Sheahan Patrick, Walsh Rory McConn
Department of Otolaryngology, Beaumont Hospital, Dublin 9, Ireland.
J Laryngol Otol. 2003 Jul;117(7):558-60. doi: 10.1258/002221503322113012.
Petrosal cholesteatomas are rare lesions, which may be congenital or acquired in nature. We report an exceptional case occurring in a seven-year old girl who presented with a unilateral conductive hearing loss, despite normal tympanic membrane appearance. Early diagnosis was facilitated by computed tomography (CT) scanning. Although this case satisfied the criteria for congenital cholesteatoma, it is likely that the petrous apex was secondarily involved. Complete cholesteatoma removal was accomplished using a transtemporal supralabyrinthine approach, which allowed for hearing preservation, while avoiding the morbidity associated with a craniotomy. The present case constitutes the youngest case of petrosal cholesteatoma reported. We suggest that a lower threshold for the use of CT scanning in unilateral conductive hearing loss may allow for the earlier detection of more cases of petrosal cholesteatomas, as well as facilitating their removal using more limited approaches associated with less morbidity.
岩部胆脂瘤是一种罕见的病变，其性质可能是先天性的或后天获得性的。我们报告了一例特殊病例，发生在一名7岁女孩身上，她表现为单侧传导性听力损失，尽管鼓膜外观正常。计算机断层扫描（CT）有助于早期诊断。虽然该病例符合先天性胆脂瘤的标准，但岩尖很可能是继发受累。采用经颞上迷路入路完成了胆脂瘤的完全切除，该方法既能保留听力，又能避免开颅手术相关的并发症。本病例是报道的最年轻的岩部胆脂瘤病例。我们建议，对于单侧传导性听力损失，降低CT扫描的使用阈值可能有助于更早地发现更多岩部胆脂瘤病例，并便于采用与较低并发症相关的更有限的方法进行切除。
