经耳道内镜切除外耳道骨瘤。
Endoscopic transcanal removal of external auditory canal osteomas.
机构信息
Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; Communication Enhancement Center, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
出版信息
Biomed J. 2021 Aug;44(4):489-494. doi: 10.1016/j.bj.2020.04.003. Epub 2020 Apr 21.
BACKGROUND
External auditory canal (EAC) osteomas are rare, slow-growing benign neoplasms. Microscopic surgical excision had been reported for symptomatic osteomas. However, there was no study published on the feasibility of transcanal endoscopic ear surgery (TEES) for EAC osteoma. In this study, we propose two methods of TEES for symptomatic EAC osteomas and report the surgical outcomes of our patients.
METHODS
Fifteen patients diagnosed with symptomatic EAC osteoma who underwent TEES were recruited at two otolaryngology referral centers. The extent of osteoma and degree of EAC stenosis was calculated based on high-resolution computed tomography (HRCT) imaging. We divided all the patients into two groups, solitary pedunculated osteoma or broad-based osteomas. The postoperative outcomes and complications were recorded for at least 6 months of outpatient follow-up.
RESULTS
In this study, twelve patients with solitary osteoma underwent the first method, a direct transcanal removal procedure. In this approach, only a small bare bony area remained postoperatively, and it healed completely within 1 month. Three patients with broad based osteoma underwent the second method, a transcanal approach involving a skin flap. The degree of stenosis in all patients ranged from 29% to 90%. All of them could be treated completely through a transcanal endoscopic approach. No intraoperative or postoperative complications were noted during follow-up, and no canal stenosis and no recurrences were noted during at least 6 months of follow-up.
CONCLUSIONS
This endoscopic transcanal approach to EAC osteomas demonstrated good results for lesion removal without recurrence or intraoperative complications.
背景
外耳道（EAC）骨瘤是罕见的、生长缓慢的良性肿瘤。有报道称，对于有症状的骨瘤，可采用显微镜下外科切除。然而，目前尚无关于经耳道内镜耳部手术（TEES）治疗 EAC 骨瘤可行性的研究。本研究中，我们提出了两种治疗有症状 EAC 骨瘤的 TEES 方法，并报告了我们患者的手术结果。
方法
在两个耳鼻喉科转诊中心共招募了 15 名诊断为有症状 EAC 骨瘤并接受 TEES 的患者。根据高分辨率计算机断层扫描（HRCT）成像，计算骨瘤的范围和 EAC 狭窄的程度。我们将所有患者分为两组，孤立性有蒂骨瘤或宽基底骨瘤。记录至少 6 个月门诊随访的术后结果和并发症。
结果
在这项研究中，12 名孤立性骨瘤患者采用了第一种方法，即直接经耳道切除术。在这种方法中，术后仅留下一小块裸露的骨区，并且在 1 个月内完全愈合。3 名宽基骨瘤患者采用了第二种方法，即经耳道皮瓣入路。所有患者的狭窄程度均为 29%至 90%。所有患者均可通过经耳道内镜入路完全治疗。在随访期间，未出现术中或术后并发症，至少 6 个月的随访期间未出现狭窄和复发。
结论
本研究中，经耳道内镜治疗 EAC 骨瘤，在不复发和无术中并发症的情况下，可获得良好的病灶切除效果。
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