外中耳恶性肿瘤12例临床分析
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1.首都医科大学附属北京天坛医院;2.首都医科大学附属北京天坛医院 耳鼻咽喉头颈外科

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Analysis of 12 patients with carcinoma of the external and middle ear carcinoma
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Department of Otorhinolaryngology Head and Neck Surgery,Beijing Tiantan Hospital,Capital Medical University

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    目的 探讨外中耳恶性肿瘤的治疗策略。方法 回顾分析2014年3月—2020年12月经治的12例外中耳恶性肿瘤患者的临床资料,其中鳞状细胞癌6例,腺样囊性癌6例;10例为初诊患者,其中I期1例、III期3例、IV期6例,2例复发患者无法分期;4例手术切除,8例综合治疗(手术+放/化疗)。手术方式包括颞骨外侧切除术2例,颞骨次全切除术9例,颞下窝B型入路1例。利用生命表法计算生存率,Log-rank检验比较生存差异。结果 随访8-53个月;3年生存率73%;单因素分析提示切缘阳性(p=0.033)与不良预后相关。结论 外中耳恶性肿瘤病程隐匿,手术切除结合术后放疗是有效的治疗策略。

    Abstract:

    Objective: To evaluate the treatment and outcomes of malignant neoplasms involving the external and middle ear. Methods: Twelve cases of external and middle ear carcinoma treated from 2014 March to 2020 December were reviewed retrospectively for their clinical characteristics and treatment outcomes, including six squamous cell carcinoma patients and six adenoid cystic carcinoma patients. Ten patients were treated originally at our hospital, including one patient in T1 stage, three in T3 stage and six in T4 stage, according to the University of Pittsburgh-modified TNM staging system. All patients underwent surgery,with eight patients received postoperative radiotherapy and/or chemotherapy. Surgical approach included lateral temporal bone resection (n = 2), subtotal temporal bone resection (n = 9), and lateral skull base tumor resection with infratemporal fossa type B approach (n = 1). Outcomes: The 3-year overall survival (OS) rate was 73%. The positive margin (p = 0.033) was associated with worse OS. Conclusion: The incidence of carcinoma originating from the external and middle ear is low with insidious onset. Surgical resection is the preferred treatment, in combination with postoperative radiotherapy and/or chemotherapy may be an effective comprehensive treatment strategy. Given the rarity of the pathology, many controversies still exist concerning optimal management.

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  • 收稿日期:2022-06-01
  • 最后修改日期:2022-07-17
  • 录用日期:2022-07-25
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