本组外耳道胆脂瘤自发性者27例,外耳道狭窄所致者7例.以慢性耳钝痛及耳漏为主要表现,均有不同程度骨性外耳道侵蚀扩大,其中5例侵犯中耳乳突,面神经垂直段骨管破坏2例.行外耳道胆脂瘤清除术及外耳道成形术、改良乳突根治术治愈,随访1～5年无复发.结论老年外耳道胆脂瘤具有破坏性,多为自发性,须与外耳道恶性肿瘤、坏死性外耳道炎等相鉴别,治疗原则为彻底清除胆脂瘤.

Objective To analyze the clinical features of extemal auditory canal cholesteatoma in senior patients. Methods Thirty-four senior patients with external auditory canal cholesteatoma from January 1993 to January 2004 were retrospectively analyzed. Results 27 cases were diagnosed as spontaneous cholesteatorna and 7 cases as secondary eholesteatoma caused by external auditory canal stenosis. The main symptoms of these patients were otalgia and otorrhea. All cases had various degrees of external auditory canal bone lesions, and five of them had erosions in middle ear or in mastoid, 2 had facial canal lesions. All cases were treated by clearing lesions from external auditory canal or combined with modified radical mastoidectomy. No case relapsed after follow-up for one to five years. Conclusion Bone erosions frequently happen in auditory canal cholesteatoma in senior patients, which should be differentiated from other diseases, such as malignant tumors. Completely clearing cholesteatoma, granulation tissue and sequestrum is very important for the treatment of this disease.