Zhang Xiao-tong, Sun Bin, Ling Ying, Zhang Yan, Zhang Qing, Kang An-jing, Xu Min
Department of Otorhinolaryngology Head and Neck Surgery, Xi'an Jiaotong University, Shaanxi 710004, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2010 Aug;45(8):640-4.
To study the clinical pathology and treatments on the pseudocyst of auricle.
Sixty cases of auricular pseudocyst were treated by surgery from 1993 to 2008 in our hospital. Their operation effects and the clinic pathological features were analyzed.
The clinic pathological data showed that the source of serous effusion of auricular pseudocyst origin from cartilage membrane in the top wall. In the early stage of the cyst, the top wall of auricular pseudocyst was the cartilage membrane. With the course progresses, the cartilage membrane in the top wall of auricular pseudocyst was proliferating, thickened and generated new cartilage. The new cartilage was formed from small piece to the big one, and eventually became an entire new cartilage on the top wall of auricular pseudocyst. Serous effusion at this time was terminated, and this cyst became intra-cartilaginous effusion of auricle. Finally the fluid between cartilages was absorbed and organized. In the cyst, the new cartilage and auricle cartilage were organized and adhered together each other. The auricle became thickened and deformed. The observation of capsule wall under light microscope showed that there were a few fibrous desmoplasia, anapetia and lymphocyte infiltrating in the fibrous tissue, as well as that there were cartilage cell layers from firmness to thicker. The cartilage cells and their lacunes were small, and the cartilage capsule and the basilaris substantia was showed as eosin. This data indicated that the cartilage was neogenesis but not degenerating. Sixty patients were followed up from 3 months to 1 year. The effect of surgical treatment for the auricular pseudocyst was satisfactory. There was no auricular deformation in these patients with the operation.
Auricular pseudocyst can be divided into the early period (acute exudative period), the medium period (cartilage formation period) and the late period (proliferative and organized period). The treatment should be based on the pathological findings of auricular pseudocyst. The operation is easy, safe and reliable. The key of the operation is the complete removal of perichondrium and cartilage at the top of auricular pseudocyst.
探讨耳廓假性囊肿的临床病理及治疗方法。
对1993年至2008年我院收治的60例耳廓假性囊肿患者行手术治疗，分析其手术效果及临床病理特征。
临床病理资料显示，耳廓假性囊肿的浆液性渗出源于囊肿顶壁的软骨膜。囊肿早期，耳廓假性囊肿顶壁为软骨膜。随着病程进展，耳廓假性囊肿顶壁的软骨膜增生、增厚并产生新的软骨。新软骨由小片状逐渐形成大片状，最终在耳廓假性囊肿顶壁形成完整的新软骨。此时浆液性渗出终止，囊肿变为耳廓软骨内积液。最后软骨间的液体被吸收并机化。囊肿内新形成的软骨与耳廓软骨相互机化粘连，耳廓增厚变形。光镜下观察囊壁，纤维组织中有少量纤维组织增生、无细胞区及淋巴细胞浸润，软骨细胞层由薄变厚。软骨细胞及其陷窝较小，软骨囊及基底实质呈嗜酸性。此资料表明软骨是新生而非退变。60例患者随访3个月至1年，耳廓假性囊肿手术治疗效果满意，术后患者无耳廓变形。
耳廓假性囊肿可分为早期（急性渗出期）、中期（软骨形成期）和晚期（增生机化期）。治疗应根据耳廓假性囊肿的病理表现进行。手术操作简便、安全可靠。手术关键是彻底切除耳廓假性囊肿顶部的软骨膜及软骨。
