中华耳科学杂志2024，Vol.22Issue(1)：66-71,6.DOI:10.3969/j.issn.1672-2922.2024.01.016
儿童中耳胆脂瘤合并颅内并发症的临床特征及诊疗分析
Clinical Characteristics and Diagnosis and Treatment Analysis of Middle Ear Cholesteatoma Complicated with Intracranial Complications in Children
摘要
Abstract
Objective This paper focuses on clinical characteristics and key factors in diagnosis and treatment of middle ear cholesteatoma with intracranial complications in children.Methods Three cases of middle ear cholesteato-ma with intracranial complications treated at Henan Children's Hospital and Beijing Children's Hospital,Capital Medi-cal University,from June 2020 to February 2023 were reported,including clinical manifestations,treatment methods and outcomes.Results The cases included 1 boy and 2 girls.Clinical presentation included ear discharge and signs of meningitis with fever and headaches.One patient experienced severe mental state changes with projectile vomiting.Head CT and MRI,as well as temporal bone CT,revealed epidural abscess in 2 cases and cerebellar abscess in 1 case.Empiric antibiotics,multidisciplinary consultation and management of high fever,headaches,vomiting and conscious-ness changes were implemented while the individualized perioperative plan was developed.Radical mastoidectomy was performed under general anesthesia facilitated by a neurosurgeon for intracranial lesions,followed by targeted antibiot-ics based on culture and drug sensitivity test.Complete recovery was achieved in all three patients with no recurrence during follow-ups.Conclusion Intracranial complications should be suspected in children with middle ear cholesteato-ma showing high fever and headaches.Timely head CT and MRI evaluation and multidisciplinary consultation can facil-itate perioperative management.Canal wall-down mastoidectomy for lesion removal and unobstructed drainage is the treatment of choice once the patient is stabilized.关键词
儿童/中耳胆脂瘤/颅内并发症/诊断/治疗Key words
children/middle ear cholesteatoma/intracranial complications/diagnosis/treatment引用本文复制引用
乾恩乐,任红波,刘薇,段清川,杨伟光,蔡芳宇,韩富根,张杰..儿童中耳胆脂瘤合并颅内并发症的临床特征及诊疗分析[J].中华耳科学杂志,2024,22(1):66-71,6.基金项目
北京市医院管理局儿科学科协同发展中心专项项目(XTYB201828) （XTYB201828）
国家区域医疗中心开放课题资助项目(NRMC0105) （NRMC0105）
