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目的 :探讨中耳胆固醇肉芽肿 (CG)的病因、发病机制、诊断及治疗。方法 :回顾性分析 8例 (9耳 )CG患者的临床资料。 8例 (9耳 )均为轻～中度传导性聋 ,鼓膜呈“蓝鼓膜”征 ,鼓室压曲线图为B型 (除 1例鼓膜紧张部穿孔外 ) ,其中 7例 (8耳 )行鼓室探查术 ,开放上鼓室、鼓窦及乳突气房 ,彻底清除肉芽组织 ,有 5例行中耳置管术 ,2例行中耳乳突改良根治术 ;另 1例仅行鼓膜穿刺抽液。结果 :1例失访。 7例 (8耳 )术后随访 0 .5～ 6年 ,6例 (7耳 )无复发 ;1例 (1耳 )复发 ,再次行手术治疗 ,术后 1年无复发。结论 :对不明原因的血性耳溢液及蓝鼓膜 ,应结合CT提高术前诊断率。对CG应采取手术治疗 ,清除病变 ,建立鼓室及乳突的通气、引流。
Objective: To investigate the etiology, pathogenesis, diagnosis and treatment of middle ear cholesterol granuloma (CG). Methods: The clinical data of 8 patients (9 ears) with CG were retrospectively analyzed. 8 cases (9 ears) were mild to moderate conductive deafness, the tympanic membrane showed “blue tympanic membrane” sign, Tympanogram was type B (except 1 case of tympanic membrane perforation), of which 7 cases (8 ears) Tympanometry, open the upper tympanic cavity, the mastoid sinus and mastoid space, complete removal of granulation tissue, 5 cases of middle ear catheterization, 2 cases of middle ear otitis media modified radical mastectomy; the other 1 cases only tympanic membrane puncture liquid. Results: One case was lost. Seven patients (8 ears) were followed up for 0.5-6 years. No recurrence was found in 6 cases (7 ears). One case (1 case) recurred. Surgical treatment was performed again and no recurrence occurred after 1 year. Conclusion: For unexplained bloody ear discharge and blue tympanic membrane, combined with CT should improve the preoperative diagnosis rate. CG should take surgical treatment, removal of lesions, the establishment of tympanic and papillae ventilation, drainage.