耳鼻喉头颈外科PPT课件 耳部肿瘤 耳神经瘤.pptVIP

耳部肿瘤Tumors of Ear Company Logo Lesions of the ear Benign neoplastic lesions of the external ear 1 Malignant neoplasms of the external ear 2 Benign neoplastic lesions of the middle and inner ear 3 Malignant neoplasms of the middle and inner ear 4 Company Logo Anatomy of Ear Company Logo 外耳良性肿瘤 外耳道乳头状瘤 papilloma of extenal canal 男性好发，反复挖耳所致 出血、阻塞感、听力减退 耳道多发或单发桑葚状肿物，质地较硬 手术切除：肿瘤边缘正常皮肤1mm以上 Company Logo 外耳良性肿瘤 耳廓和外耳道血管瘤 hemangioma 主要位于耳廓 毛细血管瘤 capillary hemangioma 海绵状血管瘤 cavernous hemangioma 蔓状血管瘤arterial racemosum hemangioma 非手术治疗：冷冻、激光、放射、局部注射硬化剂 手术治疗 Company Logo 外耳良性肿瘤 耵聍腺瘤 ceruminoma 好发于外耳道软骨部耵聍腺分布区 发病缓慢，肿瘤较大可致听力障碍 外耳道后下局限性隆起，黄豆大小，表面皮肤正常 手术治疗：易恶变，切除范围包括肿瘤边缘至少0.5cm Company Logo 外耳良性肿瘤 外耳道骨瘤 exostosis 早期无症状，肿瘤体积增大可出现耳闷、听力下降 外耳道骨部球星隆起，皮肤正常，质硬 CT显示外耳道骨性段骨样密度增生 手术治疗 Company Logo 外耳恶性肿瘤 腺样囊性癌 adenoid cystic carcinoma，ACC 低度恶性肿瘤，生长缓慢 症状不典型，持续多年，易复发 耳痛、耳道肿块，听力下降、耳鸣、流脓、耳痒 耳道皮下隆起，界限不清，质硬，触痛，肉芽，溃疡 手术治疗：彻底切除为主，辅助放疗 Company Logo 外耳恶性肿瘤 恶性黑色素瘤adenoid cystic carcinoma 低度恶性肿瘤，生长缓慢 症状不典型，持续多年，易复发 耳痛、耳道肿块，听力下降、耳鸣、流脓、耳痒 耳道皮下隆起，界限不清，质硬，触痛，肉芽，溃疡 手术治疗：彻底切除为主，辅助放疗 Company Logo 黑色素瘤 Melanoma Dark and flat macule with variegated colors. Its borders are irregular, with indentations and notches. Pattern encompasses a radial growth phase (located at the dermal–epidermal junction) and a vertical growth phase with invasion of the adjacent dermis (lower part of figure; haematoxylin and eosin stain, magnification 400) Company Logo 鳞状细胞癌 Exophytic, hyperkeratotic tumor with central ulceration, accompanied with seroanguinous exudate. middle and lower areas have islands and strands of invasive squamous carcinoma. Superficial sampling might not reach the underlying tumour risking underdiagnosis and a well-differentiated invasive tumour might closely resemble a reactive squamous proliferation, and risk