颞下颌关节焦磷酸钙沉积病延伸至外耳道和中耳，并合并耳硬化症：一例病例报告。

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中文摘要

焦磷酸钙沉积病（CPPD）由焦磷酸钙晶体引起，很少在关节中形成肿瘤。作者描述了一例颞下颌关节（TMJ）肿瘤性CPPD，延伸至外耳道（EAC）和中耳。一名71岁男性因初步诊断为右侧TMJ的CPPD而被转诊至该科室。计算机断层扫描显示肿块延伸至外耳道、鼓室腔和骨性咽鼓管，并伴有乳突气房混浊。听力图显示双侧混合性听力损失，提示合并双侧耳硬化症。进行了肿块部分切除术，并同期在同侧植入Baha®。组织病理学发现在手术标本中晶体不明显。通过薄膜X射线衍射（XRD）分析鉴定出焦磷酸钙晶体。同一耳中CPPD和耳硬化症的共病是一种罕见情况。考虑到CPPD的不可预测性，作者选择对涉及外耳道和中耳的病变进行部分切除，以避免任何并发症。由于合并耳硬化症，Baha®在该患者双侧混合性听力损失的听觉管理中发挥了重要作用。

英文摘要

Calcium pyrophosphate deposition disease (CPPD) is caused by CPP crystals and rarely forms tumors in joints. The authors describe a case of tumoral CPPD in the temporomandibular joint (TMJ), extending into the external auditory canal (EAC) and the middle ear. A 71-year-old man was referred to the department with a tentative diagnosis of CPPD in the right TMJ. Computed tomography showed the mass extending into the EAC, tympanic cavity, and bony Eustachian tube, with opacification of the mastoid cells. The audiogram revealed bilateral mixed hearing loss, suggesting the coexistence of bilateral otosclerosis. Partial resection of the mass and simultaneous implantation of a Baha® on the same side were performed. Histopathological findings revealed indistinct crystals in the surgical specimens. Calcium pyrophosphate crystals were identified using thin-film X-ray diffraction (XRD) analysis. The comorbidity of CPPD and otosclerosis in the same ear is a rare condition. Considering the unpredictable nature of CPPD, the authors opted for partial resection of the lesion involving the EAC and the middle ear to avoid any complications. Due to coexisting otosclerosis, Baha® played an important role in the auditory management of bilateral mixed hearing loss in this patient.