手术治疗Ⅲ型外耳道胆脂瘤的临床效果分析(附8例报告)  

Clinical Analysis of Surgical Treatment of Type Ⅲ External Auditory Canal Cholesteatoma(with 8cases)

作　　者：董思淇[1] 郝青青[1] 刘日渊[1] 徐广雨[1] 赵辉[1] 杨仕明[1] 

机构地区：[1]中国人民解放军总医院耳鼻咽喉头颈外科,北京100853

出　　处：《中华耳科学杂志》2013年第4期557-560,共4页Chinese Journal of Otology

基　　金：国家自然科学基金面上项目(课题号:30600701);教育部高等学校全国优秀博士学位论文作者专项资金(课题号:2007B67)

摘　　要：目的探讨骨性外耳道后壁和乳突遭破坏的Ⅲ型外耳道胆脂瘤的治疗方法。方法收集8例临床诊断为Ⅲ型外耳道胆脂瘤患者,行完壁式乳突切开+鼓室成形术+自体皮质骨外耳道后壁重建术治疗。结果 7例患者术后随访恢复了外耳道的正常生理结构;1例患者术后重建外耳道后壁出现窦道与乳突腔相通,二次手术后恢复了外耳道的正常生理结构;全部8例患者术后随访均无胆脂瘤复发、无重建外耳道后壁塌陷及狭窄闭锁、听力有不同程度的提高。结论完壁式乳突切开+鼓室成形术+自体皮质骨外耳道后壁重建术治疗Ⅲ型外耳道胆脂瘤,能有效清除病灶组织、恢复外耳道及中耳的正常生理结构、术后复发率低、听力结果满意,值得进一步观察和深入研究。Objective To investigate treatment of stage III external auditory canal cholesteatoma （EACC） with damage to the posterior external auditory canal and mastoid. Methods Eight patients with stage III EACC underwent intact canal wall mastoidectomy with tympanoplasty and canal wall reconstruction with autologous cortical bone. Results On follow-up, all pa- tients showed physiological external auditory canal structures and improvement of listening ability without stenosis or lesion re- currence, except for one patient who needed a revision operation for a fistula between the reconstructed wall and the mastoid. Conclusion Intact canal wall mastoidectomy with tympanoplasty and canal wall reconstruction with autologous cortical bone is an effective treatment technique worth further in-depth study.

关 键 词：外耳道胆脂瘤 完璧式乳突切开术 外耳道后壁重建术 自体皮质骨 

分 类 号：R739.61[医药卫生—肿瘤]