広範な外耳道真珠腫の1症例

Extensive Cholesteatoma of Auditory Canal:Report of a Case

はじめに

　外耳道真珠腫はさほどに稀な疾患ではないが，骨破壊が広範になると，鑑別診断に苦慮する場合がある。また最近欧米ではkeratosis obturansとexternal auditory canal cholesteatomaの2つの概念が提唱されている。

　今回われわれは，外耳道真珠腫の広範な進展例を報告し，合わせてkeratosis obturansとexternal auditory canal cholesteatomaについても若干の考察を加えた。

A 74-year-old male with a chief complaint of dull earache on the left was seen. Routine ENT examination revealed an extensive obstruction of the left external bony canal with intact drum. Image diagnosis including Schuller's view, CT and MRI showed an invasive lesion into the antrum which was aerated with no additional bone change. Bacteriological studies disclosed corynebacterium & enterococcus. The patient was diabetic.

Modified radical mastoidectomy (Bondy) was performed and no apparent infection was seen both in the mastoid and the tympanic cavity. Pathological findings was hyperkeratosis with bone sequestra. A bibliographical discussion for keratosis obturans and external auditory canal cholestea-toma was also included.