Belcadhi Malek, Chahed Houda, Mani Radhouane, Bouzouita Kamel
Department of Otolaryngology, University Hospital Farhat Hached, Sousse 4000, Tunisia.
Ear Nose Throat J. 2010 Aug;89(8):E1-6. doi: 10.1177/014556131008900801.
Spontaneous cholesteatoma of the external auditory canal (EAC) is an uncommon condition that is difficult to diagnose. In a patient with such a possibility, serious clinical investigation along with radiologic and histologic exploration should be performed early on because a delay in treatment can lead to severe complications. Given the rarity of EAC cholesteatoma, no therapeutic consensus has emerged. The type of management depends on the extensiveness of invasion and bone erosion and the status of the neighboring structures. The primary therapeutic objectives are to eradicate the cholesteatoma and then to fill in the residual cavity, which in our opinion can be best accomplished with a muscle flap and EAC reconstruction. Postoperative follow-up should be carried out to look for infections, stenosis, and recurrence. We report a new case of spontaneous EAC cholesteatoma, and we review its diagnostic and therapeutic challenges.
外耳道原发性胆脂瘤是一种罕见且难以诊断的疾病。对于存在这种可能性的患者，应尽早进行全面的临床检查以及影像学和组织学检查，因为治疗延迟可能导致严重并发症。鉴于外耳道胆脂瘤的罕见性，目前尚未形成治疗共识。治疗方式取决于病变侵犯范围、骨质侵蚀情况以及邻近结构的状态。主要治疗目标是彻底清除胆脂瘤，然后填充残留腔隙，我们认为采用肌瓣和外耳道重建术能最好地实现这一目标。术后应进行随访，观察有无感染、狭窄及复发情况。我们报告一例新的外耳道原发性胆脂瘤病例，并对其诊断和治疗挑战进行综述。
