Hwang Joshua C, Dedhia Raj D, Bernard Joan E, Steele Toby O
Department of Otolaryngology-Head and Neck Surgery, University of California, Davis, Sacramento, California.
Department of Otolaryngology, University of Tennessee Health Science Center, Memphis, Tennessee.
Allergy Rhinol (Providence). 2020 Sep 6;11:2152656720956594. doi: 10.1177/2152656720956594. eCollection 2020 Jan-Dec.
Nasopharyngeal oncocytic lesions are a spectrum of benign lesions that represent a reactive or hyperplastic response to chronic inflammation. Though oncocytic lesions are typically asymptomatic, unilateral, and benign, this article discusses a rare case of large, bilateral oncocytic cysts and downstream otologic sequelae with a focus on identifying and discussing similar disease processes.
Case report and literature review. A 67-year-old patient with 57 pack year smoking history presented for one year of left sided hearing loss and aural fullness. Clinic endoscopic exam demonstrated severe inflammatory and cystic changes lining the bilateral tori. Imaging and tissue sampling confirmed the cause was minor salivary gland cysts with papillary projections lined by oncocytic cells within bilateral tori tubarius. He was successfully treated with myringotomy with pressure equalizing tube, counseling on tobacco cessation, and surveillance with serial nasopharyngoscopy.
Chronic eustachian tube dysfunction is a possible rare presentation and sequelae of large oncocytic cysts of the nasopharynx. Oncocytic cysts should be considered on the differential diagnosis for nasopharyngeal masses causing such dysfunction.
鼻咽嗜酸性细胞病变是一系列良性病变，代表对慢性炎症的反应性或增生性反应。尽管嗜酸性细胞病变通常无症状、单侧且为良性，但本文讨论了一例罕见的双侧巨大嗜酸性细胞囊肿及下游耳科后遗症病例，重点在于识别和讨论类似的疾病过程。
病例报告及文献综述。一名有57年吸烟史、67岁的患者因左侧听力损失和耳闷前来就诊，病史长达一年。临床内镜检查显示双侧咽鼓管圆枕有严重的炎症和囊性改变。影像学检查和组织取样证实病因是双侧咽鼓管圆枕内有小涎腺囊肿，囊肿有乳头状突起，内衬嗜酸性细胞。患者通过鼓膜切开置管术、戒烟咨询及定期鼻咽镜监测得到成功治疗。
慢性咽鼓管功能障碍可能是鼻咽部巨大嗜酸性细胞囊肿罕见的表现及后遗症。对于导致此类功能障碍的鼻咽部肿物，嗜酸性细胞囊肿应列入鉴别诊断。
