Study On The Basic Characteristics And Clinical Management Of Cholesteatoma Of External Auditory Canal

Objective:Through the External auditory canal cholesteatoma(External auditory canal cholesteatoma,EACC)imaging examination in patients with temporal bone(CT)electronic otoscope intraoperative(operation)and postoperative clinical indicators of observation,analysis of EACC history because the hair cause of disease pathogenesis clinical manifestations and imaging characteristics to explore different types,further puts forward the treatment method and therapeutic effect of cholesteatoma of new knowledge and understanding of the disease,provide new ideas for clinical treatment.Methods:By retrospective analysis in shanxi medical university first hospital otolaryngology ward to select line in September,2019 to February 2017 hospitalized patients with surgical treatment of EACC the expansion of the research focuses on analyzing the bone erosion,symptoms of clinical manifestation and treatment of all patients in the preoperative level and coronary temporal bone CT scans,observe the pathological changes of CT imaging characteristics and the surrounding bone damage,and according to the characteristics of CT manifestations and pathological changes will EACC were all preoperative patients with postoperative clinical parting line of pure tone hearing threshold measurement,according to the result of detection and hearing impairmentAll patients were required to collect intraoperative data of the patients during surgical treatment under general anaesthesia microscope and compare them with the results of preoperative imaging evaluation,so as to further verify the value of preoperative imagingevaluation for clinical guidance of surgery.Results:A total of 13 articles were included.The total positive rate of HPV in domestic laryngeal cancer patients was 12%(95% CI: 9% to 15%).Subgroup analysis results:HPV positive rate in patients with northern laryngeal cancer [12%(95% CI: 7% to 17%)]HPV positive rate in patients with southern laryngeal cancer [13%(95% CI: 9% to 17%)],HPV positive rate in female patients with laryngeal cancer [26%(95% CI: 3% to 55%)]and HPV positive rate in male patients with laryngeal cancer [11%(95% CI: 7% to15%)],moderately and moderately differentiated HPV positive rate in patients with laryngeal cancer [15%(95% CI: 8% to 21%)] and HPV positive rate in patients with highly differentiated laryngeal cancer [9%(95% CI: 6% to 13%)],glottic type HPV positive rate of laryngeal cancer [(10%(95% CI: 6% to 3%)] and HPV positive rate of patients with non-glottic laryngeal cancer [(13%(95% CI: 7% to 19%)],HPV positive rate in patients with stage 1+2 laryngeal cancer [16%(95% CI: 10% to 21%)] and HPV positive rate in patients with stage 3+4 laryngeal cancer [17%(95% CI: 10% to 25%)],There was no statistically significant difference between the groups.High-risk HPV positive rate in patients with laryngeal cancer [10%(95% CI: 7% ~ 13%)]is higher than the low-risk HPV positive rate [3%(95% CI: 1% ~ 4%)],The difference between groups was statistically significant(P<0.00001);HPV positive rate in patients with laryngeal cancer without smoking history [19%(95% CI: 12% to 26%)] is higher than the rate in patients with smoking history of laryngeal cancer [7%(95% CI: 2% to 12%)],the difference was statistically significant(P=0.004);HPV positive rate in patients with laryngeal cancer without drinking history [12%(95% CI: 9% to 16%)]is higher than the rate in patients with laryngeal cancer who had a history of drinking [ 5%(95% CI: 3% to8%)],the difference was statistically significant(P=0.001).Conclusion:External auditory canal cholesteatoma(EACC)is a relatively rare external auditory canal disease,clinicians are often not familiar with the disease misdiagnosed as otitis externa or external auditory canal fungal disease its typical clinical manifestations:otorrhea earache varying degrees of hearing loss focal bone erosion and keratin accumulated inside the osseous external auditory canal,part of the symptoms of aural fullness tinnitus migraine patients with clinically must distinguish with obturator keratinization disorder,obturator keratinization disease often causes earache and bilateral conductive deafness,and expand to the surrounding wall of the ear canalExternal auditory canal cholesteatoma due to its biological erosion resistance,easily damaged bone erosion and adjacent structure,if not timely diagnosis and treatment,can cause serious complications,the treatment principle is early diagnosis,early treatment,thoroughly remove cholesteatoma lesions,regular follow-up review,to avoid the recurrence of clinical staging,treatment is also different,temporal bone high-resolution computed tomography(CT)has become one of the essential for the external canal cholesteatoma projects,it can clearly show the destruction of cholesteatoma lesions,to guide the external auditory canal cholesteatoma staging classification and treatment is of great significanceExternal otoplasty is an effective alternative to conservative treatment,but requires long-term follow-up and sometimes regular cleaning of the ear canal.