先天性外耳道狹窄合併膽脂瘤

Congenital Stenosis of External Auditory Canal Associated with Cholesteatoma

楊尚融(Shang-Jung Yang) ； 沈炳宏(Ping-Hung Shen) ； 賴仁淙(Jen-Tsung Lai)

《台灣耳鼻喉頭頸外科雜誌》 41卷1期 (2006/02) Pp. 30-34

https://doi.org/10.6286/2006.41.1.30

摘要

外耳道膽脂瘤為少見病例，大約每一千名耳科新病人中可發現一例，而先天性外耳道膽脂瘤則更為罕見。先天性膽脂瘤可以發生在顳骨的岩尖部(petrous apex)、鱗狀部(squamosa)、乳突、中耳腔以及外耳道，典型的特徵是位於中耳腔前方，而少見於外耳道。本文報告一名2歲又4個月大男孩，因左耳外耳道異物而轉介至本科，電腦斷層顯示有一軟組織密度病灶位在左耳外耳道內側骨質部並伴有局部骨質的破壞與侵蝕，手術中發現在極為狹小的耳道內部有大量銀白色角質鱗狀落屑堆積，耳道壁也有被侵蝕的情形。治療上我們採取耳道成形手術，病人術後定期接受檢查治療，目前尚無復發。我們認為外耳道狹窄是先天性外耳道膽脂瘤形成的潛在因素，除手術治療外應長期追蹤治療。

關鍵字

先天性膽脂瘤 ； 外耳道 ； 膽脂瘤

並列摘要

External canal cholesteatoma is a rare lesion, and the incidence is estimated to be one per thousand new otological patients. However, congenital cholesteatoma of the external auditory canal is extremely rare. Congenital cholesteatoma has been known to occur within a petrous apexial, squamous portion of the temporal bone, mastoid, middle ear, and external ear canal. Often congenital cholesteatoma occurs in the anterior compartment of the middle ear, but the external auditory canal has been seldom reported in the literature. We presented one such unusual case. This was a boy, two years and four months old, who complained of a foreign body in the left auditory canal. Computer Tomography identified tissue with a soft density lying in the medial portion of the external canal and partially eroding the adjacent bone. Surgical identified retained squamous debris within the external canal, together with localized bone destruction. No relapse has been detected up to the present. The potential for development of external canal cholesteatoma in congenital and acquired aural stenosis is well recognized. Long term follow up should be carried out in addition of surgery.

並列關鍵字

congenital cholesteatoma ； External auditory canal ； Cholesteatoma