Title: [Clinical features and surgical treatment of external auditory canal cholesteatoma in 149 cases].
Abstract: Objective:The aim of this study is to explore the clinical characteristics, surgical management and treatment results of type Ⅰto type Ⅳ external auditory canal cholesteatoma(EACC). Method:One hundred and forty-nine patients(150 ears) with EACC underwent different surgical approach according to the classification of EACC and the lesion range: ① 44 ears: external auditory canal lesion resection with or without reconstruction of external auditory canal ② 23 ears: external auditory canal lesion resection with reconstruction of external auditory canal and the tympanoplasty(TypesⅠto Ⅲ); ③ 32 ears: external auditory canal lesion resection with reconstruction of external auditory canal and modified mastoidectomy and reconstruction of the posterior wall of external auditory canal; ④ 28 ears: external auditory canal lesion resection with reconstruction of external auditory canal and tympanoplasty(Types Ⅰ to Ⅲ) and modified mastoidectomy and reconstruction of the posterior wall of external auditory canal; ⑤12 ears: canal wall down mastoidectomy (CWD) with plasty of the cavity of auricular concha; ⑥ 11 ears: epitympanum dectomy and reconstruction with tympanoplasty. Result:In the 150 ears, there were 38 ears classified as Type Ⅰ, 52 as Type Ⅱ, 58 as Type Ⅲ and 2 as Type Ⅳ based on the Shin classification. All patients were followed up for more than half a year. The postoperative outcomes were satisfactory with low rate of cholesteatoma recurrence and the hearing was improved to varying degrees. Conclusion:Base on the variety of lesions, the surgical treatment method of choice depends on the extent of the lesion. Effective postoperative follow-up can reduce recurrence and avoid the second operation.目的:探讨Ⅰ~Ⅳ型外耳道胆脂瘤(EACC)的临床特征、手术方式及治疗效果。 方法:根据EACC分型及术中病变范围对149例(150耳)EACC患者采取不同的手术方式:①44耳采取外耳道病变去除+伴或不伴外耳道成型或外耳道口扩大术;②23耳采取外耳道病变去除+外耳道成型+鼓室成形术(Ⅰ~Ⅲ型);③32耳采取外耳道病变去除+外耳道成型+改良乳突根治+外耳道后壁重建术;④28耳采取外耳道病变去除+外耳道成型+鼓室成形术(Ⅰ~Ⅲ型)+改良乳突根治+外耳道后壁重建术;⑤12耳采取开放式乳突根治+外耳道成形;⑥11耳采取上鼓室开放+鼓室成形术+外侧壁重建术。 结果:Ⅰ型38耳,Ⅱ型52耳,Ⅲ型58耳,Ⅳ型2耳。所有患者均随访6个月以上,术后均干耳,听力均不同程度提高,复发率低。 结论:EACC病变形式多样化,手术方式宜根据乳突气化程度、病变严重程度及听力状况个体化选择。有效的术后随访可减少复发,避免二次手术。.
Publication Year: 2020
Publication Date: 2020-06-01
Language: en
Type: article
Indexed In: ['pubmed']
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Cited By Count: 2
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