摘要
本文收集自民國70年4月至83年3月，有雙側膽脂瘤患者且接受兩耳手術，計有30例，共60耳。追蹤時間至少1年以上，最長為13年，平均追蹤時間為6年。於常規耳部乳突X光檢查，診斷出雙側膽脂瘤僅有3例。耳部細菌培養結果，最常見為綠膿桿菌及變形桿菌。其中3個聽小骨全損者有17耳（28%），皆完整者僅有5耳（8%）。術後聽力結果，除1耳未能追蹤到手術後聽力，平均聽力增加6 dB。追蹤至今，只有1耳有膽脂瘤復發情形（1.7%）。有11位（37%）的雙側膽脂瘤是經由第一耳手術後長期追蹤中，發現第二耳產生膽脂瘤，而予以手術治療。我們發現，雙側膽脂瘤手術後聽力增加（6 dB）與文獻報告中的單側膽脂瘤（6.5 dB）相比較，其結果相近；復發率相比較，則明顯較低。又雙側膽脂瘤術後皆為乾耳，沒有開放腔的問題，可見雙側膽脂瘤的預後，並沒有較差。早期發現及治療與手術後的細心追蹤，尤其是單側膽脂瘤的對側耳，是改善預後的重要關鍵。
關鍵字
雙側膽脂瘤並列摘要
Cholesteatoma involving bilateral ears are not common in our practice. The prognosis of these cases remains uncertain. In this retrospective study, we tried to find out the recurrence rate and hearing result after surgery. Thirty patients with bilateral cholesteatoma had received operation from April 1981 to March 1994, the mean follow-up period was six years. Among them, three patients were suspected to have bilateral cholesteatoma by the pre-operative mastoid routine. There were totally destroyed ossicular chains in seventeen ears, and intact ossicular chains in five ears. Recurrence was noted in only one ear till now. The average post-operative hearing gain was 6 dB, which showed no significant difference from those of unilateral cholesteatoma in literatures. In conclusion, the prognosis of bilateral cholesteatoma after surgery is still optimistic in comparison with that of unilateral cholesteatoma. The key to improve the prognosis depends on early surgical intervention and close follow-up.
並列關鍵字
bilateral cholesteatoma延伸閱讀
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