误诊贝尔面瘫的儿童颞骨先天性胆脂瘤1例及原因分析
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1.南京明基医院;2.南京明基医院 耳鼻咽喉头颈外科

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Analysis of Congenital cholesteatoma of temporal bone in a child: amisdiagnosed casereport and literature review
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Department of Otorhinolaryngology head and Neck Surgery, Nanjing Benq Hospital

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    摘要:

    目的 探讨儿童颞骨先天性胆脂瘤误诊原因及临床诊断。方法 回顾性总结1例误诊贝尔面瘫的儿童颞骨先天性胆脂瘤临床资料,并复习相关文献,对儿童颞骨先天性胆脂瘤的临床及影像学特点进行讨论。结果 该例患者颞骨CT示:左颞骨内骨内软组织影,膨胀性生长,听骨破坏,范围累及半规管、迷路上气房、水平段及迷路段面神经管。MRI示:左侧鼓室见大量T1WI呈等低信号,T2WI+FS呈等高信号影,病变向内深达前庭、上半规管、水平半规管及壶腹部边缘。术前诊断:先天性胆脂瘤。行乳突根治+鼓室成型术+面神经减压术,术后恢复良好。结论 儿童颞骨先天性胆脂瘤临床少见,容易误诊为其他疾病,临床症状及影像学方法是诊断儿童颞骨先天性胆脂瘤主要方法,同时需要提高对该疾病的认识,减少误诊。

    Abstract:

    Objective To investigate the misdiagnosis causes and clinical diagnosis of congenital cholesteatoma of temporal bone in children.Methods The clinical data of a child with congenital cholesteatoma of the temporal bone misdiagnosed with Bell facial palsy were reviewed, and the clinical and imaging characteristics of congenital cholesteatoma of the temporal bone were discussed. Results? CT scan of the temporal bone of this patient showed intraosseous soft tissue image in the left temporal bone, expansive growth, destruction of the ossicle, involving the semicircular canal, superior labyrinth air chamber, horizontal segment, and labyrinth facial neural tube. MRI showed a large amount of iso-hyposignal on T1WI and iso-hypersignal on T2WI+FS in the left tympanum. The lesions extended inward to the vestibule, superior semicircular canal, horizontal semicircular canal and ampulla margin. Preoperative diagnosis: congenital cholesteatoma. Mastoid radical cure + tympanum molding art + facial nerve decompression art, postoperative recovery is good.Conclusions Congenital cholesteatoma of the temporal bone in children is rare in clinic and easily misdiagnosed as other diseases. Clinical symptoms and imaging methods are the main methods for diagnosis of congenital cholesteatoma of the temporal bone in children. At the same time, it is necessary to improve the understanding of the disease to reduce misdiagnosis

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  • 收稿日期:2022-05-19
  • 最后修改日期:2022-07-07
  • 录用日期:2022-07-15
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