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先天性胆脂瘤晚期行鼓室成形并完壁式乳突切开术的疗效研究

A study on the efficacy of combined surgery in advanced-stage congenital cholesteatoma with canal-wall-up surgery.

机构信息

Department of Otorhinolaryngology, Eskişehir Osmangazi University, Eskişehir, Turkey.

Department of Otorhinolaryngology, Yunus Emre State Hospital, Eskişehir, Türkiye.

出版信息

Eur Arch Otorhinolaryngol. 2024 Nov;281(11):5747-5752. doi: 10.1007/s00405-024-08820-9. Epub 2024 Jul 18.

Abstract

PURPOSE

This study aimed to compare the outcomes of patients with advanced congenital cholesteatoma who underwent microscopic or endoscope-combined Canal Wall Up Tympanomastoidectomy (CWUT) in our clinic and to determine the contribution of endoscope use in reducing recurrence/residual rates.

METHODS

In this retrospective study, the data of individuals who underwent microscopic or combined endoscopic surgery between 2008 and 2022 in our clinic were scanned from the database. Demographic data, preoperative computed tomography (CT) findings, preoperative and postoperative hearing results, operation and intraoperative status of the ossicles, duration of surgery, postoperative follow-up period, recurrence and residual disease status during follow-up were investigated.

RESULTS

The data of 37 pediatric cases operated in our clinic were included in the study. All of the included cases were Potsic Stage 4 patients who underwent CWUT. The mean age of the operated individuals was 8.7 years (5-12 years) and the mean follow-up period was 47.3 months (12-112 months). 19 cases were performed microscopically only, 2 recurrences and 5 residuals were detected. 18 cases were performed combined and 1 recurrence and 1 residual was found.

CONCLUSION

In this study, it was determined that using an endoscope together with a microscope in congenital cholesteatoma cases, decreased the rate of recurrence and residual disease by protecting the external auditory canal in patients with advanced mastoid invasion.

摘要

目的

本研究旨在比较我院行显微镜或内镜联合鼓室成形术(CWUT)治疗晚期先天性胆脂瘤患者的疗效,探讨内镜在降低复发/残留率方面的作用。

方法

本回顾性研究从数据库中扫描了 2008 年至 2022 年期间在我院行显微镜或联合内镜手术的患者资料。调查了患者的人口统计学数据、术前 CT 表现、术前和术后听力结果、听骨手术和术中情况、手术时间、术后随访时间、随访期间的复发和残留疾病情况。

结果

本研究纳入了 37 例在我院接受手术的儿科病例。所有纳入病例均为接受 CWUT 的 Potsic 分期 4 期患者。手术患者的平均年龄为 8.7 岁(5-12 岁),平均随访时间为 47.3 个月(12-112 个月)。19 例仅行显微镜手术,发现 2 例复发和 5 例残留。18 例行联合手术,发现 1 例复发和 1 例残留。

结论

本研究表明,在晚期乳突侵袭性先天性胆脂瘤病例中,联合使用显微镜和内镜可通过保护外耳道来降低复发和残留疾病的发生率。

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