Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Clin Exp Otorhinolaryngol. 2010 Dec;3(4):203-6. doi: 10.3342/ceo.2010.3.4.203. Epub 2010 Dec 22.
The aim of this study was to compare the hearing outcomes between canal wall up mastoidectmy (CWUM) and canal wall down mastoidectmy (CWDM).
One hundred seventy one chronic suppurative otitis media (CSOM) patients were enrolled in this retrospective study. The patients who underwent the second staged ossiculoplasty at least 6 months after mastoidectomy and who had an intact, well aerated tympanic cavity as well as intact mobile stapes at the time of operation were selected from the medical record. Based on the type of mastoid surgery, the patients were categorized into two groups: the CWUM (n=38) and CWDM groups (n=133). The hearing results of the CWUM and CWDM groups were compared using the pre- and post-operative air-bone gap (ABG) at 3 months after ossiculoplasty.
The preoperative ABG in both groups (CWUM and CWDM) were 28.4±15.6 dB and 31.8±14.5 dB, respectively (P=0.18). Both groups didn't show any significant difference (10.9 dB vs. 13.5 dB, respectively) (P=0.21) for the postoperative ABG closure. The proportion of patients with an ABG less than 20 dB was 58.6% of the CWDM patients and 68.4% of the CWUM patients (P=0.25).
The type of mastoid surgery (CWUM and CWDM) did not affect the hearing results of CSOM patients. When choosing the type of mastoidectomy procedure for CSOM surgery, the hearing outcomes are basically the same for both types of procedure.
本研究旨在比较完壁式乳突切除术(CWUM)和完壁式乳突切开术(CWDM)的听力结果。
本回顾性研究纳入了 171 例慢性化脓性中耳炎(CSOM)患者。选择那些在乳突切除术后至少 6 个月接受第二期听骨链成形术且在手术时具有完整、通气良好的鼓室腔以及完整、活动的镫骨的患者。根据乳突手术类型,将患者分为两组:CWUM 组(n=38)和 CWDM 组(n=133)。比较 CWUM 和 CWDM 组在听骨链成形术后 3 个月的术前和术后气骨导差(ABG)。
两组(CWUM 和 CWDM)的术前 ABG 分别为 28.4±15.6 dB 和 31.8±14.5 dB(P=0.18)。两组患者术后 ABG 关闭无显著差异(分别为 10.9 dB 和 13.5 dB)(P=0.21)。CWDM 组中有 ABG 小于 20 dB 的患者比例为 58.6%,CWUM 组为 68.4%(P=0.25)。
乳突手术类型(CWUM 和 CWDM)不会影响 CSOM 患者的听力结果。在选择 CSOM 手术的乳突切除术类型时,两种类型的手术在听力结果上基本相同。