中国听力语言康复科学杂志2026，Vol.24Issue(5)：501-506,6.DOI:10.3969/j.issn.1672-4933.2026.05.010
先天性巨大中耳胆脂瘤合并中耳畸形个案研究
Congenital Giant Middle Ear Cholesteatoma Combined with Middle Ear Malformation:A Case Report
摘要
Abstract
Objective This study aims to enhance the diagnostic capability of clinicians in diagnosis and differential diagnosis,promote individualized surgical strategy development,and emphasize the value of imaging in preoperative evaluation and the importance of selecting appropriate surgical approaches,by analyzing the clinical data of a case of congenital giant middle ear cholesteatoma with middle ear malformation,which is prone to misdiagnosis due to its concealed location and atypical early symptoms,often resulting in delayed optimal treatment;this study systematically summarizes the clinical features,reviews the key aspects of modified radical mastoidectomy under otomicroscopy,and discusses the pathogenesis with reference to domestic and international literature.Methods This report describes a 7-year-old male who presented with recurrent right otorrhea for 2 years and had received repeated diagnoses of acute otitis media with a poor response to anti-infective therapy;however,following comprehensive examination at our institution,the patient was definitively diagnosed with congenital giant middle ear cholesteatoma with middle ear malformation,and preoperative staging was determined as Potsic stage IV.After thorough preoperative discussion and with informed consent obtained from the family,the patient underwent modified radical mastoidectomy under otomicroscopy,achieving complete lesion removal while preserving the original anatomical structures.Results Postoperative histopathological examination confirmed the diagnosis of cholesteatoma.During follow-up,the patient had no postoperative complications such as tinnitus,vertigo,or facial palsy,and demonstrated normal communication ability;no second-stage surgical intervention is currently planned.Conclusion Congenital middle ear cholesteatoma with otorrhea as the primary manifestation,but without facial pain,facial palsy,or vertigo,is susceptible to misdiagnosis as otitis media.Imaging modalities including high-resolution CT of the temporal bone,middle ear MRI,and diffusion-weighted imaging are indispensable for early localization,extent assessment,and treatment planning.Once the diagnosis has been established,appropriate surgical intervention should be performed promptly to achieve complete removal of the lesion,preserve native structures to the greatest extent,minimize irreversible damage to surrounding tissues and functions,and thus improve the long-term prognosis and quality of life.关键词
先天性中耳胆脂瘤/先天性中耳畸形/乳突改良根治术Key words
Congenital middle ear cholesteatoma/Congenital middle ear malformation/Modified radical mastoidectomy分类
医药卫生引用本文复制引用
唐语祺,何伟平,郭华民,刘景..先天性巨大中耳胆脂瘤合并中耳畸形个案研究[J].中国听力语言康复科学杂志,2026,24(5):501-506,6.基金项目
国家自然科学基金项目"小青龙汤通过WDR5/H3K4me3调控巨噬细胞糖酵解M2极化抗变应性鼻炎机制研究"(82474584) （82474584）
