Kim Bo Gyung, Kim Hyo Jun, Lee Seung Jae, Lee Eunsang, Lee Se A, Lee Jong Dae
Department of Otorhinolaryngology-Head and Neck Surgery, Soonchunhyang University College of Medicine, Bucheon, Korea.
Clin Exp Otorhinolaryngol. 2019 Nov;12(4):360-366. doi: 10.21053/ceo.2018.01333. Epub 2019 Feb 1.
The traditional canal wall down mastoidectomy (CWDM) procedure commonly has potential problems of altering the anatomy and physiology of the middle ear and mastoid. This study evaluated outcomes in patients who underwent modified canal wall down mastoidectomy (mCWDM) and mastoid obliteration using autologous materials.
Our study included 76 patients with chronic otitis media, cholesteatoma, and adhesive otitis who underwent mCWDM and mastoid obliteration using autologous materials between 2010 and 2015. Postoperative hearing airbone gap and complications were evaluated.
During the average follow-up of 64 months (range, 20 to 89 months), there was no recurrent or residual cholesteatoma or chronic otitis media. No patient had a cavity problem and anatomic integrity of the posterior canal wall was obtained. There was a significant improvement in hearing with respect to the postoperative air-bone gap (P<0.05). A retroauricular skin depression was a common complication of this technique.
The present study suggests that our technique can prevent various complications of the classical CWDM technique using autologous tissues for mastoid cavity obliteration. It is also an appropriate method to obtain adequate volume for safe obliteration.
传统的开放式乳突根治术（CWDM）通常存在改变中耳和乳突解剖结构及生理功能的潜在问题。本研究评估了接受改良开放式乳突根治术（mCWDM）并使用自体材料进行乳突腔填塞的患者的治疗效果。
我们的研究纳入了76例在2010年至2015年间接受mCWDM并使用自体材料进行乳突腔填塞的慢性中耳炎、胆脂瘤和粘连性中耳炎患者。评估术后听力气骨导差及并发症情况。
在平均64个月（范围20至89个月）的随访期间，无胆脂瘤复发或残留，也无慢性中耳炎。无患者出现术腔问题，且获得了后鼓室壁的解剖完整性。术后气骨导差方面听力有显著改善（P<0.05）。耳后皮肤凹陷是该技术的常见并发症。
本研究表明，我们的技术可利用自体组织进行乳突腔填塞，预防经典CWDM技术的各种并发症。这也是获得足够容积以安全填塞的合适方法。
