Tos M, Lau T
ENT Department, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.
Auris Nasus Larynx. 1989;16(2):61-73. doi: 10.1016/s0385-8146(89)80038-0.
The late results in 740 patients with cholesteatoma subjected to one-stage canal wall down mastoidectomy (262 patients), modified canal wall up mastoidectomy (324 patients), and tympanoplasty without mastoidectomy (154 patients) were analyzed with regard to hearing and the condition of the drum. Mean observation time was 9.3 years, range 3-21 years. Postoperative hearing (air bone gap and pure tone average) and as hearing at the last evaluation was significantly better in the canal wall up group, than in the canal wall down group, but also the preoperative hearing was better in the canal wall up group. The postoperative hearing was best in the group with tympanoplasty only without mastoidectomy. It is concluded that no single method is optimal in all cases of cholesteatoma and that cholesteatoma surgery should be individualized.
对740例胆脂瘤患者的远期结果进行了分析，这些患者分别接受了一期开放式乳突根治术（262例）、改良式完壁式乳突根治术（324例）和单纯鼓室成形术（154例），分析内容涉及听力和鼓膜状况。平均观察时间为9.3年，范围为3至21年。完壁式乳突根治术组术后听力（气骨导差和纯音平均听阈）以及最后一次评估时的听力明显优于开放式乳突根治术组，而且完壁式乳突根治术组术前听力也更好。单纯鼓室成形术组术后听力最佳。得出的结论是，在所有胆脂瘤病例中没有一种单一方法是最佳的，胆脂瘤手术应个体化。
