耳小骨奇形27耳の検討 : 聴力改善不成功例を中心に  [in Japanese] Congenital Ossicular Malformation : A Study of 27 Ears  [in Japanese]

    • 森岡 繁文 MORIOKA Shigefumi
    • 京都府立医科大学耳鼻咽喉科・頭頸部外科学教室 Department of Otolaryngology-Head and Neck Surgery, Kyoto Prefectural University of Medicine
    • 坂口 博史 SAKAGUCHI Hirofumi
    • 京都府立医科大学耳鼻咽喉科・頭頸部外科学教室 Department of Otolaryngology-Head and Neck Surgery, Kyoto Prefectural University of Medicine
    • 瀧 正勝 [他] TAKI Masakatsu
    • 京都府立医科大学耳鼻咽喉科・頭頸部外科学教室 Department of Otolaryngology-Head and Neck Surgery, Kyoto Prefectural University of Medicine

    • 兵庫 美砂子 HYOGO Misako
    • 京都府立医科大学耳鼻咽喉科・頭頸部外科学教室 Department of Otolaryngology-Head and Neck Surgery, Kyoto Prefectural University of Medicine
    • 鈴木 敏弘 SUZUKI Toshihiro
    • 京都府立医科大学耳鼻咽喉科・頭頸部外科学教室 Department of Otolaryngology-Head and Neck Surgery, Kyoto Prefectural University of Medicine
    • 久 育男 HISA Yasuo
    • 京都府立医科大学耳鼻咽喉科・頭頸部外科学教室 Department of Otolaryngology-Head and Neck Surgery, Kyoto Prefectural University of Medicine

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Abstract

耳小骨奇形は胎生期の耳小骨形成障害によって生じ, 時に耳介や外耳道の形態異常を伴ったさまざまな病態を示す. 近年の手術技法の進歩により, 耳小骨奇形の多くの症例では手術によって聴力の著明な改善が得られQOLの向上につながっている. しかしながら, 一部には手術による聴力改善が不可能な症例や, 術中には改善を見込むものの聴力改善に至らない, もしくは改善した後に再び悪化する症例も存在する. 今回は過去7年間に当院で手術を行った耳小骨奇形症例27耳の検査所見, 病態, および手術成績等につき検討し, 特に聴力改善不成功もしくは遅発性に悪化した症例の要因について考察する.

Despite otological surgerical progress improving clinical congenital ossicular malformation management, some cases remain inadequately treated. We report 27 cases of congenital ossicular malformation, focusing on reasons for remaining or delayed postoperative hearing loss evaluated in 27 congenital ossicular malformation cases in Kyoto Prefecture from 2002 to 2008. Overall success was 93% (25/27) 6 months postoperatively. Two ears had no hearing improvement and three delayed hearing loss 8 to 48 months postoperatively. The first two ears underwent small fenestration stapedotomy with malleus attachment piston, and the other three tympanoplasty type III using an autologous ossicle or total ossicular replacement prosthesis (TORP) as a columella. We discuss problems and solutions using a malleus attachment piston or prosthesis, preoperative audio-and radiological findings, and operative findings including facial nerve anomaly and congenital cholesteatoma.

Journal

Nippon Jibiinkoka Gakkai Kaiho  

Nippon Jibiinkoka Gakkai Kaiho 113(10), 790-797, 2010-10-20 

The Oto-Rhino-Laryngological Society of Japan, Inc.

References:  19

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Codes

  • NII Article ID (NAID) :
    10028256524
  • NII NACSIS-CAT ID (NCID) :
    AN00191551
  • Text Lang :
    JPN
  • Article Type :
    Journal Article
  • ISSN :
    00306622
  • NDL Article ID :
    10880720
  • NDL Source Classification :
    ZS43(科学技術--医学--耳鼻咽喉科学)
  • NDL Call No. :
    Z19-250
  • Databases :
    CJP  CJPref  NDL  J-STAGE