目的:在没有异物进入外耳道(EAC)的病史的情况下,发现了源自锤骨侧突(FBGLP)的异物肉芽肿的特殊表现。这项研究报告了临床特征,病理学,FBGLP患者的预后。
方法:回顾性研究。
方法:山东省耳鼻喉科医院.
方法:19例儿科患者(年龄,1-10年)与FBGLP。
方法:临床数据收集于2018年1月至2022年1月。
方法:分析患者的临床病理特征。
结果:所有患者均为急性病程,并在治疗无效的3个月内。最常见的症状是化脓性(57.9%)和出血性(42.1%)耳漏。FBGLP影像学检查显示,软质肿块阻断了EAC,而没有骨骼破坏,偶尔会伴有中耳积液。最常见的病理结果是异物肉芽肿(94.7%,18/19),肉芽组织(73.7%,14/19),角化沉淀(73.7%,14/19),钙沉积(63.2%,12/19),毛干(47.4%,9/19),胆固醇晶体(5,26.3%),和含铁血黄素(15.8%,3/19)。异物肉芽肿和肉芽组织显示CD68和caspase-3的表达水平高于正常鼓室粘膜,而Ki-67水平在所有组织中都同样低。随访3个月至4年无复发。
结论:FBGLP是由耳朵中的内源性外来颗粒引起的。我们建议使用经外耳道方法进行FBGLP手术切除,因为这显示了有希望的结果。
OBJECTIVE: A special presentation of foreign body granuloma originating from the lateral process of the
malleus (FBGLP) was noted in the absence of a history of foreign body entry into the external auditory canal (EAC). This study reported the clinical features, pathology, and prognosis of patients with FBGLP.
METHODS: Retrospective study.
METHODS: Shandong Provincial ENT Hospital.
METHODS: Nineteen pediatric patients (age, 1-10 yr) with FBGLP.
METHODS: Clinical data were collected from January 2018 to January 2022.
METHODS: Clinicopathologic characteristics of the patients were analyzed.
RESULTS: All patients had an acute course, and were within 3 months of ineffective medical treatment. The most common symptoms were suppurative (57.9%) and hemorrhagic (42.1%) otorrhea. FBGLP imaging examinations demonstrated a soft mass blocking the EAC without bone destruction and occasionally concomitant effusion in the middle ear. The most common pathologic findings were foreign body granuloma (94.7%,18/19), granulation tissue (73.7%, 14/19), keratotic precipitate (73.7%, 14/19), calcium deposition (63.2%, 12/19), hair shafts (47.4%, 9/19), cholesterol crystals (5, 26.3%), and hemosiderin (15.8%, 3/19). Foreign body granuloma and granulation tissue showed higher expression levels of CD68 and cleaved caspase-3 than did the normal tympanic mucosa, whereas Ki-67 levels were similarly low in all tissues. The patients were followed up for 3 months to 4 years without recurrence.
CONCLUSIONS: FBGLP is caused by endogenous foreign particles in the ear. We recommend the trans-external auditory meatus approach for FBGLP surgical excision, as this shows promising outcomes.