摘要
乳頭瘤為一常見之腫瘤，然而發生於中耳腔者較少見。文獻報告之中耳乳頭瘤皆含合併有中耳炎，是否為慢性發炎造成細胞化生而產生，目前尚無定論。中耳之乳頭瘤須與膽脂瘤、膽脂肉芽瘤（choles-terol granuloma）及其他腫瘤進行鑑別診斷。同時，由於其復發率高，中耳乳頭瘤至少需實行乳突鑿開術以完全清除病灶，避免復發。我們經歷一76歲女性病患，主訴右耳耳漏超過10年。理學檢查發現有右耳中耳炎並懷疑有中耳腫瘤。高解像度之顳骨電腦斷層檢查顯示右耳中耳腔內有一呈現軟組織密度的腫瘤，乳突骨有輕微的骨質破壞。於是病患接受右側鼓室成形合併乳突鑿開術，術中發現中耳腔內充滿一易脆，息肉樣（polypoid）腫瘤，我們將腫瘤及不正常的中耳黏膜完全移除，病理診斷為乳頭瘤。病患術後追蹤至今１年無復發情形。
並列摘要
Papilloma is a common tumor but it is rarely seen in the middle ear. Reported papillomas of the middle ear were frequently associated with otitis media. It is proposed that ongoing cell metaplasia of otitis media could be the etiology, but it was not definitely proved. The differential diagnosis primarily include choleasteatoma and other tumors such as choles-terol granuloma. Radical mastoidectomy is mandatory to reduce recurrence. Here we report on a 76-year-old women who had right otorrhea and otalgia for more than ten years. Otitis media with an associated middle ear cavity, with osteolytic changes. Subse-quently, this patient had a radical mastoidectomy. A fragile polypoid tumor in the middle ear was found and removed completely. The pathological report of the excised tumor showed papilloma. There has been no recurrence after a one-year follow-up. We suggest that a middle ear papilloma should be distinguished from other middle ear tumors such as cholesterol granuloma and radical mastoidectomy to prevent recurrence.
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