外耳道胆脂瘤临床表现与CT特征分析

Clinical Manifestations and CT Characteristics Analysis of External Auditory Canal Cholesteatoma

目的：探讨外耳道胆脂瘤（EACC）的CT特征和临床表现特点。方法：回顾性分析52例EACC患者的临床资料，其中自发性24例，外耳道狭窄16例，手术后8例，外伤后2例，外耳道肿物堵塞2例。冠状位、水平位高分辩率颞骨CT观察EACC部位、范围、邻近结构破坏情况，并根据病变部位和周围结构破坏程度将病变分为A、B、C三型。结果：本组EACC患者主要表现为疼痛、渗出、肉芽形成等炎症反应，在自发性组和外耳道狭窄组其发生率分别高达58％、62％、42％和25％、54％、29％。52例中，43例颞骨CT显示外耳道内软组织阴影，其中7例软组织阴影内见死骨碎片；A型病变28例，B型6例，C型18例。结论：EACC具有一定的临床和CT特征；对病变进行CT分型有助于了解病变侵袭范围，并指导手术方法的选择。

Objective：To discuss the computer tomography characteristics and clinical manifestations of external auditory canal cholesteatoma. Methods：52 cases of external auditory canal cholesteatoma were retrospectively reviewed. Among them ,24 cases were spontaneous , stenosis of the external auditory canal in 16 cases, postsnrgery in 8 cases, posttrauma in 2 cases and lesion occluding in the external meatus in 2 cases. Clinical data were analyzed for the history, symptoms, physical examination. Lesions were divided into Type A, B, C of CT according to temporal bone CT characteristic based on lesion location and adjacent bone destruction. Results：The most common presenting symptoms in this study were otalgia, otorrhea and granulation tissue formation, the incidence of 58% ,62% ,42% and 25% ,54% ,29% was in spontaneous and stenosis of the external auditory canal group respectively. CT imaging in 43 of 52 cases exhibited a soft tissue mass in the external ear canal, intramural bone fragments were identified in seven cases. Type A, B, C of CT imaging were in 28,6 and 18 cases respectively. Conclusions：External auditory canal cholesteatoma is a disease entity with characteristic CT imaging and clinical features, typing of CT plays an important role in determining lesion region and surgical management of external auditory canal eholesteatoma.