Medial Meatal Fibrosisの2症例 : 浅在化鼓膜に対する再手術後に発症した症例 [in Japanese] Two cases of media meatal fibrosis occurred revision myringoplasty for lateralized tympanic membrane [in Japanese]
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Medial meatal fibrosis (MMF) is a disease which causes obstruction in the medial portion of the external auditory canal due to proliferation of fibrous tissue. Otoscopic findings of the MMF were similar to that of the lateralized tympanic membrane, but are different in the presence of thick scar or granulation tissue behind it. Two cases of MMF occurred following revision myringoplasty are reported.<BR>Case 1 is a 50-year-old male with a complaint of bilateral hearing loss. He had a history of bilateral tympanoplasty for chronic otitis media 20 years ago. The tympanic membranes were bilaterally lateralized. Hearing levels were 55dB (right) and 55dB (left), with A-B gaps of 30dB and 28.7dB, respectively. Revision myringoplasty was performed on the left ear by placing a temporal fascia using underlay technique and by repositioning the lateralized tympanic membrane using Lore's method. Ear canal packing was removed on the 12th day after the surgery. Follow-up study revealed that the tympanic membrane was thick due to prominent fibrosis behind it. Conservative treatment such as removal of the superficial granulation tissue and scar could not improve his hearing. Re-operation is planned.<BR>Case 2 is a 40-year-old female with a history of left tympanoplasty 20 years ago presented with a complaint of left hearing loss. Revision myringoplasty by the same technique as used in case 1 failed to improve her hearing due to formation of MMF. Conservative treatment could not improve the condition. One year later, the third operation was conducted by removing all the fibrous tissues obstructing the ear canal and by repairing the tympanic membrane and the ear canal using free skin graft. She has been well after the operation with hearing improvement of 18.8dB.<BR>On these (each) 2 cases there was postoperative lateralized tympanic membrane. We think Medial Meatal Fibrosis was induced in each case, because we performed myringoplasty that lateralized tympanic membrane was preserved. After all we should excise lateralized tympanic membrane and clean granulation on external auditory canal then cover exposed bone face with flap.
- Otology Japan
Otology Japan 5(2), 143-147, 1995-05-15
THE JAPAN OTOLOGICAL SOCIETY