Division of Otolaryngology, University of Utah, Salt Lake City, Utah 84132, USA.
Otolaryngol Head Neck Surg. 2013 Aug;149(2):292-5. doi: 10.1177/0194599813489521. Epub 2013 May 14.
With different mastoidectomy approaches available to the surgeon for treatment of cholesteatoma, we review long-term outcomes of intact canal wall (ICW) mastoidectomy with tympanoplasty.
Case series with chart review.
Academic medical center.
All cases of cholesteatoma treated with ICW mastoidectomy by the senior author over a period of 9 years for which at least 2 years of follow-up data exist. Patient and disease information was collected retrospectively and analyzed.
One hundred forty-eight patients with 156 affected ears were treated and followed for a median of 5.3 years (range, 2.1-14.8). The majority of the operations (144/156, 92%) were staged. Of those that were staged, 51/144 (35%) had residual cholesteatoma at the second stage. Thirteen patients (8%) had recurrence of their cholesteatoma, of which 6 required a subsequent canal wall down (CWD) mastoidectomy.
ICW mastoidectomy with tympanoplasty continues to be a successful treatment for cholesteatoma. We found a substantial residual rate at the second stage, justifying the necessity of staging in most cases. Recurrence rate of cholesteatoma using this technique is low, as is the progression to CWD mastoidectomy.
对于外科医生治疗胆脂瘤的不同乳突切除术方法，我们回顾了完整的鼓室（ICW）乳突切除术伴鼓室成形术的长期结果。
病例系列与图表回顾。
学术医疗中心。
所有由资深作者采用 ICW 乳突切除术治疗胆脂瘤的病例，在 9 年期间至少有 2 年的随访数据。回顾性收集患者和疾病信息并进行分析。
148 例患者的 156 只患耳接受了治疗和随访，中位数为 5.3 年（范围为 2.1-14.8）。大多数手术（144/156，92%）是分期的。在分期的病例中，51/144（35%）在第二期仍有残余胆脂瘤。13 例（8%）患者的胆脂瘤复发，其中 6 例需要进行后续的鼓室下（CWD）乳突切除术。
ICW 乳突切除术伴鼓室成形术仍然是治疗胆脂瘤的有效方法。我们发现第二期仍有相当高的残余率，这证明了分期在大多数情况下是必要的。采用这种技术的胆脂瘤复发率低，进展为 CWD 乳突切除术的比例也低。
