Kim Woo Jin, Lee Yeo Myeong, Kim Do Hun, Choe Sihong, Lee Donghoo, Park Sung Yool, Kang MiSeon, Cho Hwa Jin, Heo Kyung Wook
Department of Otorhinolaryngology-Head &Neck Surgery, Inje University Busan Paik Hospital, Busan, South Korea.
Department of Pathology, Inje University Busan Paik Hospital, Busan, South Korea.
Int J Pediatr Otorhinolaryngol. 2019 Jan;116:199-203. doi: 10.1016/j.ijporl.2018.11.006. Epub 2018 Nov 9.
Recurrence rates following preauricular sinus (PAS) surgery vary. Few studies have investigated recurrence after primary PAS surgery in histopathological terms. We performed a histopathological analysis of the causes of revision surgery for PAS, with a view to reducing the recurrence rate after primary surgery.
We reviewed the medical records of patients who underwent revision surgery after primary excision of a PAS between 2002 and 2017. A pathologist reviewed the histopathology slides.
In total, 24 patients underwent revision surgery; of those, histopathology slides were available for 18 patients (19 revisions). The mean interval between primary and revision surgery was 50.4 months. We detected lumen with stratified squamous epithelium in 14 of the 19 (73.7%) revisions. Cartilage tissue was attached to the epithelial lining of the lumen in 14 of the 17 (82.4%) slides containing lumen. Inflammatory changes were found in all slides, and granulation tissue was detected in 10 of 19 revision surgery slides.
To prevent PAS recurrence after primary surgery, we recommend a wide local excision including the inflammatory soft tissue, with concomitant partial removal of the cartilage of the ascending helix adjacent to the PAS.
耳前窦道（PAS）手术后的复发率各不相同。很少有研究从组织病理学角度调查初次PAS手术后的复发情况。我们对PAS修复手术的原因进行了组织病理学分析，以期降低初次手术后的复发率。
我们回顾了2002年至2017年间接受初次PAS切除术后进行修复手术的患者的病历。一名病理学家对组织病理学切片进行了检查。
共有24例患者接受了修复手术；其中，18例患者（19次修复）有组织病理学切片。初次手术与修复手术之间的平均间隔时间为50.4个月。在19次修复中的14次（73.7%）中，我们检测到有分层鳞状上皮的管腔。在17张含有管腔的切片中的14张（82.4%）中，软骨组织附着于管腔的上皮内衬。在所有切片中均发现炎症变化，在19次修复手术切片中的10次中检测到肉芽组织。
为防止初次手术后PAS复发，我们建议进行广泛的局部切除，包括炎性软组织，并同时部分切除与PAS相邻的耳轮上升部的软骨。
