Li Lihua, Ren Jihao
Department of Otolaryngology, Head and Neck Surgery, The Second Xiangya Hospital, Central South University, 139 Renmin Road, Changsha, Hunan, China.
Auris Nasus Larynx. 2012 Oct;39(5):534-6. doi: 10.1016/j.anl.2011.11.001. Epub 2011 Nov 23.
We report the case of a 32-year-old Chinese woman who presented with a large cholesteatoma in her right upper neck after a history of ipsilateral chronic otitis media since childhood. Intraoperatively, a cholesteatoma was found in the mastoid cavity, and the mass in her neck was attached to the mastoid cortex by a stalk. Direct erosion of the mastoid tip may have led the cholesteatoma epidermis to enter the deep surface of the sternocleidomastoid muscle, allowing debris accumulation to form the mass, similar to the propagation of pus in a Bezold's abscess. Neck cholesteatoma secondary to aural cholesteatoma is fairly rare. Only five reports were identified before 1989 followed by no reports in the past 20 years. The case we reported is a reminder to otolaryngologists that this unusual condition still occurs.
我们报告了一例32岁的中国女性病例，该患者自幼患有同侧慢性中耳炎，此次因右上颈部出现巨大胆脂瘤前来就诊。术中发现乳突腔内有胆脂瘤，颈部肿物通过蒂与乳突皮质相连。乳突尖的直接侵蚀可能导致胆脂瘤表皮进入胸锁乳突肌深层表面，使碎屑积聚形成肿物，类似于贝佐尔德脓肿中脓液的扩散。耳源性胆脂瘤继发颈部胆脂瘤相当罕见。1989年之前仅发现5例报告，在过去20年中则无相关报告。我们报告的该病例提醒耳鼻喉科医生，这种罕见情况仍会发生。
