Uyar Yavuz, Oztürk Kayhan, Keles Bahar, Arbağ Hamdi, Ulkü Cağatay Han
Department of Otolaryngology, Meram Faculty of Medicine, Selçuk University, Konya, Turkey.
Ann Otol Rhinol Laryngol. 2006 Feb;115(2):150-5. doi: 10.1177/000348940611500212.
We aimed to investigate the long-term results of anterior atticoantrostomy in adult patients with cholesteatoma.
A total of 83 ears in 78 patients were operated on by the anterior atticoantrostomy technique, supported by a periosteal flap, between 1991 and 2002.
Cholesteatoma recurred in only 4 ears (4.8%). In the 79 ears without recurrence, re-perforation was observed in 3 ears (3.8%), and retraction pockets developed in the attic of 5 ears (6.3%), 2 of which needed ventilation tubes. Absorption or migration of cartilage grafts was not seen in any of the patients. The mean air-bone gap was 34.8 +/- 13.4 dB and 16.9 +/- 14.7 dB, and the mean high-tone bone conduction was 19.0 +/- 6.2 dB and 21.1 +/- 6.6 dB, in the preoperative and postoperative periods, respectively.
In the reconstruction of the posterior canal wall, a cartilage graft supported by a periosteal flap prevents attic retraction and may increase the vascularization of the graft. After anterior atticoantrostomy, the recurrence rate and the probability of leaving residual tissue are low. Therefore, we believe that anterior atticoantrostomy is a relatively safe and effective technique that can be used in the management of cholesteatoma.
我们旨在研究成年胆脂瘤患者行前鼓窦切开术的长期效果。
1991年至2002年间，对78例患者的83耳采用带骨膜瓣支撑的前鼓窦切开术进行手术。
仅4耳（4.8%）胆脂瘤复发。在79耳未复发的病例中，3耳（3.8%）出现再穿孔，5耳（6.3%）上鼓室出现内陷袋，其中2耳需要置入通气管。所有患者均未出现软骨移植物吸收或移位。术前和术后平均气骨导差分别为34.8±13.4dB和16.9±14.7dB，平均高频骨导分别为19.0±6.2dB和21.1±6.6dB。
在重建后鼓室壁时，带骨膜瓣支撑的软骨移植物可防止上鼓室内陷，并可能增加移植物的血管化。前鼓窦切开术后，复发率和残留组织的发生率较低。因此，我们认为前鼓窦切开术是一种相对安全有效的技术，可用于胆脂瘤的治疗。
