Wang Tianying, Li Yi, Li Ying, Wang Danni, Zhao Shouqin
Department of Otorhinolaryngology Head and Neck Surgery，Beijing Tongren Hospital，Capital Medical University，Beijing，100730，China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2022 May;36(5):372-375. doi: 10.13201/j.issn.2096-7993.2022.05.010.
To investigate the clinical features, diagnosis, and treatment experience of congenital stenosis of an external auditory canal with external auditory canal cholesteatoma. The clinical data of 152 patients（153 ears） with congenital external auditory canal stenosis complicated with external auditory canal cholesteatoma treated in the Department of Otorhinolaryngology Head and Neck Surgery of Beijing Tongren Hospital affiliated to Capital Medical University from January 2009 to December 2019 were analyzed retrospectively, including the age of onset, clinical manifestations, signs, audiology, high-resolution computed tomography（HRCT） of the temporal bone, mode of operation and so on. According to the preoperative imaging findings, intraoperative findings,and pathological results, 152 patients with congenital external auditory canal stenosis with external auditory canal cholesteatoma were treated with canaloplasty and tympanoplasty while clearing the cholesteatoma. All patients were followed up for 2-2.5 years, there was no recurrence of cholesteatoma, and the reconstructed external auditory canal was spacious. The hearing levels of 108 ears who underwent hearing reconstruction were significantly improved, and the average hearing threshold was reduced by 20-35 dB. The stenosis of the external auditory meatus is easy to be complicated with cholesteatoma of the external auditory canal,and the occurrence of cholesteatoma of the external auditory canal is directly related to the diameter of the external auditory canal meatus.But the time of occurrence of the cholesteatoma is not directly related to the diameter of the external auditory canal. Severe congenital stenosis of the external auditory canal with auricle deformity is easy to be missed and misdiagnosed due to retroauricular redness, swelling, and ulceration. For this kind of patient, cholesteatoma should be treated first, and then plastic surgery such as auricle reconstruction should be performed. Retroauricular incisions should be avoided to create conditions for auricle reconstruction in the future.
探讨先天性外耳道狭窄合并外耳道胆脂瘤的临床特点、诊断及治疗经验。回顾性分析2009年1月至2019年12月在首都医科大学附属北京同仁医院耳鼻咽喉头颈外科治疗的152例（153耳）先天性外耳道狭窄合并外耳道胆脂瘤患者的临床资料，包括发病年龄、临床表现、体征、听力学、颞骨高分辨率计算机断层扫描（HRCT）、手术方式等。根据术前影像学表现、术中所见及病理结果，对152例先天性外耳道狭窄合并外耳道胆脂瘤患者在清除胆脂瘤的同时行外耳道成形术及鼓室成形术。所有患者均随访2 - 2.5年，胆脂瘤无复发，重建后的外耳道宽敞。108例行听力重建的耳听力水平明显提高，平均听阈降低20 - 35 dB。外耳道狭窄易合并外耳道胆脂瘤，外耳道胆脂瘤的发生与外耳道道口直径直接相关，但胆脂瘤发生的时间与外耳道直径无直接关系。重度先天性外耳道狭窄合并耳廓畸形的患者，因耳后红肿、溃疡等易被漏诊和误诊。对于此类患者，应先治疗胆脂瘤，再行耳廓重建等整形手术。应避免耳后切口，为今后耳廓重建创造条件。
