Congenital cholesteatoma clinical features and surgical results
Congenital cholesteatoma clinical features and surgical results
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DOI：
10.1016/j.amjoto.2005.11.016
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发表时间：
2006-09-01
影响因子：
2.5
通讯作者：
Moriyama, Hiroshi
中科院分区：
文献类型：
--
作者：
Kojima, Hiromi;Tanaka, Yasuhiro;Moriyama, Hiroshi
我们分析了63例患者的63耳先天性中耳瘤，这些患者在24年的时间里接受了手术。我们调查了患者的症状、鼓膜表现、中耳瘤的形态和位置、相关的听小骨异常、手术方法和治疗结果。年龄2 ~ 51岁，平均13.3岁，其中闭合型57耳，开放型6耳。73%的患者年龄在15岁或以下。60.3%的患者主诉听力损失为主要症状。特别是开放型中耳炎，所有的病人都以听力损失为主诉，大多数病人的鼓膜正常。大多数中耳瘤位于鼓室后上部或周围。病变局限于鼓室26耳（41.3%），岩尖1耳（1.6%）。晚期中耳乳突瘤由鼓室向乳突窦延伸35耳（55.6%），多发性中耳乳突瘤1耳（1.6%）。在63耳中，8耳（12.7%）怀疑合并听小骨异常。开放型中耳炎6耳中有3耳（50.0%）出现上述异常。镫骨上部结构破坏占63.5%，以足板上小柱法最常用，其次为镫骨上小柱法和Wullstein Ⅰ型法。(C)2006年爱思唯尔公司All rights reserved.
We analyzed congenital cholesteatomas in 63 ears of 63 patients who were operated on over a 24-year period. We investigated the presenting symptoms, tympanic membrane findings, cholesteatoma morphology and location, associated anomalies of the ossicles, surgical methods, and outcome of treatment. The age of the patients ranged from 2 to 51 years (mean, 13.3 years), and the closed type of cholesteatoma and the open type were found in 57 ears and 6 ears, respectively. Seventy-three percent of the patients were 15 years or younger. Hearing loss was complained of as a presenting symptom by 60.3% of the patients. In particular, all the patients with the open type of cholesteatoma reported hearing loss as a chief complaint, and most of them had a normal tympanic membrane. Many of the cholesteatomas were located at or around the posterosuperior part of the tympanic cavity. The lesion was confined to the tympanic cavity in 26 (41.3%) ears and to the petrous apex in 1 (1.6%) ear. Advanced cholesteatoma that extended from the tympanic cavity into the mastoid antrum was seen in 35 (55.6%) ears, and multiple cholesteatoma was present in 1 (1.6%) ear. Associated anomalies of the ossicles were suspected in 8 (12.7%) of the 63 ears. Among patients with the open type of cholesteatoma, such anomalies were found in 3 (50.0%) of 6 ears. The super structure of the stapes was destroyed in 63.5% of the patients, so the columella on the foot plate method was most frequently used for ossiculoplasty, followed by the columella on the stapes method and the Wullstein type I method. (C) 2006 Elsevier Inc. All rights reserved.