真珠腫性中耳炎に対する外耳道軟素材再建術式の治療成績 Results of tympanoplasty with soft posterior meatal wall reconstruction in ears with cholesteatoma
We performed tympanoplasty with soft posterior meatal wall reconstruction on 41 ears from November 1999 to December 2004 at Kagawa University Medical Hospital. The mean follow up period was 39 months (from 18 to 66 months). No retraction of the posterior meatal wall was observed in 3 ears (7.3%), while attic retraction was seen in 10 ears (24.4%), and balloon-shaped retraction pocket into the mastoid cavity was found in 28 ears (68.3%). In most cases, the posterior meatal wall began to retract within 1 or 2 months. The retraction of the posterior meatal wall occured mainly within one year after surgery. In 29 ears, CT scan was performed after more than 1 year postoperatively. Aeration was seen in 6 ears (20.7%) in the attic and mastoid cavity, in 2 cases (6.9%) in the attic, and in 4 cases (13.8%) in the mastoid cavity only. ll of the Non-retraction cases showed good aeration both in the attic and mastoid cavity. In addition, aeration was seen in 7 ears (78%) of the attic retraction cases. On the other hand, the aeration was only seen in 2 ears (12%) of the cases showing a balloon-shaped retraction pocket into the mastoid cavity. The success rates for a recovery of hearing were 68.8% in tympanoplasty type Ill (3i 10/16, 3c 12/16) and 57.1% in type IV (4i 2/2, 4c 2/5). The mastoid cavity problems occurred in 14.6%(6/41). Recurrence of cholesteatoma was found in 4.8%(2/41).<BR>In conclusion, the above described surgical method was considered useful because it was easy to perform, and demonstrated good success rate regarding an improvement in postoperative hearing, a low rate of recurrence, and few mastoid cavity problems. However, narrow-neck retraction pocket formation did occur in a few cases and, as a result, long-term observations are thus needed for these patients.
- Otology Japan
Otology Japan 16(2), 87-91, 2006-05-25
THE JAPAN OTOLOGICAL SOCIETY