外耳道癌和中耳癌诊断、治疗的探讨

Clinical observation of seventeen cases of carcinoma of the external auditory canal and middle ear

为探讨外耳道癌及中耳癌的诊断、治疗，对17例患者的临床资料进行了分析，分析表明外耳道癌与中耳癌的症状相似，主要有耳内疼痛、耳漏及听力下降，大多数常两处同时受侵犯；除因原发病灶复发致死外，尚未见其它因素对本病的预后有明显影响。鉴于手术治疗对局部解剖结构破坏性大，且对浸润范围较广的癌，多数情况下亦难以将其切除干净，故主张：①对局限于外耳道或中耳腔癌，可先行耳道切除或扩大乳突根治术加术后放疗；②对略超出中耳之癌，可行术前放疗，然后再进行扩大乳突根治术或颞骨次全切除术；③对超出中耳范围较广者，可应用乳突开放术，然后进行根治性放疗。

The clinical observation of 17 cases with carcinoma of the external auditory canaland middle ear revealed that no other factors can affect the prognosis greatly except the deathcaused by recurrence of primary focus. Because operations would destroy the local anatomic structure and in most cases it is difficult to excise widly aggressive tumors perfectly, the author suggests that the auditory canals should be excised or extended mastoidotympanectomy with radiotherapy after operation be prefomed for the tumors limited to external canal or haddle ear. Radiotherepy before operation can be conducted before extended mastoidotympanectomy or subtotal temporal bone resection for the cases with tumors beyond the middle ear. For the cases with tumorslargely beyond the middle ear mastoidotomy can be preformed before thorough radiotherapy.