外耳道囊性腺样癌的手术治疗

Surgical treatment for adenoid cystic carcinoma of the external auditory canal

目的:研究外耳道囊性腺样癌的临床手术治疗。方法:回顾分析我院1987～2001年收治的经病理确诊为外耳道囊性腺样癌患者12例,男7例,女5例,年龄27～60岁,平均41.3岁。6例局限于外耳道者行外耳道套样切除加部分外耳道骨壁磨除或乳突根治术;5例侵及范围广累及中耳、乳突、甚至岩锥者行颞骨侧位切除加腮腺部分或全切除术;1例侵及颅内者行颞骨切除及侧颅底手术,切除颅内肿瘤并以帽状腱膜、带蒂颞肌瓣修补。结果:1例随访1年,9例随访均在2年以上,最长者13年;其中8例(初诊4例,复发者4例)术后无复发,2例复发并有肺转移,其中1例死亡,1例带癌生存至今。2例失访。结论:广泛彻底手术切除是治疗本病的关键。

Objective:To investigate the surgical treatment of meatal adenoid cystic carcinoma.Methods:12patients,7males,5females,aged from27to60with an average age of41.3,who were di ag-nosed pathologically to suffer from the carcinoma and treated in our department from1987to2001were retrospectively analyzed.In the6cases whose carcinoma was restricted within external auditory canal muff-like resection was performed with partial bone removed or mastoidectomy.In the5cases whose tumor in-volved the middle ear,mastoid and even petrous pyramid lateral-temporal bone resec tion was performed with partial or total parotidectomy.1case with cranium invasion was treated with temporal bone resection and lateral skull base operation,with the defect of skull base having been repaired with galea aponeurotica and pedicel temporal-valve prosthesis.Results:One patient was followed up for only one year and9pa-tients were followed up for more than2years (the longest for13years).No recurrence in8patients,in-cluding4patients diag nosed initially and4recurrent patients after first surgery done else where.2patients had relapse with pul monary metastasis,one of them died and the other is still alive.Contact was lost with2of them.Conclusion:The analysis shows that extensive and complete surgery is the key to treat this dis ease.