Grandis J R, Hirsch B E, Yu V L
Department of Otolaryngology, Eye and Ear Institute of Pittsburgh, PA 15213.
Arch Otolaryngol Head Neck Surg. 1993 Jun;119(6):687-9. doi: 10.1001/archotol.1993.01880180107021.
Malignant external otitis and squamous cell carcinoma of the external auditory meatus are both characteristically seen in the older population. While some of the signs and symptoms of these two diseases are similar (otalgia, otorrhea, bone destruction on computed tomographic scan), they have rarely been reported in the same patient. We present an unusual case of temporal bone cancer and malignant external otitis presenting concurrently in an elderly, nondiabetic host. Precipitating factors and diagnostic criteria are discussed. This case illustrates the importance of an adequate biopsy specimen in all patients presenting with presumed "classic" malignant external otitis. Consideration must also be given for the existence of malignant external otitis in the presence of carcinoma. Finally, evolution of malignant external otitis in this patient following aural irrigation supports previous suggestions that this disease may be induced iatrogenically.
恶性外耳道炎和外耳道鳞状细胞癌在老年人群中均较为常见。虽然这两种疾病的一些体征和症状相似（耳痛、耳漏、计算机断层扫描显示骨质破坏），但同一患者同时出现这两种疾病的情况鲜有报道。我们报告了一例老年非糖尿病患者同时并发颞骨癌和恶性外耳道炎的罕见病例。文中讨论了诱发因素和诊断标准。该病例说明了对于所有疑似“典型”恶性外耳道炎的患者，获取足够活检标本的重要性。对于存在癌症的患者，也必须考虑是否存在恶性外耳道炎。最后，该患者在耳冲洗后恶性外耳道炎的进展支持了之前关于这种疾病可能由医源性因素诱发的观点。
