Magliulo Giuseppe
G. Ferreri Department of Otorhinolaryngology, Audiology, and Phoniatrics, La Sapienza University of Rome, Rome, Italy.
Ann Otol Rhinol Laryngol. 2009 May;118(5):345-9. doi: 10.1177/000348940911800505.
I describe the clinical symptoms and signs of acquired atresia of the external auditory canal (EAC) and the technique used to manage it.
Forty-one consecutive patients affected by acquired atresia of the EAC were assessed by otoscopy, pure tone audiometry, computed tomography, and traditional and echo-planar diffusion-weighted magnetic resonance imaging. The anatomic and functional hearing results were evaluated.
At surgery for acquired atresia of the EAC, an EAC cholesteatoma was found in 3 of the 41 patients. Twenty-three of the 41 patients were followed for at least 5 years. Recurrence was seen in 9 of the 25 ears (36%) over the entire period of observation. Twenty-one, 23, and 22 of the patients had a normal or nearly normal contour and size of the ear canal at 6 months, 1 year, and 5 years, respectively. The results were similar for the air-bone gap.
The main complication following surgery was recurrence. There was recurrence at 6 months in 4 patients (16%). Recurrence was seen in 12% of the cases at the 5-year follow-up. Similar findings were clear on evaluation of the hearing results. This result demonstrates that the surgical procedure, even when performed correctly, did not afford a stable, long-lasting outcome in a cohort of patients.
我描述后天性外耳道闭锁(EAC)的临床症状和体征以及用于处理它的技术。
对41例连续性后天性外耳道闭锁患者进行耳镜检查、纯音听力测定、计算机断层扫描以及传统和回波平面扩散加权磁共振成像评估。评估解剖学和功能性听力结果。
在后天性外耳道闭锁手术中,41例患者中有3例发现外耳道胆脂瘤。41例患者中有23例至少随访了5年。在整个观察期内,25只耳朵中有9只(36%)出现复发。分别有21例、23例和22例患者在6个月、1年和5年时外耳道轮廓和大小正常或接近正常。气骨导间距结果相似。
手术后的主要并发症是复发。4例患者(16%)在6个月时出现复发。在5年随访中,12%的病例出现复发。在听力结果评估中也有类似的明显发现。这一结果表明,即使手术操作正确,在一组患者中也未能获得稳定、持久的结果。