颞骨先天性胆脂瘤的临床诊治分析

The retrospect and analysis of the clinical diagnosis and therapy for congenital cholesteatoma of temporal bone

目的 :探讨颞骨先天性胆脂瘤的诊断及治疗方法。方法 :对 1980～ 2 0 0 2年收治的 16例患者的临床资料进行回顾性分析。结果 :16例均经手术治疗、病理证实。经 0 .5～ 3年的随访 ,面瘫恢复或部分恢复 6例 ,听力提高 5例 ,2例复发再次手术治愈 ,无特殊严重的并发症。结论 :诊断本病应根据患者的症状、体征及影像学检查结果 ,MRI可良好地显示病灶及其与周围 (包括颅内结构 )的关系 ,同时也是诊断先天性胆脂瘤的重要方法。鼓膜完整不是诊断的必要条件 ,手术径路的选择应根据病变范围而定 ,彻底清除病变是防止复发的关键。

Objective:To discuss the diagnosis and the therapy methods of congenital temporal bone cholesteatoma. Method: Reviewing and analyzing the clinical data and information about 16 cases of congenital temporal bone patients from 1980 to 2002. Result: The surgery were proceeded for removing cholesteatoma focus in all patients and the diagnosing were made by histopathologic investigation. Following for half to three years, 6 cases of facial nerve paralysis got partially or totally healing, hearing function improved in 5 cases, 2 cases relapsed and operation were made again for resecting . recrudescent cholesteatoma. There were no any subsequent symptoms happened. Conclusion: The diagnosis of congenial temporal bone cholesteatoma mainly base on the patient's clinical symptoms and manifestation, and imaging examination. MRI can clearly show cholesteatoma focus and other organs or tissues (including some encephalic frameworks) around it, which also is one of important inspection techniques for discriminating from congenital encephalic cholesteatoma near rock part of temporal bone. The drum integrity is not necessary condition for diagnosing this disease, the surgery approaches are selected by the size and position of focus. The key for preventing recrudescence is to drastically eliminate cholesteatoma tissues.