Petrous bone cholesteatoma: our experience of 51 patients with emphasis on cochlea preservation and use of endoscope
Petrous bone cholesteatoma: our experience of 51 patients with emphasis on cochlea preservation and use of endoscope
复制标题
岩骨胆脂瘤：51例患者的经验，重点关注耳蜗的保存和内窥镜的使用
作者：
Zhen Gao;Gang Gao;Wei;Xian;Jing Yu;C. Dai;Bing Chen;F. Chi;Jing Wang;Ya
摘要背景：岩骨胆脂瘤是一种罕见的局部侵袭性病变，可导致严重的并发症。手术是其治疗的主要手段。目的：分析一系列PBC患者的临床特点和手术治疗结果，特别注意耳蜗术前的保留和内窥镜的应用。材料和方法：对本中心手术治疗的51例PBC患者进行回顾性研究。结果：听力损失(72.5%)和面瘫(58.8%)是最常见的两种症状。根据Sanna的分类，最常见的亚型是翼上迷路亚型(51.0%)，其次是块状亚型(33.3%)。在大多数患者中，采用岩层次全切除术根治性切除PBC(80.4%)。6例行内窥镜辅助治疗。根据不同病例采用不同的面神经处理方法。术后不重视听力康复(44只死耳)，但尽可能保留耳蜗者占45.3%。磁共振弥散加权成像(DWI)序列显示5例患者复发。在接受内窥镜辅助手术的患者中没有发现复发。结论和意义：根治性切除和功能重建构成了PBC手术的框架。人工耳蜗的保存是未来人工耳蜗术成功与否的关键。内窥镜的使用有可能提高手术精度，减少复发。
Abstract Background: Petrous bone cholesteatoma (PBC) is a rare but local aggressive lesion which can lead to severe complications. Surgery is the mainstay for its treatment. Objectives: To analyse the clinical characteristics and surgical outcomes in a series of patients with PBC, paying special attention to cochlea preservation and use of endoscope. Materials and methods: Retrospective study of 51 patients with PBC who underwent surgery at our centre. Results: Hearing loss (72.5%) and facial paralysis (58.8%) were the two most common symptoms. According to Sanna’s classification, supralabyrinthine subtype (51.0%) was the most common subtype, followed by the massive subtype (33.3%). In most patients, PBC was radically removed using subtotal petrosectomy (80.4%). Endoscope was used for assistance in six cases. Various managements of facial nerve were used in different cases. Hearing rehabilitation was not emphasized (44 postoperative dead ear); however, cochlea was preserved as far as possible (45.3%). Recurrence was identified in five patients by MRI with diffusion weighted imaging (DWI) sequence. No recurrence was detected in patients underwent surgery with endoscope assistance. Conclusions and significance: radical excision and functional reconstruction constitute the framework of PBC surgery. Cochlea preservation is critical for possible cochlear implantation in the future. Use of endoscope has the potential to enhance surgical precision and reduce recurrence.
影响因子：
--
作者：
B. Gantz;U. Fisch
通讯作者：
B. Gantz;U. Fisch