耳内镜诊断治疗外耳道胆脂瘤

Diagnosis and treatment of external auditory canal choiesteatoma by oto-endoscopy

目的探讨耳内镜手术治疗外耳道胆脂瘤的方法、疗效及适应证。方法分析经临床和病理确诊的21例外耳道胆脂瘤的临床情况：按Holt分期：I期17耳，Ⅱ期2耳，Ⅲ期2耳。I期局限于外耳道的外耳道胆脂瘤行外耳道胆脂瘤清除术；II期伴外耳道狭窄或闭锁的外耳道胆脂瘤行胆脂瘤清除术加外耳道戍形术；Ⅲ期侵及中耳的外耳道胆脂瘤行改良乳突根治术。所有患者随访3个月-半年。结果20耳术后无复发，Ⅱ期1例外耳道狭窄术后复发加作外耳道成形。结论外耳道胆脂瘤不同分期采用不同手术方法治疗。耳内镜手术治疗适用于外耳道胆脂瘤I期。

Objective To discuss the apply of oto-endoscopy in diagnosis and treatment of external auditory canal cholesteatoma. Methods There are 21 cases （21 ears） with the external auditory canal cholesteatoma from July 2006 to June 2008 in our department. There are 17 cases in phase Ⅰ,2 cases in phase Ⅱ and 2 cases in phase Ⅲ according to Holt staging. 17 cases of phase I were removed extemal auditory canal cholesteatoma only under oto-endoscopy, 2 cases of phase Ⅱ were performed external auditory canal plasty besides removing external auditory canal eholesteatoma, 2 cases of phase Ⅲ were treated by modified radical mastoidecomy, respectively. Results 20 cases external auditory canal cholesteatoma of were not recurred following-up three to six monthes. However one case failed with stricture of external auditory canal after treated only by oto-endoscopy was performed external auditory canal plasty. Conclusion The different stage cases of external auditory canal cholesteatoma were treated by different ways and oto-endoscopy is fit for treating early external auditory canal cholesteatoma.