發(fā)布時(shí)間：2018-08-30 18:48

【摘要】：目的 外耳道軟骨部腫物并不少見(jiàn)，但由于其部位深在，早期癥狀不明顯，致使我們臨床醫(yī)生及患者本人常對(duì)此部位的腫瘤警覺(jué)性不高。在外耳軟骨部腫物中，，良性腫瘤和瘤樣病變較多，對(duì)它們進(jìn)行早期診斷和及時(shí)的手術(shù)治療，是預(yù)防癌變的可靠措施。關(guān)于此病國(guó)內(nèi)外文獻(xiàn)少有系統(tǒng)記載,現(xiàn)將我科有完整病歷記錄的住院患者資料進(jìn)行系統(tǒng)性分析總結(jié)，探討外耳道軟骨部腫物的臨床特點(diǎn)、治療原則和方法,提高對(duì)其認(rèn)識(shí)，做到早期診斷，早期治療，改善預(yù)后。 方法 回顧性分析2012年9月～2015年1月吉林大學(xué)第二醫(yī)院耳鼻咽喉-頭頸外科住院收治并經(jīng)病理證實(shí)的資料完整的外耳道軟骨部腫物46例，分析內(nèi)容包括發(fā)病年齡、性別、臨床表現(xiàn)、體征、病理類(lèi)型、影像學(xué)資料、臨床分期等多個(gè)方面。根據(jù)腫物的大小、良惡性,采用了不同的術(shù)式，術(shù)后進(jìn)行隨訪，在隨訪期間定期進(jìn)行術(shù)腔清理，必要時(shí)復(fù)查CT或MRT，以期減少?gòu)?fù)發(fā)的概率，增加手術(shù)治療效果。 結(jié)果 在收入院手術(shù)治療的46例外耳道軟骨部腫物中，良性腫物44例，其中以皮內(nèi)痣最多見(jiàn)，共18例，占總數(shù)的39.1%；其次為表皮樣囊腫9例，占總數(shù)的19.6%，而耵聹腺瘤、血管瘤、神經(jīng)鞘瘤、脂溢性角化病、乳頭狀瘤相對(duì)少見(jiàn)。惡性腫瘤2例，均為腺樣囊性癌。全組患者隨訪3～28個(gè)月不等,所有患者隨訪期間未復(fù)發(fā)，生活質(zhì)量良好。 結(jié)論 1.外耳道軟骨部腫物以良性者多發(fā)，而惡性腫瘤較少見(jiàn)。 2.在本研究中，外耳道軟骨部良性腫瘤以皮內(nèi)痣最多見(jiàn)，其次為表皮樣囊腫，而耵聹腺瘤、血管瘤、神經(jīng)鞘瘤、脂溢性角化病相對(duì)少見(jiàn)；外耳道軟骨部惡性腫瘤以腺樣囊性癌多見(jiàn)。 3.即使臨床癥狀不明顯，外觀規(guī)則的腫物，術(shù)中必要時(shí)也應(yīng)行快速病理檢查，以免誤診，導(dǎo)致切除范圍不足。
[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.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類(lèi)號(hào)】：R739.61

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