Wang Xiaoqian, Wu Peina, Huang Hongming, Fu Min, Ge Runmei
Department of Otorhinolaryngology, Guangdong General Hospital and Guangdong Academy of Medical Science, Guangzhou 510080, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2016 May;51(5):343-7. doi: 10.3760/cma.j.issn.1673-0860.2016.05.006.
To investigate the clinical and imaging characteristics of chronic otitis media with intact tympanic membrane.
Ten patients were retrospective studied in the department of otorhinolaryngology of Guangdong general hospital from December 2006 to January 2015. The clinical characteristics of their manifestations, audiology and imaging examinations were analyzed.
All the cases could be divided into two groups: the intracranial complication group who was primarily diagnosed as intracranial complications, and the hearing loss group who primarily complained of hearing loss. Five cases belonged to the first group, which include 1 cerebellar abscess, 3 meningitis and 1 meningoencephalitis, 2 of them were profound hearing loss, 2 were mixed hearing loss, and 1 was normal hearing. The other 5 cases belonged to the hearing loss group, 3 were mixed deafness, 2 were conductive deafness. All the case showed positive high-resolution computed tomography (HRCT) features. In the first group, four cases showed the soft tissue shadow in tympanic antrum/superior tympanic pouch and 1 case showed a wide damage of skull base, in addition to intracranial complications. In the second group, five cases showed soft tissue imaging in tympanic antrum/superior tympanic pouch. Pathology showed that 2 cases were cholesterol granuloma(one was in the first group and the other was in the second group), 4 were intracranial inflammatory(the first group) and 4 were cholesteatoma(the seond group).
In chronic otitis media with intact tympanic membrane, intracranial complications may be the primarily diagnosis, which should be paid much attention by multidisciplinary team. HRCT and audiology were valuable for early diagnosis.
探讨鼓膜完整型慢性中耳炎的临床及影像学特征。
回顾性分析2006年12月至2015年1月在广东省总医院耳鼻咽喉科就诊的10例患者。对其临床表现、听力学及影像学检查的临床特征进行分析。
所有病例可分为两组:以颅内并发症为主的颅内并发症组和以听力下降为主诉的听力损失组。第一组5例,包括1例小脑脓肿、3例脑膜炎和1例脑膜脑炎,其中2例为极重度听力损失,2例为混合性听力损失,1例听力正常。另外5例属于听力损失组,3例为混合性耳聋,2例为传导性耳聋。所有病例高分辨率计算机断层扫描(HRCT)均表现为阳性特征。第一组中,除颅内并发症外,4例鼓窦/上鼓室有软组织影,1例颅底广泛破坏。第二组中,5例鼓窦/上鼓室有软组织影像。病理显示,2例为胆固醇肉芽肿(1例在第一组,1例在第二组),4例为颅内炎症(第一组),4例为胆脂瘤(第二组)。
在鼓膜完整型慢性中耳炎中,颅内并发症可能是主要诊断,多学科团队应予以高度重视。HRCT和听力学检查对早期诊断有重要价值。