外耳道胆脂瘤的临床特征及疗效分析

The Clinical Characteristics and Therapeutical Analysis of External Auditory Canal Cholesteatoma

目的：研究外耳道胆脂瘤的临床特征及疗效分析。方法回顾性分析了106例（108耳）外耳道胆脂瘤患者的临床资料，主要包括病因、临床症状、耳内镜及颞骨CT检查结果及治疗方法。结果患者的平均年龄34.29岁（6～86岁）,男36例，女70例。单耳发病104例，其中右耳65例，左耳39例，双耳2例。临床表现主要以耳闷胀感、听力下降、反复耳痛多见，外耳道可见耵聍栓塞、肉芽、白色胆脂瘤团块。85例行耳内镜手术，11例行外耳道扩大术，10例行乳突改良根治术。术后随访6月～5年，所有病例均治愈。结论外耳道胆脂瘤主要发生在单耳，右耳多见。伴性别差异，本组病例女性﹥男性，40岁以下多见。主要病因考虑后天性阻塞为主，多合并耵聍栓塞。外耳道胆脂瘤应预防为主，早期诊断，早期治疗，手术治疗是唯一的方法，结合颞骨CT检查及术中情况决定手术方式，大多数病例可在耳内镜下完成，治疗效果显著。

Objective To explore the clinical characteristics and therapeutical analysis of external auditory canal cholesteatoma（EACC）. Method The clinical data of 106 patients（108 sides） with EACC from Jul.2008 to Mar.2013 were retrospectively analyzed, associated etiologic factors, symptoms, clinical findinds, endoscopy of ear, imaging features, and treatment therapy. Result The average age of patients was 34.29 years（range 6~86 years）,36 patients were man,70 patients were women. There was greater incidence 0f EACC on the right side ears（65 of 104 patients）. Main clinical findings were ear fullness, hearing loss, repeated earache. External auditory canal visible impacted cerumen, granulation, cholesteatoma. There were 85 cases underwent endoscopic operation, 11 cases of external auditory canal enlargement, 10 cases received radical resection mastoid process improvement. Patients were followed up in June to 5 years. Of the 106 patients, all cases were cured. Conclusion EACC occurred mainly in the single ear, right ear is common. The disease with gender differences, more common in women. EACC occurred mainly under the age of 40. Acquired obstruction mainly consider the main cause, and impacted cerumen. EACC should give priority to prevention, early diagnosis, early treatment, operation treatment is the only method, combining with the temporal bone CT scan and intraoperative decide operation way, most cases can be completed in under ear endoscope, significant treatment effect.