Liu Hongyan, Zhang Yibo, Zhang Ting, Li Feitian, Dai Chunfu
Department of Otology and Skull Base Surgery, Eye, Ear, Nose, and Throat Hospital, Fudan University, Shanghai, People's Republic of China.
Key Laboratory of Hearing Medicine, Ministry of Health, Eye, Ear, Nose, and Throat Hospital, Fudan University, Shanghai, People's Republic of China.
Head Neck. 2017 Dec;39(12):2444-2449. doi: 10.1002/hed.24915. Epub 2017 Sep 30.
The purpose of this study was to analyze the correlation between the pathology and clinical presentations in patients with adenoid cystic carcinoma (ACC) of the external auditory canal.
Twenty-nine patients with ACC of the external auditory canal who underwent surgery were retrospectively reviewed.
Fifty percent of patients with solid pattern disease had recurrences, followed by those with cribriform (33%) and tubular (0%) pattern. Perineural invasion was common (55%), and occurred most frequently in the solid subtype (67%). The rate of otalgia was less in patients with perineural invasion (31% vs 46%). Most tumors (59%) involved the parotid gland, but it was not seen on preoperative MRI (35%).
The solid subtype presents the worst prognosis, and is prone to perineural invasion. Despite frequently occurring in ACC of the external auditory canal, perineural invasion may not be associated with otalgia. In ACC of the external auditory canal, high rates of occult parotid involvement support adjunctive superficial parotidectomy.
本研究旨在分析外耳道腺样囊性癌（ACC）患者的病理与临床表现之间的相关性。
回顾性分析29例行手术治疗的外耳道ACC患者。
实性型疾病患者的复发率为50%，其次是筛状型（33%）和管状型（0%）。神经周围侵犯很常见（55%），在实性亚型中最常发生（67%）。神经周围侵犯患者的耳痛发生率较低（31%对46%）。大多数肿瘤（59%）累及腮腺，但术前MRI未显示（35%）。
实性亚型预后最差，且易发生神经周围侵犯。尽管神经周围侵犯在外耳道ACC中经常发生，但可能与耳痛无关。在外耳道ACC中，隐匿性腮腺受累率高支持辅助性腮腺浅叶切除术。
