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Middle ear and mastoid glomus tumors (glomus tympanicum): an algorithm for the surgical management.

机译:中耳和乳突性球囊肿肿瘤(鼓状鼓膜):一种用于手术治疗的算法。

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OBJECTIVE: Glomus tumors are slow-growing benign lesions and represent the most common primary neoplasms of the middle ear. The objective of the present study is to report our surgical strategy in the management of glomus tympanicum tumors. METHODS: Between December 1988 and July 2008, 68 patients with histologically confirmed glomus tympanicum tumor underwent surgical treatment. The follow-up of the series ranged from 6 to 194 months (mean, 33.4 months). RESULTS: Distribution of tumors according to Fisch and Mattox classification was as follows: type A, 44 cases (64.7%); type B, 24 cases (35.3%). All of the 44 Class A tumors were safely removed via either a stapedectomy-type transcanal approach or a retroauricolar-transcanal approach. Five patients with Class B tumors were operated on through a transmastoid approach. Nineteen patients with larger Class B tumors underwent a subtotal petrosectomy with blind sac closure of the external auditory canal and middle ear obliteration. Gross total tumor removal was achieved in all 68 cases. In one case (1.4%) there was recurrence after 9 years, for which the patient was re-operated. No residual/recurrence has been detected on computed tomography in the rest of the patients. CONCLUSION: Surgical excision of glomus tympanicum tumors is a safe procedure, allowing total tumor removal with minimal morbidity, a low recurrence rate, and a low complication rate.
机译:目的:Glomus肿瘤是生长缓慢的良性病变,代表了中耳最常见的原发肿瘤。本研究的目的是报告我们处理鼓膜性鼓膜肿瘤的手术策略。方法:在1988年12月至2008年7月之间,对68例经组织学证实为鼓膜球虫的患者进行了手术治疗。该系列的随访时间为6到194个月(平均33.4个月)。结果:根据Fisch和Mattox分类,肿瘤分布如下:A型44例(64.7%); A型44例。 B型24例(35.3%)。通过a骨切除术式经管入路或后耳廓经管入路可安全清除所有44种A类肿瘤。五名B类肿瘤患者通过经乳突入路手术。 19名B类肿瘤较大的患者接受了小结部分的岩壁切除术,外耳道盲囊闭合,中耳闭塞。全部68例均实现了总的肿瘤去除。 1例(1.4%)在9年后复发,患者再次手术。在其余患者中,在计算机断层扫描上未检测到残留/复发。结论:手术治疗鼓膜胃炎是一种安全的方法,可以完全切除肿瘤,发病率低,复发率低,并发症发生率低。

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