摘要
目的探讨青少年颞骨内先天性胆脂瘤的早期诊断和治疗方法。方法对5例青少年颞骨先天性胆脂瘤的回顾性分析。5例均无耳流脓和头外伤史,鼓膜完整,颞骨气化良好。听力检查为传导聋或混合聋。2例伴面神经麻痹,1例伴眩晕。结果根据病变部位,分别采用不同的手术径路切除胆脂瘤:经鼓室1例,经乳突—鼓室3例;经乳突—迷路1例。术中发现2例伴中耳先天性畸形。3例行鼓室成形术。2例面瘫者分别于术后l～4个月恢复。结论本病早期无特征性临床症状和体征,容易误诊。临床医生对鼓膜完整、进行性听力下降的传导聋伴/或不伴面神经麻痹者要高度怀疑此病。颞骨高分辨CT检查有助于诊断。
Purpose To discuss a method of early diagnosis and treatment of youngsters' intratemporal bone congenital cholesteatoma. Methods 5 patients with intratempolal bone congenital cholesleatoma treated surgically were retrospective analyzed. None of five cases had a history of otorrhea or head trauma. All S patients had intact tympanic membranes and good pneumatic mastoids. The audiograms revealed them to be conductive or mixed hearing loss. Two patients suffered facial palsy and one patient had vertigo. Results According to the lesion position, the cholesteatoma was resected through different surgical approach.Transtympanic approach was used in one case, trangmaetoid-tympanic approach was used in 3 cases and translabyrinthine-transcochlear approach was used in another case. Tympanoplasty was performed in 3 cases. The facial nerve function of 2 patients recovered patients in 1-4 months after surgery. Conclusion Because of the paucity of characteristic symptoms and signs at die early stage, it is often neglected by physicians as well as patients When a patient had intact tympanic membrane,progressive conductive hearing loss and/or facial palsy,congenital cholesteatoma shouold be suspected.The high resolution CT scan of temporal bone could help the diagnosis.
出处
《中国眼耳鼻喉科杂志》
2002年第6期355-357,共3页
Chinese Journal of Ophthalmology and Otorhinolaryngology
