Smyth G D
Laryngoscope. 1985 Jan;95(1):92-6. doi: 10.1288/00005537-198501000-00022.
Although there is an increasing awareness of the risks of complications following intact canal wall tympanoplasty (ICWT) for cholesteatoma, long-term evidence to support a preference for alternative techniques in which the canal wall having been removed, the resultant cavity is obliterated, is comparatively scarce. In order to clarify this uncertainty, long-term results with both operations have been analyzed to determine incidence rates for postoperative complications and functional results. Recurrent cholesteatoma (retraction pocket) has occurred in 14% of ICWT ears and 1% of ears with mastoid obliteration and tympanic reconstruction. The incidence of clinically detected residual disease with both operations has been extremely low so far, in spite of greater than 20% incidence of epithelial pearls at the second stage of separate planned two-stage procedures with each technique. It is concluded that reduction to the greatest degree possible of cholesteatomatous complications from tympanoplasty necessitates removal of the canal wall.
尽管对于胆脂瘤行完整外耳道壁鼓室成形术（ICWT）后并发症风险的认识日益提高，但支持倾向于采用去除外耳道壁并封闭由此形成的腔隙的替代技术的长期证据相对较少。为了澄清这种不确定性，对两种手术的长期结果进行了分析，以确定术后并发症的发生率和功能结果。复发性胆脂瘤（内陷袋）在ICWT术后耳中发生率为14%，在乳突封闭和鼓膜重建术后耳中发生率为1%。尽管在每种技术单独计划的两阶段手术的第二阶段上皮珠的发生率超过20%，但到目前为止，两种手术临床检测到的残留疾病发生率都极低。得出的结论是，要最大程度减少鼓室成形术的胆脂瘤性并发症，必须去除外耳道壁。
