Jang Chul Ho, Kim Young Yoon, Seong Jong Yuap, Kang Sung Hoon, Jung Eun Kyung, Sung Chung Man, Kim Seung Beom, Cho Yong Beom
Department of Otolaryngology, Chonnam National University Medical School, Gwangju, South Korea.
Department of Otolaryngology, Chonnam National University Medical School, Gwangju, South Korea.
Int J Pediatr Otorhinolaryngol. 2016 Aug;87:5-10. doi: 10.1016/j.ijporl.2016.05.029. Epub 2016 May 20.
BACKGROUND & OBJECTIVE: External auditory canal cholesteatoma (EACC) is caused by an invasion of squamous tissue into a localized area of periosteitis in the bony canal wall. The clinical characteristics of pediatric EACC are still unknown because of its rare occurrence. To date, only a single paper has reported that pediatric EACC has a less aggressive growth pattern compared to adult EACC. Further studies are required to understand the clinical behavior of EACC, i.e., its aggressiveness. The purpose of this study was to evaluate the clinical characteristics of pediatric EACC.
The clinical records of all patients diagnosed with EACC in our department from January 1, 2012 to February 29, 2016 were retrospectively reviewed, focusing on the extension of bone erosion, symptoms, and clinical findings.
Seven patients had primary pediatric EACC (age range, 5-17 years). All patients showed unilateral EACC. Otalgia and intermittent otorrhea were common symptoms. Bacterial cultures were performed for four patients with otorrhea, which was controlled by diluted vinegar irrigation with a topical antibiotic solution. The most common bone destruction sites were the inferior and posterior walls. All patients required surgical treatment. Four patients (patient nos. 1, 3, 4, and 5) were treated via a postauricular transcanal approach. Three patients (patient nos. 2, 6, and 7) required mastoidectomy.
Pediatric EACC is not less aggressive than adult EACC. Therefore, early diagnosis and adequate treatment are necessary. Further studies are required to elucidate the clinical features of pediatric spontaneous EACC.
外耳道胆脂瘤(EACC)是由鳞状组织侵入骨管壁局限性骨膜炎区域所致。小儿EACC的临床特征因其罕见性仍不为人知。迄今为止,仅有一篇论文报道小儿EACC与成人EACC相比生长方式侵袭性较小。需要进一步研究以了解EACC的临床行为,即其侵袭性。本研究的目的是评估小儿EACC的临床特征。
回顾性分析2012年1月1日至2016年2月29日在我科诊断为EACC的所有患者的临床记录,重点关注骨质侵蚀范围、症状和临床检查结果。
7例患者患有原发性小儿EACC(年龄范围5 - 17岁)。所有患者均为单侧EACC。耳痛和间歇性耳漏是常见症状。对4例有耳漏的患者进行了细菌培养,通过用局部抗生素溶液稀释醋冲洗来控制耳漏。最常见的骨质破坏部位是下壁和后壁。所有患者均需手术治疗。4例患者(病例编号1、3、4和5)通过耳后经耳道入路治疗。3例患者(病例编号2、6和7)需要进行乳突切除术。
小儿EACC的侵袭性并不比成人EACC小。因此,早期诊断和适当治疗是必要的。需要进一步研究以阐明小儿自发性EACC的临床特征。