Kang Myung-Koo, Ahn Joong-Ki, Gu Tae-Woo, Han Chi-Sung
Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, University of Dong-A, Busan, Korea.
Otolaryngol Head Neck Surg. 2009 May;140(5):687-91. doi: 10.1016/j.otohns.2008.11.027. Epub 2009 Feb 21.
To report the long-term results of epitympanoplasty with mastoid obliteration technique.
Two hundred adult cases had undergone epitympanoplasty with mastoid obliteration from December 1994 to May 2003. The mean postoperative observation period was 91 months, with a minimum of five years. Epitympanoplasty with mastoid obliteration technique has four major procedures: the widening of the external auditory canal and removal of the scutum; preservation of the posterior canal wall; epitympanoplasty; and mastoid obliteration. We examined postoperative complications and hearing outcomes.
There was no retraction pocket formation and recurrence of cholesteatoma. Residual cholesteatoma in the tympanic cavity was seen in 10 cases (5%) and three cases were seen in the mastoid cavity (1.5%). Other complications were otorrhea (15 cases), perforation (8 cases), material extrusion (6 cases), and posterior auricular infection (4 cases). The average preoperative pure tone air-bone gap, postoperative pure tone air-bone gap, and air-bone gap closure were 31.5 +/- 12.4 dB, 25.3 +/- 12.2 dB, and 6.2 +/- 12.6 dB, respectively. There were significant differences between the preoperative and postoperative values (P < 0.01).
The authors believe that epitympanoplasty with mastoid obliteration technique can combine the advantages of canal wall down and canal wall up techniques while improving their shortcomings.
报告上鼓室成形术联合乳突充填术的长期疗效。
1994年12月至2003年5月期间,200例成年患者接受了上鼓室成形术联合乳突充填术。术后平均观察期为91个月,最短为5年。上鼓室成形术联合乳突充填术有四个主要步骤:外耳道扩宽及盾板切除;保留外耳道后壁;上鼓室成形术;乳突充填术。我们检查了术后并发症及听力结果。
未出现内陷袋形成及胆脂瘤复发。鼓室内残留胆脂瘤10例(5%),乳突腔内3例(1.5%)。其他并发症包括耳漏(15例)、穿孔(8例)、材料挤出(6例)及耳后感染(4例)。术前平均纯音气骨导差、术后平均纯音气骨导差及气骨导差缩小分别为31.5±12.4dB、25.3±12.2dB及6.2±12.6dB。术前与术后数值之间存在显著差异(P<0.01)。
作者认为,上鼓室成形术联合乳突充填术可结合开放式和完壁式技术的优点,同时改善其缺点。