非胆脂瘤型慢性中耳炎Ⅰ型鼓室成形术手术方法的改良

Modification of surgical procedures of type 1 tympanoplasty for non-cholesteatomatous chronic otitis media.

作者信息

Kakigi Akinobu, Takeda Taizo, Nakatani Hiroaki, Kozakura Kenichi, Sawada Shoichi, Nishioka Rie, Fukushima Kei, Taguchi Daizo, Matsumoto Noboru

机构信息

Department of Otolaryngology, Faculty of Medicine, University of Tokyo, Bunkyo-ku, Tokyo, Japan.

出版信息

ORL J Otorhinolaryngol Relat Spec. 2010;71 Suppl 1:71-3. doi: 10.1159/000265124. Epub 2010 Feb 24.

DOI:10.1159/000265124

PMID:20185952

Abstract

OBJECTIVE

To introduce our modified procedures of type 1 tympanoplasty and to assess their efficacy.

METHODS

We modified the surgical procedures of type 1 tympanoplasty and have used these procedures since September 1999. The modified points are enlargement of the facial recess approach, no elevation of the posterior meatal skin and the tympanic annulus, and endoaural repair of tympanic membrane perforation. 51 patients with simple chronic otitis media have undergone this modified type 1 tympanoplasty. Postoperative hearing was evaluated according to the criteria proposed by the Otological Society of Japan.

RESULTS

The average follow-up period was 15 months (range 6-35). The hearing result was considered successful when the postoperative hearing level satisfied with at least one of three conditions as follows: (1) air-bone gap <15 dB, (2) hearing gain >15 dB, or (3) hearing level >30 dB. The success rate was 94.1%. The average postoperative air-bone gap, hearing gain and hearing level were 3.9, 10.0 and 29.3 dB, respectively.

CONCLUSION

Our modified tympanoplasty is useful to achieve better postoperative hearing results.

摘要

目的

介绍我们改良的Ⅰ型鼓室成形术手术方法并评估其疗效。

方法

我们对Ⅰ型鼓室成形术的手术方法进行了改良，并自1999年9月起采用这些方法。改良要点包括扩大面神经隐窝入路、不掀起外耳道后壁皮肤和鼓环以及经耳内修复鼓膜穿孔。51例单纯慢性中耳炎患者接受了这种改良的Ⅰ型鼓室成形术。根据日本耳科学会提出的标准评估术后听力。

结果

平均随访时间为15个月（范围6 - 35个月）。当术后听力水平满足以下三个条件中的至少一个时，听力结果被认为是成功的：（1）气骨导差<15dB，（2）听力增益>15dB，或（3）听力水平>30dB。成功率为94.1%。术后平均气骨导差、听力增益和听力水平分别为3.9dB、10.0dB和29.3dB。