当科における鼓室形成術の聴力成績 : 伝音再建材料による検討 Hearing Results of Tympanoplasty with Ossiculoplasty Type III and IV
Three hundred and eighteen cases of ossiculoplasty using autografts and 3 types of ceramicossicular prostheses, CORP, APACERAM and cartilage connecting APACERAM in 123 ears with chronic otitis media and 164 ears with middle ear cholesteatoma were evaluated. The recurrence of inflammation, splippage and extrusion of the materials used for ossiculoplasty and hearing success rate were analyzed. The hearing results were classified as successful when the postoperative hearing level met at least one of these three conditions: 1) air bone gap less than 15dB, 2) hearing gain more than 15dB, 3) hearing level above 30dB.<BR>Recurrence of inflammation was not related to the materials used for ossiculoplasty. Prosthetic extrusion was observed in 7.4% of CORP, 8.7% of CORP with cartilage composite graft and 16.7% of APACERAM prostheses and slippage was found in 23.5% of CORP, 21.7% of CORP with cartilage composite graft and 5.6% of APACERAM, while only 4.0% of ears using cartilage connecting APACERAM demonstrated extrusion or migration of columellae.<BR>In type IV tympanoplasty, there was no significant difference in the postoperative hearing results between the materials for ossiculoplasty.<BR>In type III tympanoplasty, success rates for ossiculoplastyusing bony tissue, cartilage, CORP, CORP with cartilage composite graft, APACERAM and cartilage connecting APACERAM were 61.1%, 50.0%, 56.4%, 37.5%, 70.6% and 88.2% respectively. The good result in ossiculoplasty using cartilage connecting APACERAM might be explained by that the cartilage connecting APACERAM was tightly attached with a reconstructed tympanic membrane and superstructure of stapes without extrusion and migration.
- Otology Japan
Otology Japan 17(1), 9-15, 2007-02-25
THE JAPAN OTOLOGICAL SOCIETY