段階的鼓室成形術

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タイトル別名
  • Experience with Staged Tympanoplaty in 100 Patients
  • ダンカイテキ コシツ セイケイジュツ 100 ジ ノ ケイケン カラ
  • 100耳の経験から

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Planned staged tympanoplasty was performed in 100 patients with extensively diseased middle ear from January 1974 to September 1982. The following results were obtained.<br>1) Seventy-eight ears had cholesteatomas and 22, non-cholesteatomas. Staged operation with the closed method was performed on 70 ears, that with the open method on 30 ears.<br>2) Residual or recurrent disease was found at the second-stage operation more frequently in cholesteatoma ears than in non-cholesteatoma ears. Residual or recurrent cholesteatoma was found in about 44% of the 78 cholesteatoma ears and was reduced more often by the open method than by the closed method.<br>3) Aeration of the middle ear space was obtained more easily by the open method than by the closed method.<br>4) Postoperative hearing level was maintained within 30dB in 76% of the 79 patients who were followed over 1 year. Satisfactory hearing results were obtained more often by the open method and in the well-aerated middle ear space at the second-stage.<br>5) No significant difference in hearing results was noted between the modified type III and type IV tympanoplasties.<br>6) Staged tympanoplasty is indicated mainly for the cases with 1) extensive disease of the tympanic mucosa, 2) severely destructive change of the ossicular tissue, and 3) possibility of residual or recurrent cholesteatoma. The cases in which improvement or maintenance of hearing is a prerequisite and both air and bone conduction thresholds are elevated, are also indications for staged operation.<br>7) The incus, malleus, CORP, cartilage and temporal bone chip were used as columella materials and better hearing results were obtained in the case using CORP or cartilage.

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