Palva T
Department of Otolaryngology, University Central Hospital, Helsinki, Finland.
Acta Otolaryngol. 1987 Nov-Dec;104(5-6):487-94. doi: 10.3109/00016488709128279.
Results of canal wall up (CWU) and canal wall down (CWD) tympanomastoid one-stage surgery were evaluated in 268 ears. In the CWU group of 121 ears, 50 ears (41%) had clinical cholesteatoma, whereas cholesteatoma was present in all 147 ears operated upon by the CWD technique. The disease was much less severe in the former group, which, for instance, showed no labyrith fistula, as compared with 17 (12%) in the latter group. Extensive disease also accounts for the larger number of complications seen in the CWD group. Average hearing levels postoperatively in the CWU group were significantly better than preoperatively. In the CWD group the preoperative levels were maintained. Recurrence of cholesteatoma was noted in 2% in the CWD group, while one implantation cholesteatoma occurred in the CWU group. Of the many surgical procedures available, the one offering the best means of curing the disease should of course be chosen. Ossicular repair with bone offers good prospects of a successful one-stage reconstruction.
对268例耳进行了上鼓室保留（CWU）和上鼓室开放（CWD）鼓室乳突一期手术的结果评估。在121例耳的CWU组中，50例耳（41%）有临床胆脂瘤，而采用CWD技术手术的147例耳均有胆脂瘤。前一组疾病严重程度轻得多，例如，前一组未出现迷路瘘管，而后一组有17例（12%）出现迷路瘘管。广泛的病变也是CWD组并发症较多的原因。CWU组术后平均听力水平明显优于术前。CWD组术前听力水平得以维持。CWD组胆脂瘤复发率为2%，而CWU组出现1例植入性胆脂瘤。在众多可用的外科手术中，当然应选择最能治愈该病的手术方法。用骨进行听骨链修复为一期重建成功提供了良好前景。
