颞骨骨化纤维瘤误诊分析

Analysis of Misdiagnosis of Ossifying Fibroma of the Temporal Bone

目的总结颞骨骨化纤维瘤的临床特点、诊断及鉴别诊断措施,提高对其认识,减少误诊误治。方法回顾性分析我科收治的曾误诊为中耳炎的颞骨骨化纤维瘤1例的临床资料。结果患者因右耳疼痛伴听力下降2年余,耳鸣4个月以颞骨肿瘤收住入院。当地医院曾诊断为中耳炎,给予抗感染及糖皮质激素治疗15 d,症状改善不明显,入我院后结合病史、临床特征及医技检查结果,拟诊为颞骨占位性病变,行右侧颞骨部分切除、颞下窝肿物切除及带蒂颞肌瓣修复术,术后病理检查诊断为颞骨骨化纤维瘤。术后患者耳鸣消失,听力较前明显改善。结论颞骨骨化纤维瘤早期症状缺乏特异性,易漏诊误诊。加强对其认识、认真查体,并进行系统检查,可减少颞骨骨化纤维瘤误诊误治。

Objective To summarize the clinical features, diagnostic and differential diagnostic measures of ossifying fibroma of the temporal bone, analyze the cause of misdiagnose, improve the understanding of the disease, and avoid misdiag-nosis and mistreatment. Methods Retrospective analysis of the clinical data of a misdiagnosed case of ossifying fibroma of the temporal bone in our division was carried out. Results The patient was admitted for right ear pain associated with hearing loss for more than two years and tinnitus for four months. The patient had been diagnosed with otitis media in another local hospital. After 6 months of anti-infection and glucocorticoid treatment, improvement of symptoms was not significant. In our hospital, the patient was suspected as having lesions, combining with the history, clinical signs and medical examination. The right temporal bone resection, and infratemporal fossa tumor resection, temporalis muscle flap transfer for repair were per-formed. Postoperative pathology confirmed temporal bone ossifying fibroma. Postoperative hearing improved significantly and tinnitus disappeared. Conclusion The prophase clinical manifestations of temporal bone ossifying fibroma lack specificity and tend to be missed diagnosis and misdiagnosed. Improved awareness of temporal bone ossifying fibroma,careful examinations and system checks may reduce or avoid misdiagnosis and mistreatment of temporal bone ossifying fibroma.