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胆脂瘤的全耳道内镜耳手术

Total Transcanal Endoscopic Ear Surgery for Cholesteatoma.

作者信息

Dalğıç Abdullah, Aksoy Yıldırım Gökçe, Zorlu Mehmet Ekrem, Delice Orçun, Aysel Abdulhalim

机构信息

Department of Otolaryngology and Head & Neck Surgery, İzmir Bozyaka Training and Research Hospital, University of Health Sciences Turkey, İzmir, Turkey.

出版信息

Turk Arch Otorhinolaryngol. 2023 Mar;61(1):1-7. doi: 10.4274/tao.2023.2022-11-6. Epub 2023 Aug 11.

Abstract

OBJECTIVE

This study aimed to evaluate the outcomes of total transcanal endoscopic cholesteatoma surgery.

METHODS

Twenty-seven cholesteatoma patients that had undergone transcanal endoscopic ear surgery (TEES) were included in the study. Age, sex, operation date of patients, operated side, need for ossiculoplasty, graft material, and surgical technique were recorded. All patients were evaluated through otoscopic, endoscopic, and audiological examinations and followed up for at least five months after surgery. All patients were staged using the European Academy of Otology and Neurotology/Japan Otological Society (EAONO/JOS) Staging System on Middle Ear Cholesteatoma.

RESULTS

Mean age of the patients was 36.4 years (range, 4-67 years). According to the EAONO/JOS Staging System, 11 patients were stage 1, while 11 were stage 2, and five were stage 3. Two had lateral semicircular canal defect, one had facial canal dehiscence, and one had oval window defect. The average follow-up period was 19 months (range, 5-41 months), during which two patients experienced retraction pocket and hearing loss and one patient had perforation. One patient underwent revision surgery during follow-up and no recurrence or residual cholesteatoma was observed. The preoperative and postoperative air-bone gaps were 25.14±13.93 dB and 22.22±12.64 dB with no significant difference.

CONCLUSION

TEES is a minimally invasive and safe procedure with low complication and recurrence rates. As with all surgical procedures, experience is essential, and as experience increases, the capability to perform endoscopic otologic surgery on more complex cases may become possible.

摘要

目的

本研究旨在评估经耳道内镜胆脂瘤手术的效果。

方法

本研究纳入了27例接受经耳道内镜耳手术(TEES)的胆脂瘤患者。记录患者的年龄、性别、手术日期、手术侧别、是否需要听骨链成形术、移植材料及手术技术。所有患者均通过耳镜、内镜及听力学检查进行评估,并在术后至少随访5个月。所有患者均根据欧洲耳科学与神经耳科学学会/日本耳科学会(EAONO/JOS)中耳胆脂瘤分期系统进行分期。

结果

患者的平均年龄为36.4岁(范围4 - 67岁)。根据EAONO/JOS分期系统,11例为1期,11例为2期,5例为3期。2例存在外侧半规管缺损,1例存在面神经管裂,1例存在卵圆窗缺损。平均随访期为19个月(范围5 - 41个月),在此期间,2例患者出现回缩袋和听力损失,1例患者出现穿孔。1例患者在随访期间接受了翻修手术,未观察到复发或残留胆脂瘤。术前和术后气骨导差分别为25.14±13.93 dB和22.22±12.64 dB,差异无统计学意义。

结论

TEES是一种微创且安全的手术,并发症和复发率低。与所有外科手术一样,经验至关重要,随着经验的增加,对更复杂病例进行内镜耳科手术的能力可能会实现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0992/10424586/f1b12eedc495/tao-61-1-g1.jpg

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