- 期刊
顳骨膽固醇肉芽腫併顱內侵犯－病例報告
Cholesterol Graunloma of the Temporal Bone with Intracranial Invasion - Case Report
摘要
38歲男性，主訴頭痛、左耳痛及聽力減損1年餘。理學檢查發現左耳道狹宰，電腦斷層掃描顯示有一巨大低密度陰影從顳骨往中顱窩侵犯。術前診斷為先天性膽脂瘤，遂和神經外科合作，予以腫塊切除，病理證實為膽固醇肉芽腫。術後追踪已22個月，頭痛，耳痛完全改善，而聽力則否。顳骨膽固醇肉芽腫是一個獨立的病理及臨床名稱，乃體內對中耳或乳突腔內膽固醇所引起的異物性組織反應。本正異於膽脂瘤。其可能原因是氣化的顳骨胞阻塞，組織因缺氧而出血才引起肉芽腫反應。臨床病徵以不明原因鼓室積血為主，通常不具破壞性；少數則會引起骨質破壞而造成顱內侵犯。治療原則對於不明原因之鼓室積血者，予以引流通氣；對於已有顱內侵犯者，則需予以全切除，必須時加以填塞。
並列摘要
Intracranial invasin of cholesterol granuloma of the temporal bone is rare. A 38-year-old man was admitted with the chief complaints if headache, left otalgia and hearing impairment. Temporal bone C-T scan showed a buge cystic lesion extending from the left mestoid toward the middle cranial fossa. Surgical excision was performed and the pathology report showed cholesterol granuloma. Cholesterol granuloma of the temporal bone does represent an independent clinical pathological entity, and it is a term used for the description of a tissue response of the temporal bone to a particular foreign body, i.e., cholesterol crystal. It is different from cholesteatoma. It is probably caused by obstruction of previousluy pnematized temporal bone air cells. Its clinical hallmark is “idiopathic hemotympanum”, causing no destruction. Osteitis and bone erosion are manifestations an unusual, more advanced stage. In this presented case. Surgical cure was achieved by total excision and oblitteration. There is no sign of precurrence, twenty-two months after poeration.