Ito Tsukasa, Kubota Toshinori, Watanabe Tomoo, Futai Kazunori, Furukawa Takatoshi, Kakehata Seiji
Department of Otolaryngology, Head and Neck Surgery, Yamagata University Faculty of Medicine, 2-2-2 Iida-Nishi, Yamagata-shi, Yamagata 990-9585, Japan.
Department of Otolaryngology, Head and Neck Surgery, Yamagata University Faculty of Medicine, 2-2-2 Iida-Nishi, Yamagata-shi, Yamagata 990-9585, Japan.
Int J Pediatr Otorhinolaryngol. 2015 Dec;79(12):2265-9. doi: 10.1016/j.ijporl.2015.10.019. Epub 2015 Oct 24.
To retrospectively determine the size of the external auditory canal (EAC) in a pediatric population and to describe our experience with transcanal endoscopic ear surgery (TEES) in this pediatric population which had been successfully treated for middle ear disease using TEES.
We analyzed 31 patients ranging in age from 2 to 13 years old (median: 7.6 years) with middle ear disease who underwent TEES between November 2011 and August 2014. Sixteen of these patients had surgery for cholesteatomas; 11 for chronic otitis media; and 4 for malformation of the middle ear. A preoperative CT scan was performed to evaluate the middle ear disease. Transcanal endoscopic tympanoplasty was performed using a rigid endoscope with a 2.7mm outer diameter. Transcanal endoscopic atticoantrotomy was also performed, as necessary, on some patients to access pathologies in the antrum. The values of anterior-posterior diameters and superior-inferior diameters of the bony parts of EAC were measured retrospectively based on the preoperative CT scan data.
TEES was successfully performed in all 31 pediatric patients without resorting to a retroauricular incision. Twenty-seven patients were evaluated for postoperative hearing levels which were found to fall within an acceptable range and for postoperative air-bone gap (ABG) by pure tone audiometry with a resulting mean of 8.6dB. The smallest anterior-posterior diameters of the external ear canal ranged from 3.2 to 7.1mm (5.0±1.0mm) and the smallest superior-inferior diameters ranged from 3.4 to 10.3mm (5.9±1.3mm).
TEES can be used to safely and effectively treat middle ear disease even in the pediatric population in its narrow EAC.
回顾性确定儿科人群中外耳道（EAC）的大小，并描述我们在该儿科人群中使用经耳道内镜耳手术（TEES）的经验，这些患儿已通过TEES成功治疗中耳疾病。
我们分析了2011年11月至2014年8月期间接受TEES的31例年龄在2至13岁（中位数：7.6岁）的中耳疾病患儿。其中16例患者因胆脂瘤接受手术；11例因慢性中耳炎；4例因中耳畸形。术前行CT扫描以评估中耳疾病。使用外径为2.7mm的硬性内镜进行经耳道内镜鼓室成形术。必要时，也对部分患者进行经耳道内镜上鼓室鼓窦切开术，以处理鼓窦内的病变。根据术前CT扫描数据，回顾性测量EAC骨部的前后径和上下径值。
所有31例儿科患者均成功进行了TEES，无需耳后切口。对27例患者进行了术后听力水平评估，发现其听力水平在可接受范围内，并通过纯音听力测定法评估了术后气骨导差（ABG），平均为8.6dB。外耳道最小前后径范围为3.2至7.1mm（5.0±1.0mm），最小上下径范围为3.4至10.3mm（5.9±1.3mm）。
即使在EAC狭窄的儿科人群中，TEES也可用于安全有效地治疗中耳疾病。
