儿童外耳道阻塞性角化病的临床特点

尹德佩; 朱慧娥; 马慧敏; 陈培培; 窦训武

doi:10.13201/j.issn.1001-1781.2018.19.015

儿童外耳道阻塞性角化病的临床特点

- 苏州大学儿童医院耳鼻咽喉头颈外科(江苏苏州, 215003)

详细信息

通讯作者: 朱慧娥, E-mail:hunziyin99@sina.com

中图分类号: R764.1

收稿日期: 2018-05-04

The clinical characteristics of pediatric external auditory canal keratosis obturans

- Department of Otolaryngology Head and Neck Surgery, Children's Hospital of Soochow University, Suzhou, 215003, China

More Information

Corresponding author: ZHU Huie, E-mail: hunziyin99@sina.com

Received Date: 04 May 2018

摘要

摘要: 目的: 探讨儿童外耳道阻塞性角化病的临床特点。方法: 回顾性分析23例外耳道胆脂瘤患儿的临床资料,分析其主诉症状、病程、临床特征、CT表现、手术方式及预后情况,并与外耳道阻塞性角化病进行鉴别诊断。结果: 所有患者中20例(22耳)修正诊断为外耳道阻塞性角化病。其中单纯右耳11例,单纯左耳7例,双耳发病2例。主诉疼痛20例(100%)、耳道出脓17耳(77.3%),听力下降伴耳道出脓3耳(13.6%)。行耳镜检查发现耳道肉芽17耳(77.3%);CT发现骨性耳道受压变形鼓膜受压移位18耳(81.8%),其中7耳(38.9%)表现为骨性耳道后壁压迫吸收。所有患者均在耳内镜下操作,术中发现鼓膜小穿孔4例,术后病理均显示为角化上皮。结论: 外耳道阻塞性角化上皮栓容易与外耳道胆脂瘤诊断混淆,临床上主诉耳痛、耳道肉芽伴出脓的患者,CT发现耳道骨质环形受压改变伴有鼓膜受压移位患者,需考虑为外耳道阻塞性角化病。
- 外耳道 /
- 角化病 /
- 胆脂瘤 /
- 诊断 /
- 鉴别 /
- 儿童
Abstract: Objective: To analyze the clinical characteristics of pediatric external auditory canalkeratosis obturans(KO). Method: Retrospective analyze the clinical data of twenty-three patients were diagnosed with external auditory canal cholesteatoma(EACC). Their chief complaint, the course of the disease, clinical characteristics, CT manifestations, surgical procedure and prognosis were retrospectively analyzed. The clinical characteristics between EACC and KO were compared, Result: Twenty cases(22 ears) were eventually diagnosed as KO. Among them, 2 cases were bilaterally involved. In the remaining unilateral cases, right ear was involved in 11 cases and left ear in 7 cases. All patients complained otalgia(100%). Purulent otorrhea was found in 17 ears(77.3%), and hearing loss withpurulent otorrhea in 3 ears(13.6%). Otoscopic examination found 17 ear with granulation(77.3%). CT scan found deformation of the osseous ear canal and displacement of the tympanic membrane because of compression in 18 ears(81.8%), and the bony canal was absorpt because of pression in 7 cases(38.9%). All patients underwent otoendoscopic operation, and tympanic membrane perforation was found in 4 cases. Postoperative pathologic examination results were keratin epithelial. Conclusion: EACC is easily confused with KO. KO should be considered in the following circumstances:patient who complained of ear pain, ear granulation with purulent discharge, or circinate deformation of the osseous ear canal and displacement of the tympanic membrane in CT scan.
- external auditory canal /
- keratosis /
- cholesteatoma /
- diagnosis /
- differential /
- child

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参考文献(8)

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