Donald P J, Baker S R
Laryngoscope. 1979 Feb;89(2 Pt 1):195-203. doi: 10.1288/00005537-197902000-00002.
Transmeatal atticotomy, a common otosurgical procedure near the turn of the century, has since enjoyed only sporadic periods of popularity. An earlier report illustrated the efficacy of the atticotomy operation in ablating cholesteatoma in 83% of cases. However, the ossicular chain usually suffers discontinuity either through erosion by cholesteatoma or surgical disarticulation. In ears with an intact chain, the incudostapedial joint is usually separated to avoid injury that may be transmitted to the inner ear if the rotating burr contacts the ossicles. The purpose of this paper is to portray the types of hearing restoration attempted and the results achieved in 55 patients who had an atticotomy procedure and had been followed for six months to eight years. The number of patients who attained serviceable hearing are compared to those that did not, with regard to such factors as the hearing level and state of the ossicles preoperatively as well as the extent of the surgery required for removal of the disease. The hearing results in these patients who underwent atticotomy compare favorably to those cited in the literature for tympanoplasties done with the modified radical mastoidectomy or the intact canal wall tympanomastoidectomy.
经耳道上鼓室切开术是世纪之交一种常见的耳外科手术，此后仅在零星时期受到欢迎。一份较早的报告表明，上鼓室切开术在83%的病例中对切除胆脂瘤有效。然而，听骨链通常会因胆脂瘤侵蚀或手术离断而连续性中断。在听骨链完整的耳朵中，通常会分离砧镫关节，以避免在旋转钻接触听骨时可能传递到内耳的损伤。本文的目的是描述55例接受过上鼓室切开术并随访了6个月至8年的患者所尝试的听力恢复类型及取得的结果。将获得有用听力的患者数量与未获得有用听力的患者数量进行比较，比较因素包括术前听力水平、听骨状态以及切除疾病所需的手术范围。这些接受上鼓室切开术的患者的听力结果与文献中报道的采用改良根治性乳突切除术或完整外耳道壁鼓室乳突切除术的鼓室成形术的结果相比更具优势。
