目的　探索和提高对无明显临床症状的胆脂瘤型中耳炎诊断水平 ,避免误诊和漏诊。方法　对 31例经手术和病理证实的无明显临床症状的胆脂瘤型中耳炎病史资料进行回顾性分析。结果　 31例 (31耳 )中 2 1例 (6 7 7% )无明显耳漏史 ,2 2例有鼓膜独特部位 (松弛部 ,紧张部后上方 )轻微变化 ,如内陷、隆起、小肉芽、盯聍样覆盖和针尖样穿孔 ,有 9例看不到穿孔。听力损失以中、轻度传导性聋为主。鼓室功能曲线呈B型变化为特征 ;X线诊断符合率为 4 1 9% (13/31) ,CT检查诊断符合率为 80 6 % (2 5 /31) ;胆脂瘤侵犯部位范围是上鼓室、听骨链、鼓窦、乳突和中鼓室 ;约 35 5 % (11例 )病例分别有面神经骨管受损、脑膜暴露、迷路瘘管或 (和 ) 2种以上损害。结论　易漏诊的胆脂瘤型中耳炎由于无明显临床症状 ,往往容易漏诊和误诊 ,而其病变则呈隐蔽性发展 ,只是发展过程相对缓慢。如不能及时诊断和治疗 ,危害甚大 ,须引起临床医师的警惕 Objective To explore and improve the diagnosis of cholesteatoma otitis media without obvious clinical symptoms, to avoid misdiagnosis and missed diagnosis. Methods Retrospective analysis of 31 cases of cholesteatoma otitis media history confirmed by operation and pathology without obvious clinical symptoms was retrospectively analyzed. Results Twenty-one cases (67.7%) had no history of ear-leak in 31 cases (31.7%). There were slight changes in the unique parts of the tympanic membrane (the relaxation part and the posterior part of the tension part) in 21 cases, such as invagination, Stare like cover and tip-like perforation, there are 9 cases can not see perforation. Hearing loss to moderate and mild conductive deafness. The tympanic function curve was characterized by a B-shaped change; the coincidence rate of X-ray diagnosis was 419% (13/31), and the coincidence rate of CT examination was 80 6% (25/31) Tympanic cavity, ossicular chain, drum sinuses, mastoid and middle tympanic cavity. About 35 5% (11 cases) had facial nerve tube injury, meningeal exposure, lost fistula or more than 2 injuries respectively. Conclusion Due to the absence of obvious clinical symptoms, the easily diagnosed otitis media with cholesteatoma is often misdiagnosed and misdiagnosed. However, the pathological changes are hidden, but the development process is relatively slow. If not timely diagnosis and treatment, a great harm, to be caused by clinicians vigilance