Peng Z, Wang Z X, Xie J, Wang L E, Liu Y, Gong S S
Department of Otorhinolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijng 100050, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2018 Feb 7;53(2):81-85. doi: 10.3760/cma.j.issn.1673-0860.2018.02.001.
To summarize the clinical characteristics and therapeutic experiences of the middle ear teratoma in infants. Three cases of middle ear teratoma, from 2012-2015 in Beijing Friendship Hospital were analyzed. The three cases all developed slowly and presented unilateral otorrhea and hearing loss. Otoscopy showed the granulation tissue in the external ear canal. Audiological changes varied according to the degree of severity. Imaging features showed the pocket-like occupancy lesions in the Eustachian tube area. The temporal bone CT showed mass with soft tissue density usually involved in the mastoid and tympanic cavity. MRI showed mixed signal intense on both T1 and T2 weighted imaging. All the three cases received neoplasm resection of the middle ear. Only one case received tympanoplasty surgery at the same time. And all the pathology results displayed mature teratoma. The follow-up time was 17 to 54 months. MRI showed complete removal of the tumor. Teratoma are rare in the head and neck neoplasm. When the infants suffer from the unilateral otorrhea, hearing loss, and granulation tissue formed in the external ear canal, it should be vigilant for teratoma. The differential diagnosis is middle ear cholesteatoma, congenital first branchial cyst or fistula, and middle ear carcinoma. Temporal bone CT combined with MRI could improve the accuracy of diagnosis. It should be totally resection as soon as possible if there is no contraindication. Postoperative follow-up and imaging examination are necessary to eliminate tumor recurrence.
总结婴儿中耳畸胎瘤的临床特征及治疗经验。分析了2012年至2015年在北京友谊医院收治的3例中耳畸胎瘤病例。3例均病情发展缓慢,表现为单侧耳漏及听力下降。耳镜检查可见外耳道肉芽组织。听力学改变依严重程度而异。影像学特征显示咽鼓管区呈袋状占位性病变。颞骨CT显示软组织密度肿块,通常累及乳突和鼓室。MRI在T1加权像和T2加权像上均显示混合信号强度。3例均接受了中耳肿瘤切除术。仅1例同时行鼓室成形术。所有病理结果均显示为成熟畸胎瘤。随访时间为17至54个月。MRI显示肿瘤完全切除。畸胎瘤在头颈部肿瘤中罕见。当婴儿出现单侧耳漏、听力下降及外耳道肉芽组织形成时,应警惕畸胎瘤。鉴别诊断包括中耳胆脂瘤、先天性第一鳃裂囊肿或瘘管以及中耳癌。颞骨CT联合MRI可提高诊断准确性。若无禁忌证,应尽早彻底切除。术后随访及影像学检查对排除肿瘤复发很有必要。