Bergeron M, Saliba I
Montreal University, Montreal, Quebec, Canada.
Int J Pediatr Otorhinolaryngol. 2011 Jul;75(7):976-9. doi: 10.1016/j.ijporl.2011.04.016. Epub 2011 May 24.
This case report highlights outcomes of a 6-year-old patient who preserved functional hearing after complete dissection of an extensive labyrinthine cholesteatoma causing two semicircular canals fistulas with endolymph leak, tympanic and labyrinthine fallopian canal erosion of the facial nerve and internal auditory canal invasion with cerebrospinal fluid leak. The patient preserved 40 dB average of bone conduction threshold and 92% of speech discrimination score at 26 months postoperatively. This article reveals that canal wall window mastoidectomy might be an option even in cases of extensive cholesteatomatous labyrinthine fistula therefore avoiding hearing loss and long life cleaning of a canal wall down mastoid cavity.
本病例报告重点介绍了一名6岁患者的治疗结果。该患者患有广泛的迷路胆脂瘤，在完全切除术后保留了功能性听力。该胆脂瘤导致两个半规管瘘并伴有内淋巴漏、面神经鼓室段和迷路段面神经管侵蚀以及脑脊液漏的内耳道侵犯。患者术后26个月时平均骨导阈值保留在40 dB，言语辨别得分保留了92%。本文表明，即使在广泛的胆脂瘤性迷路瘘的情况下，耳道壁开窗乳突切除术也可能是一种选择，从而避免听力损失以及对耳道壁下乳突腔进行长期清理。
