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[外耳肿瘤的外科治疗]

[Surgical treatment of tumors of the external ear].

作者信息

Kotarba E

机构信息

Kliniki Otorinolaryngologicznej Akademii Medycznej w Krakowie.

出版信息

Przegl Dermatol. 1990 Jan-Feb;77(1):61-7.

PMID:2382017
Abstract

In the years 1974-1988 in the Department of Otorhinolaryngology Medical Academy in Cracow 60 patients were treated surgically for malignant tumours of the auricle. Their mean age was 61.9 years, males prevailed (82%). In 1 case the malignant lesion involved also the external auditory meatus and in 4 cases it spread to the skin near the auricle. Histological examinations demonstrated basal cell carcinoma in 22 cases (37%), spinocellular carcinoma in 31 cases (52%), basal-spinocellular carcinoma in 6 cases (10%) and malignant melanoma in 1 case. In 3 cases of spinocellular carcinoma metastases to lymph nodes were found. In 30 cases partial amputation of the auricle was done, in one of them recurrence developed after over 5 years. Advanced malignant lesions in 30 cases required extensive operation with removal of the lesion within margins of healthy tissue, removal of lymph nodes with metastases and one-step plastic operation. Recurrences developed in 2 cases. Hyperkeratotic foci near the malignant tumour were present in 64% of these patients. They made difficult preoperative qualification and required more extensive excision of the neoplasm. After tumour removal from the external meatus the resulting tissue defect must be filled with a skin graft since healing by granulation tissue development leads to obliteration of the meatus. Two out of 7 patients required additional interventions for maintenance of the patency of the meatus.

摘要

1974年至1988年期间,克拉科夫医学院耳鼻喉科对60例耳廓恶性肿瘤患者进行了手术治疗。他们的平均年龄为61.9岁,男性居多(82%)。1例恶性病变还累及外耳道,4例病变蔓延至耳廓附近皮肤。组织学检查显示,基底细胞癌22例(37%),棘细胞癌31例(52%),基底 - 棘细胞癌6例(10%),恶性黑色素瘤1例。3例棘细胞癌患者发现有淋巴结转移。30例行耳廓部分切除术,其中1例术后5年多复发。30例晚期恶性病变需要进行广泛手术,切除病变周围的健康组织,清除有转移的淋巴结并进行一期整形手术。2例复发。64%的患者在恶性肿瘤附近有角化过度病灶。这些病灶给术前评估带来困难,需要更广泛地切除肿瘤。从外耳道切除肿瘤后,产生的组织缺损必须用皮肤移植填充,因为通过肉芽组织生长愈合会导致外耳道闭塞。7例患者中有2例需要额外干预以维持外耳道通畅。

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