Pech A, Zanaret M, Dubus K, Cannoni M, Sarrat P, Banis C
Ann Otolaryngol Chir Cervicofac. 1984;101(4):261-6.
Three cases of primary fronto-orbital cholesteatoma are reported and the relevant ORL and neurosurgical literature reviewed. Clinical diagnosis of this rare affection is not simple but is suggested by signs of infero-internal exophthalmus, an external orbital mass or exteriorized sinusitis after chronic headache. Two characteristic features are seen on radiology. The essential therapeutic problem is to prevent late recurrences, their frequency appearing to have been underestimated. Secondary cholesteatoma of iatrogenic or post-traumatic development is seen more rarely, and produces an endosinus disease treated surgically through a conventional para-lateronasal approach. Primary cholesteatoma, the more common variety, originates in the frontal diploë, is perisinusal in location and can extend into neighboring structures, particularly the external orbital apophysis. A CT Scan is essential in order to detect endocrine extension. A surgical approach adapted to the perisinusal localization of the lesion must be adopted, as for example the Cairns-Unterberger approach.
本文报告了3例原发性额眶胆脂瘤病例，并对相关的耳鼻喉科和神经外科文献进行了综述。这种罕见疾病的临床诊断并不简单，但可通过眼球下内突、眶外肿块或慢性头痛后出现的鼻窦外露性炎症等体征提示。放射学检查可见两个特征性表现。主要的治疗问题是预防晚期复发，其复发频率似乎被低估了。医源性或创伤后发展而来的继发性胆脂瘤较为少见，可导致鼻窦内疾病，需通过传统的鼻旁外侧入路进行手术治疗。原发性胆脂瘤较为常见，起源于额骨板障，位于鼻窦周围，可延伸至邻近结构，尤其是眶外骨突。为了检测其向周围组织的扩展，CT扫描至关重要。必须采用适合病变鼻窦周围定位的手术入路，例如凯恩斯-昂特贝格尔入路。
