Department of Otorhinolaryngology, Affiliated Yiwu Hospital of Wenzhou Medical University, Yiwu Central Hospital, Yiwu city, China.
J Laryngol Otol. 2021 Apr;135(4):332-335. doi: 10.1017/S0022215121000827. Epub 2021 Mar 24.
This study aimed to evaluate the clinical features and outcomes of patients with middle-ear granulation pathologies associated with attic retractions.
The clinical records of adult patients with middle-ear granulation pathologies and attic retractions confirmed via computed tomography and surgical exploration between January 2012 and January 2019 were retrospectively reviewed.
A total of 59 patients were included. Endoscopic examination showed a normal pars tensa but retraction of the pars flaccida in all patients. No granulation tissue or debris were observed. Low-pitched tinnitus was the principal complaint of 55 patients (100 per cent), followed by ear fullness (14 patients, 23.7 per cent). Of the 59 patients, 52 patients (88.1 per cent) underwent canal wall up mastoidectomy and 7 patients (11.9 per cent) underwent endoscopic endaural atticoantrotomy. No ossicular chain destruction was evident. All patients were followed up for 12 months. Tinnitus disappeared completely in 48 patients (81.4 per cent), improved significantly in 9 patients (15.3 per cent) and improved mildly in 2 patients (3.3 per cent).
A granulation tissue pathology should be considered when a patient complains of low-pitched tinnitus and exhibits retraction of the pars flaccida. Computed tomography and surgical exploration should be scheduled.
本研究旨在评估与鼓室后上隐窝回缩相关的中耳肉芽病变患者的临床特征和结局。
回顾性分析了 2012 年 1 月至 2019 年 1 月期间经计算机断层扫描和手术探查证实患有中耳肉芽病变和鼓室后上隐窝回缩的成年患者的临床记录。
共纳入 59 例患者。所有患者的内镜检查均显示鼓膜紧张部正常，但鼓膜松弛部回缩。未见肉芽组织或碎屑。55 例患者（100%）主要诉低调耳鸣，其次是耳闷（14 例，23.7%）。59 例患者中，52 例（88.1%）行完壁式乳突切开术，7 例（11.9%）行内镜耳前鼓室切开术。均未见听骨链破坏。所有患者均随访 12 个月。48 例（81.4%）患者耳鸣完全消失，9 例（15.3%）患者耳鸣显著改善，2 例（3.3%）患者耳鸣轻度改善。
当患者主诉低调耳鸣并表现为鼓膜松弛部回缩时，应考虑存在肉芽组织病变。应安排计算机断层扫描和手术探查。
