婴幼儿先天性咽鼓管良性占位的临床分析  

Clinical analysis of benign congenital eustachian tube tumor in infants

作　　者：刘薇[1] 陈敏[1] 杨扬[1] 张杰[1] LIU Wei;CHEN Min;YANG Yang;ZHANG Jie(National Center For Children’s Health,Department of Otolaryngology Head and Neck Surgery,Beijing Children’s Hospital,Capital Medical University,Beijing 100045,China)

机构地区：[1]国家儿童医学中心首都医科大学附属北京儿童医院耳鼻咽喉头颈外科,北京100045

出　　处：《中国眼耳鼻喉科杂志》2023年第6期465-469,共5页Chinese Journal of Ophthalmology and Otorhinolaryngology

基　　金：北京市医院管理中心“登峰”计划专项项目(DFL20191201)。

摘　　要：目的 观察婴幼儿先天性咽鼓管良性占位的临床特点以及耳内镜辅助手术的价值。方法 回顾分析3例婴幼儿先天性咽鼓管良性占位典型病例,记录其发病特点、临床症状、影像学特点、手术方案、术中所见、病理所见及预后。3例患者年龄均为2岁以下,病程20 d~15个月。其中2例以耳流脓就诊,1例以呼吸道梗阻就诊。颞骨CT或磁共振成像(MRI)提示咽鼓管占位,听力检查提示患侧传导性听力下降。基于病变部位、范围、与周围组织的比邻,选择经耳后耳道联合入路,显微镜、耳内镜联合术式。结果 术中见病变起源于咽鼓管,肿物基底部暴露须耳内镜辅助,并可以辨别周围大血管,术中无神经及血管损伤。术后病理结果证实迷芽瘤2例、畸胎瘤1例。随访1~4年,未见复发。结论 婴幼儿先天性咽鼓管良性占位具有起病隐匿,手术难度大等特点,显微镜联合耳内镜手术可以获得较好疗效,预后较好。Objective To observe the clinical characteristics of benign congenital eustachian tube tumor in the middle ear in infants and the application of otic endoscope during the surgery.Methods A retrospective analysis of 3 patients with benign congenital eustachian tube tumor was performed.The clinical characteristics,radiologic characters,surgery,pathology and prognosis of all patients were recorded.All cases aged under 2 years and the course duration was between 20 days and 15 months.The main complaints were ear effusion in 2 cases and respiratory obstruction in 1 case.CT or magnetic resonance imaging(MRI)demonstrated the eustachian tube tumor.Hearing test showed a conductive hearing loss.All 3 patients got middle ear tumor resection surgery from retroauricular and auditory canal approach under microscope and endoscope.Results The lesion was originated from the eustachian tube,and the mass was exposed with the use of endoscopy.The surrounding large blood vessels could be identified,and there was no nerve or vascular damage during the operation.The postoperative pathological results confirmed 2 cases of choristoma and 1 case of teratoma.All patients were followed up for 1 to 4 years,and there was no recurrence.Conclusions Because of its special location,insidious onset and difficult operation,microscopy combined with endoscopic surgery could achieve better results and better prognosis.

关 键 词：咽鼓管 良性肿瘤 婴幼儿 

分 类 号：R76[医药卫生—耳鼻咽喉科]