Andersen J, Cayé-Thomasen P, Tos M
Department of Otolaryngology, Gentofte University Hospital, Hellerup, Denmark.
Otol Neurotol. 2002 Nov;23(6):825-31. doi: 10.1097/00129492-200211000-00002.
The aim of this study was to investigate whether reconstruction of the eardrum with palisade cartilage technique could prevent retraction of the new eardrum after surgery for sinus and tensa retraction cholesteatoma in children and to investigate the postoperative hearing.
In 32 children aged 5 to 15 years, operated on from June 1995 to October 2000 for cholesteatoma (21 with sinus cholesteatoma and 11 with tensa retraction cholesteatoma) the eardrum was reconstructed with the palisade cartilage technique. Postoperatively, the children were seen as outpatients and were recently reevaluated with otomicroscopy, tympanometry, and audiometry. All patients (100%) were reevaluated on an average of 37 months (range 3-63 months).
Postoperative retractions, perforations, cholesteatoma recurrence, and hearing.
At the final examination, posterosuperior retraction was observed in two patients, both operated on for sinus cholesteatoma with reconstruction of the ossicular chain. In those cases, the palisades were not placed in the posterosuperior drilling defect behind the interpositioned incus. All the patients had an intact tympanic membrane at the final follow-up visit. One small perforation was surgically closed during the observation period. No patients developed cholesteatoma during the follow-up period. The postoperative hearing was good, and the hearing did not deteriorate with increasing observation time.
The palisade technique effectively prevented postoperative retraction of the eardrum. The postoperative hearing was good.
本研究旨在探讨采用栅栏状软骨技术重建鼓膜能否预防儿童上鼓室及紧张部内陷型胆脂瘤手术后新鼓膜的内陷，并研究术后听力情况。
1995年6月至2000年10月，对32例年龄在5至15岁的儿童进行了胆脂瘤手术（21例为上鼓室胆脂瘤，11例为紧张部内陷型胆脂瘤），采用栅栏状软骨技术重建鼓膜。术后，这些儿童作为门诊患者接受观察，并近期通过耳显微镜检查、鼓室导抗图检查和听力测定进行了重新评估。所有患者（100%）平均在37个月（范围3至63个月）后接受了重新评估。
术后内陷、穿孔、胆脂瘤复发及听力情况。
在最后一次检查时，2例患者出现后上象限内陷，这2例均为上鼓室胆脂瘤患者且进行了听骨链重建。在这些病例中，栅栏未放置在砧骨置入后的后上象限钻孔缺损处。所有患者在最后一次随访时鼓膜均完整。在观察期间，1例小穿孔通过手术封闭。随访期间无患者发生胆脂瘤。术后听力良好，且随着观察时间的延长听力并未恶化。
栅栏状技术有效地预防了术后鼓膜内陷。术后听力良好。
