病例报告患者叶××,男,64岁,农民,住院号209,441,因左耳疼痛,耳后肿胀,瘘管形成流脓4个多月,于1979年3月29日第1次入院。病人于1978年12月始,左耳少许流脓,耳后肿胀,并有小瘘管,流出黄白色分泌物,当地反复治疗不愈而来我院门诊。既往身体尚好,该耳曾有流脓史,余未见特殊。体查:一般情况好,神清合作,R20次、P110次,BP150/100。头部无畸形,双眼无特殊,右耳大致正常,左耳鼓膜慢性充血,肉眼未见穿孔、湿润,该耳后乳突区皮肤潮红、略肿、疤痕并有小瘘管,有少量白色脓性分泌物流出,探针触之可至乳突区骨表面,并有白色胆脂瘤样物,双鼻粘膜苍白,萎缩,其他无异常发现。血常规检查在正常范围,X线乳突罗氏位左慢性中耳乳突炎并胆脂瘤形成、骨膜下脓疡及瘘管。于4月6日在局麻下作左乳突根治术,耳后进路,乳突区清除大量胆脂瘤,中耳粘膜炎性改变,冲洗术腔,缝合切口,愈合良好。术中2次将组织送病理冰冻切片,报告为:慢性炎症,内包含胆脂瘤组织,石腊切片报告:耳后皮肤 Patient report Leaf × ×, male, 64 years old, farmer, hospital number 209,441, due to left ear pain, swelling of the ear, fistula formation of pus more than 4 months, on March 29, 1979 the first admission. The patient began in December 1978, left ear a little pus, ear swelling, and a small fistula, out of the yellow-white secretions, the local repeated treatment unhealed came to our hospital. Past body is still good, the ear had pus history, Yu no special. Physical examination: the general situation is good, clear cooperation, R20 times, P110 times, BP150 / 100. Head without deformity, no special eyes, the right ear is generally normal, left eardrum chronic congestion, the naked eye without perforation, moist, the posterior mastoid skin flushing, slightly swollen, scars and small fistula, a small amount of white purulent Exudate outflow, the probe touches the bone surface of the mastoid area, and white cholesteatoma samples, double nasal mucosa pale, atrophy, other no abnormal findings. Blood tests In the normal range, X-ray mammography Roche left chronic otitis media with cholesteatoma, subperiosteal abscess and fistula. On April 6 under local anesthesia for left radical mastoidectomy, behind the ear path, mastoid area to clear a large number of cholesteatoma, middle ear mucosal inflammatory changes, flush the surgical cavity, suture incision, healed well. Intraoperative 2 times the tissue sent to the pathological frozen section, reported as: chronic inflammation, including cholesteatoma tissue, paraffin section report: behind the skin