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1 病例报告 患者:女,31岁。因左耳反复流脓10余年,以左耳慢性化脓性中耳炎收入院。查体:左乳突区皮肤无红肿、破溃,压痛阴性。外耳道内少许淡黄、稀薄之脓性分泌物,无特殊气味。清除之,外耳道无塌陷,鼓膜紧张部和松弛部大穿孔,上鼓室可见少许暗红色肉芽组织。徐梅氏位回报:胆脂瘤形成。遂行手术治疗。手术过程:常规耳前切口,暴露筛区及乳突骨质,未见破坏。自筛区凿入,去除部分骨质后,见灰红色软组织,探之韧,弹性好。小心扩大骨迸路,发现先前之软组织边界清楚,周边骨质光滑、无破坏。严格无菌操作,穿刺抽出血液。定为鼓窦缺如、乙状窦前置。凿除上鼓室外侧壁,清理上鼓室内肉芽及胆脂瘤组织,常规结束手术。2 讨论 正常解剖情况下,取筛区进路,其下方即为鼓窦区,它与后、内方之乙状窦毗邻。乙状窦前置可为乙状窦板与外耳道
1 Case Report Patients: Female, 31 years old. Repeated suppurative left ear for more than 10 years to the left ear chronic suppurative otitis media income hospital. Physical examination: left mastoid skin without swelling, ulceration, tenderness negative. A little yellowish external auditory canal, thin purulent secretions, no special smell. Clear, no collapse of the external auditory canal, tympanic membrane tension and relaxation of large perforation, the tympanic cavity shows a little dark red granulation tissue. Xu Mei bit return: the formation of cholesteatoma. Surgical treatment. Surgical procedure: conventional anterior incision, exposed screen area and papillae bone, no damage. After digging into the screen area, after removing part of the bone, see the gray-red soft tissue, explore the tough, good elasticity. Carefully expand the bones and found that the previous soft tissue boundaries clear, the surrounding bone smooth, non-destructive. Strict aseptic technique, puncture out of the blood. Definite as a lack of sinus, sigmoid sinus front. Chisel in addition to the outer wall of the drum, clean the interior of the drum and cholesteatoma granulation tissue, the conventional end of surgery. 2 Discussion Under normal anatomical circumstances, take the siege approach, which is below the drum sinus area, with the posterior, sigmoid sinus adjacent to the party. The sigmoid sinus can be pre-sigmoid sinus and external auditory canal