CAJ | 학술논문

目的：探讨鼓室球瘤的临床特征与手术疗效。方法回顾性分析20例经手术病理证实的鼓室球瘤患者的临床表现、听力学特点、影像学表现、术中所见，总结其诊断要点以及手术疗效。该20例患者中仅有1例为男性其余均为女性。20例中，16例表现为搏动性耳鸣，内有15例合并听力下降，其中2例伴有耳痛；1例仅表现为非搏动性的耳鸣；1例表现为耳道出血；2例仅表现为耳部闷胀感，其中1例合并中耳感染。鼓膜均为樱桃红色，15例听力下降者9例传导聋、5例混合聋、1例重度感音神经聋，余5例听力正常。20例患者均行颞骨CT及MRI检查，表现为鼓室内不规则团块影，2例突出至外耳道，边界清楚，均无骨质破坏，增强后明显强化，4例行DSA检查，其中2例由咽升动脉供血，1例为咽升动脉及耳后动脉供血，1例由枕动脉供血。20例中，鼓室球瘤I型5例，行耳道进路肿瘤切除术；II型9例，行耳道进路肿瘤切除术；III型4例，行完壁式乳突根治加鼓室成型术；IV型2例，行开放式乳突根治加鼓室成型术。结果手术均完整切除肿物，术中术后无并发症、无输血。术后随访6个月至9年，肿物无复发。结论大部分鼓室球瘤具有典型的临床特征与影像学表现，及时手术治疗疗效确切。
목적：탐토고실구류적림상특정여수술료효。방법회고성분석20례경수술병리증실적고실구류환자적림상표현、은역학특점、영상학표현、술중소견，총결기진단요점이급수술료효。해20례환자중부유1례위남성기여균위녀성。20례중，16례표현위박동성이명，내유15례합병은력하강，기중2례반유이통；1례부표현위비박동성적이명；1례표현위이도출혈；2례부표현위이부민창감，기중1례합병중이감염。고막균위앵도홍색，15례은력하강자9례전도롱、5례혼합롱、1례중도감음신경롱，여5례은력정상。20례환자균행섭골CT급MRI검사，표현위고실내불규칙단괴영，2례돌출지외이도，변계청초，균무골질파배，증강후명현강화，4례행DSA검사，기중2례유인승동맥공혈，1례위인승동맥급이후동맥공혈，1례유침동맥공혈。20례중，고실구류I형5례，행이도진로종류절제술；II형9례，행이도진로종류절제술；III형4례，행완벽식유돌근치가고실성형술；IV형2례，행개방식유돌근치가고실성형술。결과수술균완정절제종물，술중술후무병발증、무수혈。술후수방6개월지9년，종물무복발。결론대부분고실구류구유전형적림상특정여영상학표현，급시수술치료료효학절。
Objective To report clinical characteristics and surgery outcomes in a series of cases of the glomus tympanicum tumors. Methods Data from 20 patients with pathologically confirmed glomus tympani-cum tumors were retrospectively reviewed, including clinical manifestations, audiological features, imaging and intraoperative findings. Key points in their diagnosis and surgical treatment were summarized. Results Nineteen of the 20 patients were female. Clinical manifestations included pulsatile tinnitus (n=16), hearing loss (n=15), earache (n=2), non-pulsatile tinnitus (n=1), ear canal bleeding (n=1), ear fullness (n=2), and middle ear infection (n=1). Tympanic membrane showed cherry red shadows in all cases. Of the 15 cases with hearing loss, 9 were conductive, 5 were mixed and 1 was sensorineural. CT and MRI imaging showed tympanic mass shadows of irregular shapes, extending to the external auditory canal in 2 cases, with clear boundaries and no bone destruction. DSA was ordered in 4 cases, which showed blood-supply from the ascending pharyngeal ar-tery in 2 cases, from both ascending pharyngeal and auricular arteries in 1 case and from the occipital artery in 1 case. Tumor was classified as type I in 5 cases, who underwent tumor removal by transcanal approach;type II in 9 cases, who underwent tumor removal by transcanal approach;type III in 4 cases, who underwent intact ca-nal wall tympanomastoidectomy;and type IV in 2 cases, who underwent canal wall down tympanomastoidecto-my. Results Resection of tumor was complete, with no intraoperative and postoperative blood transfusion. Pa-tients were followed up for 6 months to 9 years and showed no tumor recurrence. Conclusion Most of glomus tympanicum tumors in this series showed typical clinical and imaging features and were successfully treated with surgical resection.