Department of Otolaryngology-Head and Neck Surgery, University of Nebraska Medical Center, 981225 Nebraska Medical Center, Omaha, NE 68198-1225, USA.
Division of Pediatric Otolaryngology-Head and Neck Surgery, Department of Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago.
Otolaryngol Clin North Am. 2025 Feb;58(1):29-39. doi: 10.1016/j.otc.2024.07.008. Epub 2024 Sep 6.
Evaluation of cholesteatoma depends on clinical history and examination, with microscope and/or endoscope. A history of hearing loss with a chronic draining ear, refractory to ototopical medication, raises suspicion for cholesteatoma. Symptoms of Eustachian tube dysfunction or prior ear surgery including ear tubes should be elicited. Inflammation can be severe and should be suppressed if possible. Once cholesteatoma is diagnosed or strongly suspected, further workup includes audiometry prior to surgical excision. Imaging may supplement the workup and is especially helpful if there are concerning features including vertigo, third window symptoms, asymmetric bone line, facial nerve weakness, or for anticipatory guidance.
胆脂瘤的评估取决于临床病史和检查，包括显微镜和/或内窥镜检查。有听力损失病史且慢性耳漏，对耳局部药物治疗无效，提示胆脂瘤的可能性。应询问是否存在咽鼓管功能障碍或既往耳部手术（包括置管）的症状。炎症可能很严重，如果可能的话，应进行抑制。一旦诊断或强烈怀疑胆脂瘤，进一步的检查包括手术切除前的听力测试。影像学检查可补充检查，并在存在以下特征时特别有帮助，包括眩晕、第三窗症状、不对称骨线、面神经无力或预期指导。
