Su Zhenfu, Wu Wenming, Pan Jiaju
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2013 Feb;27(4):221-2.
The patient, a 52 year old male was admitted to the hospital, because of right hearing loss before three months. Six months ago; the patient had the right former group sinusitis and nasal polyps, and had the right former group sinus open and polypectomy operation outside the hospital. The surgery was uneventful and the postoperative dressing was done. He has no history of tinnitus, earache, ear pus, epistaxis, headache, dizziness. Physical examination on admission shows the right external auditory canal was clean, tympanic membrane integrity, pale yellow, mild depression, and poorly eardrum movement. The electronic nasopharyngoscopy show a black mass in the edge of the anterior lip of the right eustachian tube. The mass has a smooth surface, and only seen partly. Nasopharynx magnetic resonance shows in the right pharyngeal orifice visible there was a round short T2 node, maximum diameter of 13 mm, the border was clear. The parapharyngeal space had been compressed which close to the right eustachian tube torus. After the scan enhanced, the lesions was strengthened. The pure tone audiometry shows right mild conduction deafness, and the acoustic impedance showing right type B tympanogram curve. Eardrum puncture extracted got about 0.2 ml yellow liquid. Otitis media with effusion is considered. A biopsy is taken by means of the nasal endoscopic. The pathology report is the right eustachian orifice malignant melanoma. The immunohistochemical examination (Horton-Magath-Brown 45) showed a positive reaction.
患者为一名52岁男性，因三个月前出现右耳听力丧失入院。六个月前，患者患有右侧前组鼻窦炎和鼻息肉，并在院外行右侧前组鼻窦开放及息肉切除术。手术过程顺利，术后进行了换药。他无耳鸣、耳痛、耳流脓、鼻出血、头痛、头晕病史。入院体格检查显示右外耳道清洁，鼓膜完整，呈淡黄色，轻度内陷，鼓膜活动度差。电子鼻咽镜检查显示右侧咽鼓管前唇边缘有一黑色肿物。肿物表面光滑，仅见部分。鼻咽磁共振成像显示右侧咽口可见一圆形短T2结节，最大直径13mm，边界清晰。咽旁间隙受压，靠近右侧咽鼓管圆枕。扫描增强后，病变强化。纯音听力测试显示右耳轻度传导性耳聋，声阻抗显示右耳B型鼓室导抗图曲线。鼓膜穿刺抽出约0.2ml黄色液体。考虑为中耳积液。通过鼻内镜进行活检。病理报告为右侧咽鼓管口恶性黑色素瘤。免疫组化检查（霍顿-马加思-布朗45）显示阳性反应。
