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目的探讨巨大中耳乳突胆脂瘤的手术治疗。方法回顾分析我院资料完整的16例巨大中耳乳突胆脂瘤的手术方法及疗效。结果16例巨大中耳乳突胆脂瘤中,87.5%(14/16)合并有颅内外并发症,共19例次,其中颞叶脑脓肿2例,小脑脓肿1例,乙状窦血栓性静脉炎1例,耳后骨膜下脓肿7例,迷路瘘管5例,颞部脓肿1例,周围性面瘫2例。经手术治疗均痊愈,部分患者(5/16)通过鼓室成形术获得听力提高。结论巨大中耳乳突胆脂瘤虽少见,但常引起严重的颅内外并发症,手术是巨大中耳胆脂瘤的唯一治疗途径,尽早手术可减少颅内外并发症的发生。
Objective To investigate the surgical treatment of huge middle ear mastoid cholesteatoma. Methods A retrospective analysis of our hospital complete data of 16 cases of large middle ear mastoid cholesteatoma surgical methods and efficacy. Results Of the 16 cases of large middle ear mastoid cholesteatoma, 87.5% (14/16) had intracranial and extracranial complications, of which 19 cases were complicated with temporal lobe abscess, 1 case of cerebellar abscess, 1 case of sigmoid sinus thrombosis 1 case of phlebitis, 7 cases of subperiosteal abscess after ear, 5 cases of lost fistula, 1 case of temporal abscess and 2 cases of peripheral facial paralysis. Surgical treatment were cured, some patients (5/16) by tympanoplasty to improve hearing. CONCLUSIONS: The huge middle ear mastoid cholesteatoma is rare, but it often causes severe intracranial and extracranial complications. Surgery is the only way to treat large middle ear cholesteatoma. Early surgery can reduce the incidence of intracranial and extracranial complications.