Subbotina M V, Kanya O V
Irkutsk State Medical University, Department of Otorhinolaryngology, Irkutsk, Russia.
Irkutsk Regional Pathologicanatomical Bureau, Irkutsk, Russia.
Vestn Otorinolaringol. 2020;85(2):49-52. doi: 10.17116/otorino20208502149.
Presented clinical observation of a 42-year-old patient with bilateral xanthoma of the temporal bone, who has been treated for a long time for bilateral external otitis media, repeatedly mastoiditis. In this case, hyperlipidemia was detected only after the diagnosis of xanthoma was established. In this case, histological and clinical data helped to diagnose xanthomas and exclude chronic otitis media: the preservation of the auditory ossicles and hearing despite a large destruction of the temporal bone; satisfactory condition of the patient for many years in the presence of volumetric formations in both temporal areas extending into the cranial cavity, spreaded from the brain substance and not accumulating contrast according to computer and magnetic resonance imaging; normalization of hearing against the background of prolonged heating of the body - 'melting' of fats and opening the ear canal. Fistulas, through which a yellowish secret stood out either in the external auditory canal or in the behind-the-ear area, served as a kind of 'whisper valve', which made it possible to stop the pain syndrome and did not lead to the development of cerebral symptoms.
介绍了一名42岁双侧颞骨黄瘤患者的临床观察情况，该患者长期治疗双侧外耳道炎、反复乳突炎。在此病例中，直到黄瘤诊断确立后才检测到高脂血症。在此病例中，组织学和临床数据有助于诊断黄瘤并排除慢性中耳炎：尽管颞骨有大面积破坏，但听小骨和听力得以保留；在两个颞区存在延伸至颅腔的肿块、从脑实质扩散且计算机断层扫描和磁共振成像显示不积聚造影剂的情况下，患者多年来状况良好；在身体长时间受热——脂肪“融化”并开放耳道的情况下听力恢复正常。瘘管在外耳道或耳后区域有淡黄色分泌物渗出，起到一种“低语瓣膜”的作用，能够止住疼痛综合征且未导致脑部症状的发展。
