中耳胆固醇肉芽肿病例分析及诊治  

Diagnosis and treatment of cholesterol granuloma of the middle ear

作　　者：郭思荃 关兵 张俊中 

机构地区：[1]扬州大学临床医学院,苏北人民医院耳鼻咽喉头颈外科,江苏扬州225001

出　　处：《中国耳鼻咽喉头颈外科》2016年第7期402-405,共4页Chinese Archives of Otolaryngology-Head and Neck Surgery

摘　　要：目的：探讨中耳胆固醇肉芽肿诊治原则及手术治疗方案的选择和疗效。方法回顾分析我院2006年3月～2014年8月经手术和病理证实18例中耳胆固醇肉芽肿患者的临床资料。所有患者根据病变程度选择不同术式。结果所有患者均随访半年以上。2例因咽鼓管功能障碍，需长期留置鼓膜置管；1例鼻咽癌复发转移至中耳乳突内，转肿瘤科进一步治疗；其余患者术后均干耳，无复发，纯音听阈也有不同程度改善。结论中耳胆固醇肉芽肿病因主要有含气腔通气受阻、引流障碍、含气腔出血及骨髓裸露。中耳乳突手术彻底去除病变，建立乳突-鼓室-咽鼓管良好的通气系统是手术成功的关键。OBJECTIVE To discuss the diagnosis and treatment of cholesterol granuloma of the middle ear＆amp;nbsp;and the choice and effect of surgical methods. METHODS A retrospective analysis was conducted on 18 cases of cholesterol granuloma of the middle ear confirmed by surgery and pathology. Different choices of surgical methods were made according to the lesion extension of this disease. RESULTS All patients were followed up for at least 6 months. Two cases with eustachian tube obstruction had ventilation tube inserted for a long time. One case who had recurrence and metastasis of nasopharyngeal carcinoma in the middle ear was transferred to oncology department for further treatment. Post-operative dry ears were obtained in the other cases whose pure tone thresholds were improved to different degrees. CONCLUSION Etiology of cholesterol granuloma of middle ear remains controversial. It＇s supposed to result from the bleeding, occlusion of ventilation and disturbance of drainage of the air cavity because of the middle ear inflammation, and bone marrow exposure. The middle ear and mastoid surgery can completely remove the disease tissues, and establish ventilation system of mastoid-tympani-eustachian, which is the key point of the middle ear surgery.

关 键 词：中耳 胆固醇 肉芽肿 耳外科手术 

分 类 号：R764.92[医药卫生—耳鼻咽喉科]