46例外耳道软骨部肿物临床分析

发布时间：2018-08-30 18:48

【摘要】：目的外耳道软骨部肿物并不少见，但由于其部位深在，早期症状不明显，致使我们临床医生及患者本人常对此部位的肿瘤警觉性不高。在外耳软骨部肿物中，，良性肿瘤和瘤样病变较多，对它们进行早期诊断和及时的手术治疗，是预防癌变的可靠措施。关于此病国内外文献少有系统记载,现将我科有完整病历记录的住院患者资料进行系统性分析总结，探讨外耳道软骨部肿物的临床特点、治疗原则和方法,提高对其认识，做到早期诊断，早期治疗，改善预后。方法回顾性分析2012年9月～2015年1月吉林大学第二医院耳鼻咽喉-头颈外科住院收治并经病理证实的资料完整的外耳道软骨部肿物46例，分析内容包括发病年龄、性别、临床表现、体征、病理类型、影像学资料、临床分期等多个方面。根据肿物的大小、良恶性,采用了不同的术式，术后进行随访，在随访期间定期进行术腔清理，必要时复查CT或MRT，以期减少复发的概率，增加手术治疗效果。结果在收入院手术治疗的46例外耳道软骨部肿物中，良性肿物44例，其中以皮内痣最多见，共18例，占总数的39.1%；其次为表皮样囊肿9例，占总数的19.6%，而耵聍腺瘤、血管瘤、神经鞘瘤、脂溢性角化病、乳头状瘤相对少见。恶性肿瘤2例，均为腺样囊性癌。全组患者随访3～28个月不等,所有患者随访期间未复发，生活质量良好。结论 1.外耳道软骨部肿物以良性者多发，而恶性肿瘤较少见。 2.在本研究中，外耳道软骨部良性肿瘤以皮内痣最多见，其次为表皮样囊肿，而耵聍腺瘤、血管瘤、神经鞘瘤、脂溢性角化病相对少见；外耳道软骨部恶性肿瘤以腺样囊性癌多见。 3.即使临床症状不明显，外观规则的肿物，术中必要时也应行快速病理检查，以免误诊，导致切除范围不足。
[Abstract]:objective
Cartilage tumors in the external auditory canal are not uncommon, but because of their deep location and inconspicuous early symptoms, our clinicians and patients are often not vigilant to the tumors in this area. It is necessary to analyze and summarize the data of hospitalized patients with complete medical records, discuss the clinical characteristics, treatment principles and methods of cartilage mass of external auditory canal, improve the understanding of the disease, achieve early diagnosis, early treatment and improve the prognosis.
Method
From September 2012 to January 2015, 46 cases of external auditory canal cartilage tumors were retrospectively analyzed, including age, sex, clinical manifestations, signs, pathological types, imaging data and clinical stages. Size, benign and malignant, using different surgical methods, postoperative follow-up, regular cleaning during follow-up, if necessary, to review CT or MRT, in order to reduce the probability of recurrence, increase the surgical effect.
Result
Among 46 cases of ear canal cartilage tumors, 44 cases were benign, of which 18 cases were intradermal nevus, accounting for 39.1%; 9 cases were epidermoid cyst, accounting for 19.6% of the total, while cerumen, hemangioma, neurilemmoma, seborrheic keratosis and papilloma were relatively rare. 2 cases were malignant tumors, all adenoid cyst. All patients were followed up for 3~28 months. All patients had no recurrence during the follow-up period, and the quality of life was good.
conclusion
1. cartilage masses in external auditory canal are benign and multiple malignant tumors are rare.
2. In this study, endodermal nevus was the most common benign tumor of external auditory canal cartilage, followed by epidermoid cyst, and cerumen adenoma, hemangioma, neurilemmoma, seborrheic keratosis were relatively rare; adenoid cystic carcinoma was the most common malignant tumor of external auditory canal cartilage.
3. Even if the clinical symptoms are not obvious and the appearance of the tumor is regular, rapid pathological examination should be carried out when necessary during the operation to avoid misdiagnosis, resulting in insufficient resection scope.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R739.61

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