Sakagami M, Seo T, Node M, Fukazawa K, Sone M, Mishiro Y
Department of Otolaryngology, Hyogo College of Medicine, Nishinomiya, Japan.
Auris Nasus Larynx. 1999 Apr;26(2):147-51. doi: 10.1016/s0385-8146(98)00056-x.
Thirty-one cases of cholesteatoma with intact ossicular chain were reviewed to examine the extension of cholesteatoma, operation procedures, pre- and postoperative hearing levels, and postoperative condition of the ear drum. They were operated on at Departments of Hyogo College of Medicine and Osaka University Medical School from 1989-1996, which were 20.4% of all of the primary cholesteatoma cases (n = 152). Twelve cases located at attic were operated by atticotomy or canal wall up and scutumplasty, 17 cases located at attic/antrum were operated by canal wall down and reconstruction, and two cases located around stapes were operated through the ear canal. Preoperative hearing level was mild (34.2 +/- 18.4 dB) and postoperative one was slightly improved (28.7 +/- 11.2 dB). In ossicular reconstruction, modified Wullstein type III method showed better hearing gain than Wullstein type I method. Postoperative attic retraction and/or pocket occurred in 15 cases (48.4%), but no recurrent cholesteatoma was found during the present follow-up period. These findings suggested that cholesteatoma with intact ossicular chain showed good postoperative hearing results, but postoperative retraction of the ear drum should be followed up for a long time.
回顾了31例听骨链完整的胆脂瘤病例，以检查胆脂瘤的扩展情况、手术操作、术前和术后听力水平以及术后鼓膜状况。这些病例于1989年至1996年在兵库医科大学和大阪大学医学院接受手术，占所有原发性胆脂瘤病例（n = 152）的20.4%。12例位于上鼓室的病例采用上鼓室切开术或外耳道壁上抬及盾板成形术进行手术，17例位于上鼓室/鼓窦的病例采用外耳道壁下翻及重建术进行手术，2例位于镫骨周围的病例通过耳道进行手术。术前听力水平为轻度（34.2±18.4 dB），术后略有改善（28.7±11.2 dB）。在听骨重建中，改良的Wullstein III型方法比Wullstein I型方法显示出更好的听力增益。术后15例（48.4%）出现上鼓室回缩和/或袋状形成，但在目前的随访期间未发现复发性胆脂瘤。这些结果表明，听骨链完整的胆脂瘤术后听力结果良好，但应长期随访术后鼓膜回缩情况。
