外耳道癌的根治性手术治疗

Surgical treatment of carcinoma of the external auditory canal

外耳道癌是一种具有高度复发倾向的侵袭性疾病,主张在早期施行根治性手术治疗。自1968年以来我们曾收治10例外耳道原发肿瘤,其中5例曾在早期接受过局部小范围切除,术后复发并向周围扩展,而行补充根治手术,术后除1例尚在观察外,其余4例均在3年内再次复发死亡;另5例首诊便施行根治性切除及术后放射治疗,3例已存活10年以上,2例已分别存活4年及5年无复发。以上资料表明,对外耳道癌只有早期诊断与彻底治疗始能获得良好疗效。局部切除容易复发,不宜采用。

Carcinoma of the external auditory canal is an aggressive disease with a high proponsity for regional recurrence. Redical operative treatment was recommended by majority of the authors. Since 1968, ten tumors originated in the external auditory canal were treated in our hospital. Five patients were found to have inadquate tumor excision at the initial stage and were designated as extensive tumors. Another 5 cases were designated as localized tumor. Of the 5 localized tumor, 2 had wide en bloc dissection of the external auditory canal, 3 had the parotid included in the en bloc dissection. All 5 patients with localized tumor were followed-up, for 4～10 years postoperatively without evidence of recurrence. Of the 5 patients with extensive tumor, one had wide en bloc excision with parotid and facial nerve and 4 had wide en bloc dissection with subtotal temporal bone and skull base tumor. After operation, 4 patients died within 3 years, one patients is still under observation. Our results suggest that early diagnosis and adequate surgical treatment for localized external auditory canal are essential for high cure rate, inadequate local excission should be avoided.