Paradiso Michela M, Kaffenberger Benjamin H, Rock Alexander N, Dodson Edward E
Division of Dermatology, Department of Internal Medicine, 2647The Ohio State University Wexner Medical Center, Columbus OH, USA.
Division of Otolaryngology-Head and Neck Surgery, 2647The Ohio State University Wexner Medical Center, Columbus OH, USA.
Ear Nose Throat J. 2021 Jun;100(3_suppl):253S-258S. doi: 10.1177/0145561320947619. Epub 2020 Aug 17.
Otophyma is a rare condition that can result in conductive hearing loss. Current otophyma literature does not examine validated treatment outcomes for patients. Utilizing a medical and surgical approach to maintain a patent canal can lead to significant objective improvements. The aim of this case series is to describe a combined successful approach in 3 cases from an academic, multidisciplinary center. The main outcomes analyzed were pre and post air-bone gap audiogram analysis and disimpaction frequency. The results showed that post-management, patient 1 had substantial improvement in hearing, recovering 49 dB in his right ear and 25 dB in his left ear, demonstrating near complete air-bone gap closure. Patient 2 showed a similar dermatologic and functional improvement, although objective audiometric assessment related to otophyma could not be performed due to coexisting chronic otitis media and cholesteatoma. Patient 3, in the 12 months prior to comanagement, had 8 bilateral disimpactions, and following comanagement had 2 disimpactions in 23 months. All 3 patients were pleased with the resultant functional and physical appearance following comanagement. By presenting this approach and objective measures of treatment, we hope to improve future clinical decision-making in a rare condition.
耳部脂肪瘤是一种可导致传导性听力损失的罕见病症。目前关于耳部脂肪瘤的文献并未考察患者经过验证的治疗效果。采用药物和手术方法保持外耳道通畅可带来显著的客观改善。本病例系列的目的是描述一个来自学术性多学科中心的3例联合成功治疗方法。分析的主要结果是气骨导间距听力图分析的治疗前后情况以及清理耵聍的频率。结果显示，治疗后，患者1的听力有显著改善，右耳恢复了49分贝，左耳恢复了25分贝，气骨导间距几乎完全闭合。患者2在皮肤和功能方面有类似改善，不过由于同时存在慢性中耳炎和胆脂瘤，无法进行与耳部脂肪瘤相关的客观听力评估。患者3在联合治疗前的12个月内有8次双侧耵聍清理，联合治疗后在23个月内有2次耵聍清理。所有3例患者对联合治疗后的功能和外观效果都很满意。通过展示这种治疗方法和客观治疗指标，我们希望改善未来针对这种罕见病症的临床决策。
