外耳道胆脂瘤122例的临床特点与处理

External Auditory Canal Cholesteatoma 122 Cases of Clinical Characteristics and Treatment

目的探讨不同类型外耳道胆脂瘤的临床特征、手术方式及疗效。方法回顾性分析2017年9月~2019年2月,山西医科大学第一医院耳鼻咽喉头颈外科住院治疗的122例外耳道胆脂瘤患者的临床资料。结果 122例患者根据病变范围、分型,采用不同的方法彻底清除病变,治疗后随访1年,仅有3例患者术后复发。结论 EACC由于临床发病率比较低,容易漏诊,误诊为外耳道盯聍栓塞、外耳道栓塞性角化病或外耳道疖肿等。当发现外耳道皮肤充血,角化上皮栓塞、耳道扩大者应及时用耳内镜或在显微镜下彻底清除角化上皮及上皮下病变组织并送病检,治疗原则是早期诊断,早期治疗,彻底清除胆脂瘤病变,定期随访,防止复发。

Objective To discuss the clinical features, operation method and curative effect of external auditory canal cholesteatoma in different types. Methods A retrospective analysis was conducted with 122 patients of external auditory canal cholesteatoma in September 2017-February 2019 in Shanxi Medical University First Hospital Otolaryngology Head and Neck Surgery Department. Results Different methods were used to thoroughly remove lesions for 122 patients according to the pathological lesion and classification. There were only three patients with postoperative relapse again during the 1 year postoperative follow-up.Conclusion Because clinical incidence of external auditory canal cholesteatoma is low, it is easily misdiagnosed as plane at sex keratosis ceruminous embolization, the external auditory canal embolism or external auditory canal furuncle swollen etc. When the outer skin reddening, keratin epithelial embolism or expanded ear canal was found, the surgery with ear endoscope or general anesthesia surgery under the microscope must be immediately conducted to thoroughly remove the Angle of epithelium and epithelial lesions and the pathology detection should be organized. Treatment principles include early diagnosis and surgical treatment, thoroughly removal cholesteatoma lesions, regular follow-up and prevention of recurrence.