不同部位鼓室骨瘤临床特征分析

来源 :中华耳鼻咽喉头颈外科杂志 | 被引量 : 0次 | 上传用户:liqiusheng2009
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目的:探讨不同部位鼓室骨瘤患者的临床特征以及干预、治疗方法。方法:回顾总结2例不同部位鼓室骨瘤患者的临床资料,包括病史、听力学及影像学检查、手术方案和随访结果,结合国内外文献报道的36例鼓室骨瘤患者的临床特征、治疗方式及疗效进行总结分析。结果:本研究收集的2例鼓室骨瘤患者病变分别来源于中鼓室的鼓岬和砧骨,均无明显的病因和诱因,鼓膜完整,听力学检查为传导性听力损失。鼓岬来源的骨瘤患者磨除骨瘤、听骨链完整保留并恢复活动,砧骨来源的骨瘤患者切除骨瘤、取出砧骨、置入人工听骨,2例患者术后气骨导差均基本消失。分析文献报道的36例(38耳)鼓室骨瘤患者发现,平均年龄26.5岁,源于鼓岬者最多,占39.5%(15/38),主要症状为进行性听力下降、耳鸣和耳闷感。结论:鼓室骨瘤患者以鼓膜完整的传导性听力损失为临床特征,病变最常见的来源为鼓岬,手术切除病灶、保持或重建听骨链可恢复或改善听力。“,”Objective:To explore the clinical characteristics, intervention and treatment of tympanic osteoma at different locations.Methods:The medical history, audiological and imaging examination, operation and follow-up results of two patients with tympanic osteoma at different sites were reviewed and summarized. Furthermore, the clinical characteristics and interventions of 36 patients reported in literatures with tympanic osteomas were also summarized and analyzed.Results:Osteoma of the two patients collected in this study located at promontory and incus respectively;both of them presented with intact tympanum and conductive deafness, without obvious etiology or predisposing factor. Both of them underwent surgeries and the hearing improved significantly. For patient one, the ossicular chain was intact and restored to activity after removed the osteoma. For patient two, an artificial ossicle was implanted after removed the osteoma and incus. In the 36 patients reported in literatures, the average age was 26.5 years, and 39.47% of them located at promontory; in addition, the main symptoms of them were progressive hearing loss, tinnitus and ear stuffy.Conclusions:Patients with tympanic osteoma are characterized by conduction deafness with intact tympanic membrane, and the most common lesion is promontory. Hearing can be restored by excision of the osteoma and maintenance or reconstruction of the ossicle chain.
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