巨大中耳胆脂瘤的手术治疗  

Surgical treatment of giant cholesteatoma of middle ear

作　　者：杨万有[1] 刘国辉[2] 唐凌[1] 赵富伦[1] 李新[1] 姜俊宇[1] 黄桂彪 陈静[1] 郭林洁 

机构地区：[1]贵州省兴义市人民医院耳鼻咽喉科,贵州兴义562400 [2]中南大学湘雅三医院耳鼻咽喉头颈外科,湖南长沙410013

出　　处：《中国耳鼻咽喉颅底外科杂志》2008年第2期115-118,共4页Chinese Journal of Otorhinolaryngology-skull Base Surgery

摘　　要：目的探讨巨大中耳乳突胆脂瘤的手术治疗。方法回顾分析我院资料完整的16例巨大中耳乳突胆脂瘤的手术方法及疗效。结果16例巨大中耳乳突胆脂瘤中,87.5%(14/16)合并有颅内外并发症,共19例次,其中颞叶脑脓肿2例,小脑脓肿1例,乙状窦血栓性静脉炎1例,耳后骨膜下脓肿7例,迷路瘘管5例,颞部脓肿1例,周围性面瘫2例。经手术治疗均痊愈,部分患者(5/16)通过鼓室成形术获得听力提高。结论巨大中耳乳突胆脂瘤虽少见,但常引起严重的颅内外并发症,手术是巨大中耳胆脂瘤的唯一治疗途径,尽早手术可减少颅内外并发症的发生。Objective To investigate the surgical treatment of giant cholesteatoma in the middle ear.Methods The clinical data including surgical methods and therapeutic effect of 16 patients suffering from giant cholesteatoma of middle ear was analyzed retrospectively. Results Of all the 1 6 cases, preoperative extracranial or intracranial complications occurred in 14： postauricular subperiosteal abscess in seven cases ; fistula of labyrinth in five; temporal cerebral abscess and peripheral facial paralysis each in two ; cerebellar abscess, thrombophlebitis, and abscess and temporal region each in one. They were all cured with surgical treatment and 5 of them got hearing improvement by means of tympanoplasty. Conclusion Although giant cholesteatoma of the middle ear is getting fewer and fewer, it can usually cause severe extracranial and intracranial complications. Surgical operation is the only way to treat this disease. The operation should be performed as early as possible to reduce the incidence of intracranial and extracranial complications.

关 键 词：胆脂瘤 乳突 中耳 外科手术 

分 类 号：R764.92[医药卫生—耳鼻咽喉科] R764.21[医药卫生—临床医学]