摘要
目的探讨耳道扩大联合耳甲成形治疗Ⅱ～Ⅲ期外耳道胆脂瘤(EACC)的临床效果。方法回顾分析35例Ⅱ～Ⅲ期EACC患者的临床资料。结果全部患者均一次完成手术,术后病理均确诊为胆脂瘤。术后外耳道通畅,耳闷、耳痛、耳流脓症状消失。2周后干耳,术腔均在3个月内完全上皮化。术后随访3～24个月,未见胆脂瘤复发。听力结果显示患者术后言语频率气骨导差较术前明显减小,差异有统计学意义(P <0. 05)。结论Ⅱ～Ⅲ期EACC行耳道扩大联合耳甲成形具有临床应用优势。
Objective To explore the clinical effect of ear canal dilatation combined with cavity formation of auricular concha in the treatment of stage Ⅱ ～ Ⅲ external auditory canal cholesteatoma( EACC). Methods Thirtyfive cases of stage Ⅱ ～ Ⅲ EACC were analyzed retrospectively. Results All the 35 cases underwent surgery at one time. Postoperative pathology was done to confirm as cholesteatoma. After the operation,the external ear canal was unobstructed,and the symptoms of ear tightness,ear pain and ear pus all disappeared. The external auditory canal got dry within two weeks. The surgical cavity was completely epithelized within three months,and no recurrence was observed after 3 ～ 24 months. The postoperative speech frequency air-bone gap decreased significantly( P < 0. 05).Conclusions Ear canal dilatation combined with cavity formation of auricular concha has more clinical advantages in the treatment of stage Ⅱ ～ Ⅲ EACC.
引文
[1]SHIN S H,SHIM J H,LEE H K.Classification of external auditory canal cholesteatoma by computed tomography[J].Clin Exp Otorhinolaryngol,2010,3(1):24-26.
[2]PERSAUD R A P,HAJIOFF D,THEVASAGAYAMK M S,et al.keratosis obturans and external ear canal cholesteatoma:how and why we should distinguish between these conditions[J].Clin Otolaryngol,2004,29(5):577-581.
[3]徐爱国,纳玉萍.耳道耳甲成形术[J].医学综述,2011,17(24):3743-3746.
[4]钱敏飞,张华,刘君,等.外耳道胆脂瘤临床特征及治疗[J].听力学及言语疾病杂志,2014,24(2):149-152.
[5]孔维佳,周梁.耳鼻咽喉头颈外科学[M].3版.北京:人民卫生出版社,2015:121-122.
[6]顾凤明.侵及中耳的Ⅲ期外耳道胆脂瘤的手术方法探讨[J].中国耳鼻咽喉颅底外科杂志,2017,23(3):275-279.
[7]CHANG J,CHOI J,IM G J,et al.Dilute vinegar therapy for the management of spontaneous external auditory canal cholesteatoma[J].Eur Arch Otorhinolaryngol,2012,269(2):481-485.
[8]王春华,李海春,张刚,等.外耳道胆脂瘤的手术治疗[J].临床耳鼻咽喉头颈外科杂志,2015,29(4):363-366.
[9]KANEDA S,HAMADA M,ODAGIRI K,et al.Review on external auditory canal cholesteatoma and proposal of more clinical classification[J].J Laryngol Otol,2016,130(S3):S186-S186.
[10]REDAELLI D E,ZINIS L O.Spontaneous posterior wall external canal cholesteatoma[J].Ear Nose Throat,2011,90(7):298-300.
[11]刘韵,龚树生,王林娥.外耳道胆脂瘤35例的临床观察及术式选择[J].临床和实验医学杂志,2016,15(10):1030-1032.
[12]董思淇,郝青青,刘日渊,等.手术治疗Ⅲ型外耳道胆脂瘤的临床效果分析(附8例报告)[J].中华耳科学杂志,2013,11(4):557-560.
[13]唐建文,杨俊涛,吴崇华,等.乳突骨皮质重建外耳道后壁在Ⅲ型外耳道胆脂瘤手术中的应用[J].中国耳鼻咽喉颅底外科杂志,2015,21(2):159-161.
[14]张珂,潘滔,刘庆松,等.软骨外耳道后壁重建术在Ⅲ期外耳道胆脂瘤手术中的应用[J].中国微创外科杂志,2017,17(2):163-170.
