中耳神经内分泌性腺瘤的个性化手术方案选择  

Individualized Surgical Strategies for Patients with Middle Ear Adenomatous Neuroendocrine Tumors

作　　者：谢冰斌[1,2] 张少容 戴春富[3] 刘月辉 XIE Bingbin;ZHAGN Shaorong;DAI Chunfu;LIU Yuehui(Department of Otolaryngology Head and Neck Surgery,the Second Affiliated Hospital of Nanchang University,Nanchang 330006,China;Jiangxi Biomedical Engineering Research Center for Auditory Research,Nanchang 330006,China;Department of Otology and Skull Base Surgery,Eye and Ear,Nose,and Throat Hospital,Fudan University,Shanghai 200031,China)

机构地区：[1]南昌大学第二附属医院耳鼻咽喉头颈外科 [2]江西省人工听觉工程技术研究中心 [3]复旦大学附属眼耳鼻喉科医院耳神经侧颅底外科

出　　处：《中华耳科学杂志》2020年第6期1124-1129,共6页Chinese Journal of Otology

摘　　要：目的中耳神经内分泌性腺瘤临床极其少见,目前对于手术方案的选择尚无共识;本方通过总结对该病的治疗经验,探讨不同分期的中耳神经内分泌性腺瘤手术治疗策略。方法回顾性分析南昌大学第二附属医院耳鼻咽喉头颈外科和复旦大学附属眼耳鼻喉科医院2006年7月-2017年12月收治的经病理证实的中耳神经内分泌性腺瘤(MEANTs)患者共6例。所有资料均采集于患者住院病历和随访结果,随访及资料采集截止时间为2019年7月。结果2例T1N0M0的患者施以了完壁式乳突根治术并鼓室成形术;1例(病例3)T1N0M0的患者初次治疗采取了鼓室探查并肿物切除,于术后第38个月复发,二次手术采用完壁式乳突根治术并鼓室成形术;3例T2cN0M0的患者施以了颞骨侧切除术。平均随访时间为75.7个月(25-165个月),除病例3外,其他患者在随访期间内均未发现肿瘤复发。结论手术彻底切除是治疗MEANTs的主要手段,手术方式的选择根据肿瘤的分期而定。由于肿瘤具有潜在局部复发或转移的特性,术后长时期的随访至关重要。Objective Middle ear adenomatous neuroendocrine tumors(MEANTs)are extremely rare neoplasms.Universal standard surgical procedures for different stages of these tumors remain elusive.This study aims to investigate proper surgical strategies for patients with MEANTs in different stages.Methods Clinical characteristics and management strategies in 6 patients with MEANTs who were treated at the Second Affiliated Hospital of Nanchang University(Nanchang,China)and the Eye,Ear,Nose,and Throat Hospital of Fudan University(Shanghai,China)were respectively reviewed.The mean follow-up time was 63.7 months(range,13-153 months).Results Three patients underwent canal wall-up(CWU)tympanomastoidectomy,including one recurrent patient with a previous tympanotomy.The rest three patients underwent lateral temporal bone resection(LTBR).All of these patients showed no evidence of recurrence or metastasis during followed up,with hearing function preservation in patients with CWU surgery.Conclusion Complete surgical resection is the primary curative treatment for MEANTs,and the surgical strategy depends on the stage of tumor.Because of the propensity for local recurrence and invasiveness,as well as regional or distant metastasis of these tumors,it is necessary to make a long-term follow-up and observation plan postoperatively.

关 键 词：中耳类癌 中耳腺瘤 完壁式乳突根治术 颞骨侧切除术 

分 类 号：R764[医药卫生—耳鼻咽喉科]