Matsuzawa Shingo, Iino Yukiko, Yamamoto Daiki, Hasegawa Masayo, Hara Mariko, Shinnabe Akihiro, Kanazawa Hiromi, Yoshida Naohiro
Department of Otolaryngology, Saitama Citizens Medical Center, Saitama-shi, Nishi-ku, Shimane 299-1, Saitama, Japan; Department of Otolaryngology, Jichi Medical University, Saitama Medical Center, Saitama-shi, Omiya-ku, Amanuma-cho 1-847, Saitama, Japan.
Department of Otolaryngology, Tokyo-Kita Medical Center, Kita-ku, Akabanedai 4-17-56, Tokyo, Japan; Department of Otolaryngology, Jichi Medical University, Saitama Medical Center, Saitama-shi, Omiya-ku, Amanuma-cho 1-847, Saitama, Japan.
Auris Nasus Larynx. 2017 Dec;44(6):766-770. doi: 10.1016/j.anl.2016.11.014. Epub 2016 Dec 29.
We report three patients with pars flaccida-type cholesteatoma (attic cholesteatoma) with closure of the entrance to the cholesteatoma at the time of surgery. These patients were diagnosed with attic cholesteatoma requiring surgery on the basis of abnormal findings of the pars flaccida, audiometry, and temporal bone computed tomography during the clinical course. Intraoperatively, cholesteatoma matrix and granulation tissue were observed behind the intact pars flaccida epithelium, which suggested that the entrance had apparently closed and the continuity with the cholesteatoma matrix disappeared after resolution of inflammation at the pars flaccida. In such patients, a normal pars flaccida may cause cholesteatoma to be initially overlooked, or misdiagnosed as congenital cholesteatoma. The diagnosis should be carefully made on the basis of the clinical course and the results of various examinations.
我们报告了3例松弛部胆脂瘤（上鼓室胆脂瘤）患者，手术时胆脂瘤入口已闭合。这些患者在临床过程中，根据松弛部的异常表现、听力测定以及颞骨计算机断层扫描结果，被诊断为需要手术治疗的上鼓室胆脂瘤。术中，在完整的松弛部上皮后方观察到胆脂瘤基质和肉芽组织，这表明入口明显已经闭合，并且在松弛部炎症消退后，与胆脂瘤基质的连续性消失。在这类患者中，正常的松弛部可能会导致胆脂瘤最初被忽视，或被误诊为先天性胆脂瘤。应根据临床过程和各项检查结果仔细做出诊断。
