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恶性外耳道炎多发生于中老年糖尿病患者。常在耳道下部与软骨连接处有肉芽组织增生,可引起软骨炎、骨炎、骨髓炎、甚至死亡。致病菌多为绿脓杆菌。本病根据临床病史、典型的检查所见、细菌培养及病理检查不难诊断。鳞状细胞癌也是外耳道的常见恶性病变。在外耳道可发现单纯息肉、较脆的肉芽组织或溃疡,有脓性或血性分泌物、疼痛、听力丧失、脑神经麻痹等。但也可无任何症状出现。坏死性外耳道炎与外耳道鳞癌的症状和体征类似。所以对外耳道的“感染”和/或发现肉芽组织及溃疡时必须进行活检,以区别炎症或肿瘤。
Malignant otitis externa occurs mostly in middle-aged and elderly patients with diabetes. Often in the lower part of the ear canal and cartilage at the junction of granulation tissue hyperplasia, can cause chondritis, osteitis, osteomyelitis, and even death. Most pathogens are Pseudomonas aeruginosa. The disease is not difficult to diagnose based on clinical history, typical findings, bacterial culture, and pathological examination. Squamous cell carcinoma is also a common malignancy of the external auditory canal. In the external ear canal can be found simple polyps, crisp granulation tissue or ulcers, purulent or bloody discharge, pain, hearing loss, cerebral palsy and so on. But it can also occur without any symptoms. Necrotizing otitis externa is similar to the symptoms and signs of external auditory canal squamous cell carcinoma. Therefore, a biopsy must be performed to “infect” the external auditory canal and/or find granulation tissue and ulcers to distinguish between inflammation and tumors.