乳突部嚢胞の２症例

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  • Two Cases of Mastoid Cyst.

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Case 1: A 34-year-old female complained of hearing difficulty and a sensation of fullness in the left ear since 1989. Otoscopic examination revealed swelling of the upper posterior wall of the left external auditory canal without tenderness. The ear drum was intact. A CT scan of the temporal bone showed a soft tissue mass in the mastoid cavity with a bone defect, extending from the upper posterior external auditory canal to the middle cranial fossa. The ossicular chain appeared normal. MRI demonstrated increased signal intensity in the same area on both T1 and T2 weighted images. Mastoidectomy revealed a brown colored cyst in the mastoid cavity and obstruction of the aditus ad antrum with cholesterol granuloma.<BR>Case 2: A 33-year-old male complained of recurrent ear discharge since 1989. He had gradually lost hearing acuity in the right ear since 1990. Rotatory vertigo accompanied by nausea developed on September 19th, 1990. The ear drum was extensively adherent to the promontorium. Purulent ear discharge was running form a small perforation in the flaccid portion of the right ear drum. A CT scan demonstrated maldevelopment of mastoid air cells and a soft tissue mass extending from the epitympanum to the mastoid cavity. Tympanoplasty was performed after removing the entire cyst wall which obstructed the aditus ad antrum. Chronic inflammation is considered a major factor in the formation of cholesterol cyst. We concluded that growth of a cholesterol cyst is promoted not only when ventilation and drainage of the middle ear cavity is markedly reduced by inflammation in the middle ear, but also when secretion of serous fluid is markedly increased by unknown factors.

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