Nishimura Y, Minatogawa T, Kumoi T
Department of Otorhinolaryngology, Hyogo College of Medicine, Nishinomiya, Japan.
Ann Plast Surg. 1989 Jul;23(1):74-80. doi: 10.1097/00000637-198907000-00012.
Five microtic and aural atretic ears associated with intractable retroauricular abscess unresponsive to conservative treatment are reported. The pathogenesis of this abscess is primary cholesteatoma called "cholesteatoma auris congenita of atretic ear," and these lesions can be clearly explained by the embryological development of the external auditory meatus. Microtic ears with such lesions invariably have part of the cartilaginous canal patent but have an atrophic bony canal. Therefore, grade 3 microtia has never been affected theoretically. We also discuss the relationship between the retroauricular abscess and the development of the tympanic bone. The evaluation of this lesion with computed tomography is mandatory for the detection of an occult congenital cholesteatoma behind the atretic canal, and regular follow-up of the patients with microtia and aural atresia is necessary for plastic surgeons.
报告了5例小耳畸形合并耳道闭锁且伴有难治性耳后脓肿，保守治疗无效的病例。这种脓肿的发病机制是原发性胆脂瘤，称为“闭锁耳先天性胆脂瘤性耳”，这些病变可以通过外耳道的胚胎发育得到清晰解释。伴有此类病变的小耳畸形总是有部分软骨性耳道通畅，但骨性耳道萎缩。因此，理论上3级小耳畸形从未受到影响。我们还讨论了耳后脓肿与鼓骨发育之间的关系。对于检测闭锁耳道后方隐匿性先天性胆脂瘤，计算机断层扫描对该病变的评估是必不可少的，对于整形外科医生而言，对小耳畸形和耳道闭锁患者进行定期随访是必要的。
