当科における聴力正常真珠腫性中耳炎の手術症例の検討

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  • Postoperative results of middle ear cholesteatoma with normal hearing

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Twenty four cholesteatoma cases, with hearing within 20dB at three averaged speech frequencies, were operated on from 1998 to 2004. Their mean age was 26.6 years, and the mean follow-up period 31.7 months. Two cases were congenital cholesteatoma, 16 cases pars flaccid type, 4 cases pars tensa type, and 2 cases secondary acquired cholesteatoma.<BR>They were operated on by tympanoplasty without mastoidectomy (4 cases), canal wall up method (3 cases), canal wall up method and scutumplasty (2 cases), canal wall down method with canal reconstruction and mastoid obliteration (6 cases), canal wall down method with canal reconstruction (4 cases), and canal wall down method (5 cases).<BR>One case (4.0%) operated by the canal wall up method and scutumplasty had recurrence of cholesteatoma and the patient underwent revision surgery by canal wall down method. Four cases (16.7%) showed a retraction of the pars flaccid. Postoperative hearing results were within 30dB in 17 cases (70.8%). Probability of postoperative hearing gain within 20 dB in seven cases with ossicular chain disruption by cholesteatoma was lower than in the cases with normal ossicular chain.<BR>These findings encouraged us to operate on choleteatoma cases with normal hearing and to recommend the operation to the patients carefully by the informed consent.

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