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使用内镜和显微镜下耳部手术治疗儿童先天性中耳胆脂瘤:病例系列

Treatment of congenital middle ear cholesteatoma in children using endoscopic and microscopic ear surgeries: a case series.

作者信息

Xue Po, Wang Zhaoyan, Chai Yongchuan, Si Mingjue, Hu Lingxiang

机构信息

Department of Otolaryngology-Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

出版信息

Front Pediatr. 2024 May 24;12:1336183. doi: 10.3389/fped.2024.1336183. eCollection 2024.

Abstract

INTRODUCTION

Surgical removal is widely employed in children with congenital middle ear cholesteatoma (CMEC). Here, we report the surgical outcomes of CMEC removal via endoscopic ear surgery (EES) and microscopic ear surgery (MES) in children.

METHODS

Children with CMEC who underwent preoperative medical history inquiry, hearing test, endoscopic evaluation, and radiology imaging before receiving EES or MES were included. Postoperative audiological outcomes and recurrence rates were collected.

RESULTS

Seventeen children (20 ears) with stage II-IV CMEC were included. Of those, 11 ears (55.0%) underwent EES, and 9 ears (45.0%) underwent MES. The follow-up time was 35 ± 13.5 months. One child in the EES group with stage III CMEC had a recurrence during the follow-up period. In the EES group, the average minimum diameter of the external auditory canal on the affected side was 5.8 mm (4.3-8.0 mm). No linear association was found between age and the minimum diameter of the external auditory canal.

DISCUSSION

EES is a promising treatment option for children with early-stage CMEC because of its low recurrence rate and minimally invasive nature. The minimum diameter of the external auditory canal on the affected side should be meticulously examined when performing EES in children.

摘要

引言

手术切除广泛应用于先天性中耳胆脂瘤(CMEC)患儿。在此,我们报告儿童通过耳内镜手术(EES)和显微镜下耳手术(MES)切除CMEC的手术结果。

方法

纳入在接受EES或MES之前进行了术前病史询问、听力测试、内镜评估和影像学检查的CMEC患儿。收集术后听力结果和复发率。

结果

纳入17例(20耳)II-IV期CMEC患儿。其中,11耳(55.0%)接受了EES,9耳(45.0%)接受了MES。随访时间为35±13.5个月。EES组中1例III期CMEC患儿在随访期间复发。EES组患侧外耳道平均最小直径为5.8 mm(4.3-8.0 mm)。未发现年龄与外耳道最小直径之间存在线性关联。

讨论

由于复发率低且具有微创性,EES是早期CMEC患儿一种有前景的治疗选择。在对儿童进行EES时,应仔细检查患侧外耳道的最小直径。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/74ca/11157046/c5f36bdab78d/fped-12-1336183-g001.jpg

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