外耳道胆脂瘤的诊断与治疗

Diagnosis and Treatment of External Auditory Canal Cholesteatoma

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。

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.