真珠腫性中耳炎の臨床統計的観察

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  • Cholesteatoma; A Clinical Study of 104 Patients.

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The clinical features and postoperative course of 104 cases of cholesteatoma were analyzed statistically. Cholesteatoma was categorized as PF (pars flaccida), PSQ (posterosuperior quadrant) or central type. One stage surgery was performed on 44 ears (57.7%) of the PF type and on 16 ears of the PSQ type (61.5%). Canal wall-up operation was performed on 37 ears of the PF (48.7%) and 15 ears of the PSQ type (57.7%). Only 16 ears underwent canal down operations. Columella III type tympanoplasty was most frequently (37.5%) performed for ossicular chain reconstruction. The overall rate of improvement of hearing was 63.2%. Postoperatively 44.7% of the patients showed abnormal appearance of the ear drum, such as retraction pocket, adhesions or otorrhea. Recurrent cholesteatoma occurred in 17 ears of the PF type and in 2 ears of the PSQtype. Cholesteatomas extending from the aditus through the mastoid cavity showed a high rate of recurrence. Residual cholesteatoma was found in 21.4% of all ears. In general, ears without otorrhea.had better postoperative hearing than wet ears. The incidence of recurrence was especially high in wet ears of the PF type.

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