36例外耳道病变的CT诊断分析

Analysis of 36 cases of the external auditory canal disease by CT

目的:提高临床对外耳道病变CT影像的认识和重视。方法:对经病理证实的36例患者的38耳CT影像进行回顾性分析。结果:本组38耳外耳道病变中,外耳道胆脂瘤伴肉芽16耳,其中骨质破坏9耳,合并中耳胆脂瘤伴肉芽者15耳。外耳道胆脂瘤11耳,其中骨质破坏8耳,合并中耳胆脂瘤5耳。外耳道肉芽4耳,耵聍2耳,均无无骨质破坏。外中耳癌3耳,广泛骨质破坏,增强扫描强化明显。毛细血管型血管瘤1耳,外耳道呈虫蚀样破坏,并累及乳突部,MR I增强扫描明显强化。鼻咽癌侵犯外耳道1例,可见鼻咽部肿块直接蔓延至外耳道并骨质广泛破坏,增强扫描肿块强化明显。结论:外耳道病变虽然少行影像学检查,但CT对外耳道病变的鉴别有重要作用,对疾病评估更为全面。

Aim：For full recognization to CT imaging on the external auditory canal disease.Methods： CT imaging of 36 patients（38 ears） confirmed with pathology were analyzed in details.Results： There were external auditory canal diseases in 38 ears,of which 16 ears existed external auditory canal cholesteatoma combined with granuloma and 9 of them were combined with bone destruction.Fifteen ears having middle ear cholesteatoma granulation combined with granuloma.In the 38 involved ears,11 ears had external auditory canal cholesteatoma,8 of which were combined with bone destruction.There were 5 middle ear cholesteatoma.Four ears with external auditory canal granulation and 2 ears with auditory canal earwax showed no bone destruction on CT imaging.Three ears with carcinoma showed external auditory canal and middle ear with extensive bone destruction and the masses were significantly enhanced.One ear with capillary hemangioma showed mouse eaten pattern bone destruction and involved mastoid,which was significantly enhanced on MRI.In one case of nasopharyngeal carcinoma invading the external auditory canal,the mass spreaded to the external auditory canal directly with extensive bone destruction,in which the lesion were significantly enhanced on MRI.Conclusion：Although imaging examination for external auditory canal is less needed,CT plays a important role in differential diagnosis and relisble estimation of external auditory canal lesions.