Tanrivermis Sayit Asli, Saglam Dilek, Gunbey Hediye Pinar, Tastan Mustafa, Celenk Cetin
Department of Radiology, Ondokuz Mayis University Faculty of Medicine, 55139, Atakum, Samsun, Turkey.
Department of Otorhinolaryngology, Ondokuz Mayis University Faculty of Medicine, Atakum, Samsun, Turkey.
Eur Arch Otorhinolaryngol. 2017 Nov;274(11):3959-3964. doi: 10.1007/s00405-017-4721-6. Epub 2017 Aug 21.
Cholesteatoma is a benign epithelial lesion affecting the middle ear and/or mastoid process, causing otorrhea and hearing loss. Here, we retrospectively evaluated the temporal multidetector computed tomography and audiological findings of acquired cholesteatoma in children. Forty-three patients younger than 18 years old with middle ear acquired cholesteatoma were evaluated with regard to their clinical symptoms, temporal multidetector computed tomography findings, and audiometry results. The multidetector computed tomography findings were classified according to the site-ossicle-complication classification, and the relationships between the clinical, radiological, and audiological findings were evaluated. Only one patient had pars tensa cholesteatoma, and the remaining had attic cholesteatoma. The most common site-ossicles-complication classifications were S4 (acquired cholesteatoma involving four sites), O1 (involving one ossicle), and C0 (no complications), and the most common complaint was hearing loss, followed by otorrhea. There were no statistically significant relationships between the site of involvement and ossicle involvement. In addition, there were no statistically significant differences according to the S classification in either the air conduction or air-bone-gap levels; however, these levels differed statistically significantly with increasing ossicle involvement. Early diagnosis and treatment are essential to prevent hearing loss and serious complications in cases of acquired cholesteatoma. Therefore, it is important to evaluate the temporal multidetector computed tomography and audiological findings to accurately diagnose acquired cholesteatoma in children.
胆脂瘤是一种影响中耳和/或乳突的良性上皮病变，可导致耳漏和听力损失。在此，我们回顾性评估了儿童获得性胆脂瘤的颞部多排螺旋计算机断层扫描（CT）及听力学检查结果。对43例18岁以下患有中耳获得性胆脂瘤的患者的临床症状、颞部多排螺旋CT检查结果及听力测定结果进行了评估。根据病变部位-听小骨-并发症分类法对多排螺旋CT检查结果进行分类，并评估临床、影像学及听力学检查结果之间的关系。仅1例患者为紧张部胆脂瘤，其余均为上鼓室胆脂瘤。最常见的病变部位-听小骨-并发症分类为S4（累及四个部位的获得性胆脂瘤）、O1（累及一块听小骨）和C0（无并发症），最常见的主诉是听力损失，其次是耳漏。病变部位与听小骨受累之间无统计学显著相关性。此外，根据S分类，气导或气骨导差水平均无统计学显著差异；然而，随着听小骨受累数量增加，这些水平有统计学显著差异。早期诊断和治疗对于预防获得性胆脂瘤病例中的听力损失及严重并发症至关重要。因此，评估颞部多排螺旋CT及听力学检查结果对于准确诊断儿童获得性胆脂瘤很重要。
