Gliklich R E, Cunningham M J, Eavey R D
Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, MA 02114.
Arch Otolaryngol Head Neck Surg. 1993 Jun;119(6):669-71. doi: 10.1001/archotol.1993.01880180089016.
This 20-year retrospective review identifies 35 pediatric patients with aural polyps in an attempt to assess for clinical predictors of significant otopathologic conditions. Chronic otitis media (43%), cholesteatoma (29%), and retained tympanostomy tubes (23%) were the common causes. Unusual causes included mycobacterial infection and Langerhans' cell histiocytosis. Multivariate analysis revealed the co-occurrence of conductive hearing loss at presentation to be a significant clinical predictor (P = .03) of cholesteatoma; the histopathologic finding of keratin-induced giant cell reaction was nonspecific in this respect. Cholesteatoma was also prevalent in recurrent polyp cases, suggesting the need for prolonged follow-up in those children whose initial clinicopathologic evaluation does not yield a definitive diagnosis.
这项为期20年的回顾性研究确定了35例患有耳息肉的儿科患者，旨在评估严重耳科疾病的临床预测因素。慢性中耳炎（43%）、胆脂瘤（29%）和保留的鼓膜造口管（23%）是常见病因。不寻常的病因包括分枝杆菌感染和朗格汉斯细胞组织细胞增多症。多变量分析显示，就诊时伴有传导性听力损失是胆脂瘤的一个重要临床预测因素（P = 0.03）；在这方面，角质诱导巨细胞反应的组织病理学发现是非特异性的。胆脂瘤在复发性息肉病例中也很常见，这表明对于那些初始临床病理评估未得出明确诊断的儿童，需要进行长期随访。
