外耳道胆脂瘤与中耳胆脂瘤临床特征比较

王一红; 叶青; 王增林; 滕彬彬

doi:10.13201/j.issn.1001-1781.2015.14.009

外耳道胆脂瘤与中耳胆脂瘤临床特征比较

- 1 福建医科大学省立临床医学院福建省立医院耳鼻咽喉科(福州, 350001);
- 2 福建医科大学省立临床医学院福建省立医院放射科;
- 3 福建省人民医院放射科

详细信息

通讯作者: 叶青,E-mail:1158113213@qq.com

中图分类号: R764.2

收稿日期: 2015-01-19

Differences in clinical features between cholesteatoma in external auditory meatus and middle ear

- 1 Department of Otolaryngology, Fujian Provincial Hospital, Provincial Clinical Medical College of Fujian Medical University, Fuzhou, 350001, China;
- 2 Department of Radiology, Fujian Provincial Hospital, Provincial Clinical Medical College of Fujian Medical University;
- 3 Department of Radiology, Fujian Provincial People's Hospital

More Information

Corresponding author: YE Qing, E-mail: 1158113213@qq.com

Received Date: 19 January 2015

摘要

摘要: 目的:比较和探讨外耳道胆脂瘤与中耳胆脂瘤临床特征,尤其外耳道胆脂瘤和中耳胆脂瘤病变对面神经骨管破坏的不同特点。方法:回顾性分析福建省立医院耳鼻咽喉科2003-01-2014-08期间经手术证实胆脂瘤病变侵蚀面神经骨管的中耳胆脂瘤125例、外耳道胆脂瘤28例患者的临床资料。结果:外耳道胆脂瘤病程(4.97±7.51)年,中耳胆脂瘤(16.60±14.42)年,两者比较差异有统计学意义(P<0.01)。外耳道胆脂瘤75.0%(21/28)为气化型乳突,中耳胆脂瘤88.0%(110/125)为板障型乳突。外耳道胆脂瘤面神经骨管破坏78.6%(22/28)发生在乳突段,中耳胆脂瘤60.8%(76/125)发生在鼓室段,差异有统计学意义(P<0.01)。听小骨的破坏中,中耳胆脂瘤的发生率明显高于外耳道胆脂瘤,差异有统计学意义(P<0.01)。半规管缺损在中耳胆脂瘤病例中发生率为30.4%(38/125),显著高于外耳道胆脂瘤的10.7%(3/28),差异有统计学意义(P<0.05)。结论:外耳道胆脂瘤和中耳胆脂瘤所导致面神经骨管破坏的位置不尽相同。手术治疗前需认真专科检查,仔细阅片,术中细致操作,方可最大限度避免面神经损伤。
- 胆脂瘤 /
- 耳道 /
- 中耳 /
- 面神经
Abstract: Objective: Differences in clinical features, especially facial nerve canal leision between cholesteatoma in external auditory meatus and middle ear were compaired.Method: A retrospective clinical analysis was made. Clinical data included 125 cases of middle ear cholesteatoma with facial nerve canal leision and 28 cases of cholesteatoma occurred in external auditory canal from 2003-01-2014-08 in our hospital.Result: Clinical course of cholesteatoma in external auditory canal was 4.97±7.51 years, course of middle ear cholesteatoma was 16.60±14.42 years (P<0.01). 21 cases (75%) of external auditory canal cholesteatoma were manifested as pneumatic mastoid and 110 cases (88%) of middle ear cholesteatoma were manifested as diploic mastoid respectively. 22 cases (78.6%) of facial nerve canal damage-in mastoid segment in cholesteatoma of external auditory meatus and 76 cases (60.8%) of facial nerve canal damage in tympanic segment in cholesteatoma of middle ear were observed (P<0.01). The incidence rate of ossicular errosion in middle ear cholesteatoma was significantly higher than that in external auditory meatus (P<0.01). The incidence of semicircular canal defects in middle ear cholesteatoma (30.4%), was significantly higher when comparing to the incidence (10.7%) in cholesteatoma of external auditory meatus (P<0.05).Conclusion: The site of facial nerve canal lesion in middle ear cholesteatoma and cholesteatoma of external auditory meatus were different. More attention should be paid before and during operation to avoid facial nerve injury, including physical examinations, especial otologic exams, radiological reading and careful operation.
- cholesteatoma /
- ear canal /
- middle ear /
- facial nerve

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