鼓膜穿孔症例に対する鼓室形成術後成績の検討  [in Japanese] Postoperative Result for Tympanic Membrane Perforation  [in Japanese]

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Abstract

鼓膜穿孔耳の病態は単純な穿孔のみのものから, 中耳の硬化性・炎症性病変が合併し耳小骨連鎖の可動障害を有するものまで多彩である.我々は鼓膜穿孔耳の手術に際し, チェックポイントを決め手順を追って手術を進めている.その術後成績を検討した.対象は1996年6月から1999年5月までの3年間に鼓室形成術を行った鼓膜穿孔耳症例37耳である.耳小骨の可動障害となる病変を石灰化鼓膜, ツチ骨柄先端, 前鼓室棘周辺そして上鼓室と, 順を追って確認・除去した.聴力改善の成功率は全体で89.2%であった.また鼓室・中耳病変の部位と範囲に関連して, パッチテスト時に残存する伝音障害 (気導骨導差) に特徴が見られることが判明し, 術前における術式予想の参考になりうると考えられた.

Ears with tympanic membrane perforation show a wide range of pathophysiology from simple perforation to mobility impairment of the ossicular chain complicated by sclerotic and/or inflammatory lesions of the middle ear. In surgery on such ears, we determine checkpoints and proceed based on the order of procedure. We studied postoperative results for 37 ears of patients undergoing tympanoplasty in the 3 years from June, 1996 to May, 1999. Lesions accountable for mobility impairment of the ossicular chain were confirmed and removed in the order of calcified tympanic membrane, tip of malleus handle, around the anterior tympanic spur, and epitympanum. Success in improving in hearing was 89.2% overall. Conductive impairment (air conduction-bone conduction gap) left on the patch test was found to differ with the site and range of tympanic and middle ear lesions. This can serve as a guide in preoperatively predicting the type of operation required.

Journal

  • Nippon Jibiinkoka Gakkai Kaiho

    Nippon Jibiinkoka Gakkai Kaiho 105(5), 564-569, 2002-05-20

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

References:  19

Cited by:  2

Codes

  • NII Article ID (NAID)
    10008674810
  • NII NACSIS-CAT ID (NCID)
    AN00191551
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    00306622
  • Data Source
    CJP  CJPref  J-STAGE 
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