Amraoui Oussama, Belhaj Najwa, Nitassi Sophia, Oujilal Abdelilah, Essakalli Leila
Department of Otolaryngology, Head and Neck Surgery, Ibn Sina University Hospital, University Mohamed 5, Sect 9, Bloc B N° 16, Hay Riad, Rabat, Morocco.
Indian J Otolaryngol Head Neck Surg. 2022 Dec;74(Suppl 3):4306-4313. doi: 10.1007/s12070-021-02972-4. Epub 2021 Nov 13.
External auditory canal Carcinomas are rare and aggressive tumors and their prognosis depends on early diagnosis. Their clinical similarity to necrotizing otitis is a source of error and therefore of diagnostic delay. Hence the interest of our study which consists in providing ENT specialists and all practitioners with the necessary clinical, evolutionary, radiological, biological and histological elements to avoid diagnostic errors. This is a retrospective study of all patients who were hospitalized for necrotizing otitis in the department of otolaryngology of the hospital of specialties of Rabat spread over a period of 5 years. All patients received an admission CT scan, biological tests, bacteriological sampling and biopsy. As well as initial parenteral antibiotic therapy and surgery for incidentally discovered EAC carcinomas. Clinically, all patients had otalgia and granulation tissue on otoscopic examination under the microscope. 50% had otorrhea. Pseudomonas aeruginosa was isolated in 50% of the cases, staphylococcus aureus in 25% and sterile culture in 25%. From the first biopsy, the diagnosis of tumor was retained in 6/10 patients. A second biopsy was performed in patients who did not show improvement and had a sterile culture. This one allowed the diagnosis in 4 other patients. All our patients had a surgical indication and were operated and then irradiated. The survival at 5 years was 50%. Biopsy must be systematic for every patient hospitalize for necrotizing otitis. Without hesitating to do it again each time the evolution is not good and the culture is sterile.
外耳道癌是罕见的侵袭性肿瘤，其预后取决于早期诊断。它们在临床上与坏死性外耳道炎相似，这是误诊的根源，因此会导致诊断延迟。因此，我们的研究很有意义，旨在为耳鼻喉科专家和所有从业者提供必要的临床、病情发展、放射学、生物学和组织学依据，以避免诊断错误。这是一项对拉巴特专科医院耳鼻喉科5年内收治的所有坏死性外耳道炎患者的回顾性研究。所有患者均接受了入院时的CT扫描、生物学检查、细菌学采样和活检。以及初始的肠外抗生素治疗和对偶然发现的外耳道癌进行手术。临床上，所有患者均有耳痛，耳镜检查显微镜下可见肉芽组织。50%的患者有耳漏。50%的病例分离出铜绿假单胞菌，25%分离出金黄色葡萄球菌，25%为无菌培养。首次活检后，10例患者中有6例确诊为肿瘤。对病情无改善且培养为无菌的患者进行了第二次活检。这又使另外4例患者得以确诊。我们所有的患者都有手术指征，均接受了手术，然后进行了放疗。5年生存率为50%。对于每一位因坏死性外耳道炎住院的患者，活检都必须系统进行。每次病情发展不佳且培养为无菌时，都要毫不犹豫地再次进行活检。
