Smyth G D
J Laryngol Otol. 1976 Aug;90(8):713-41.
This survey was carried out to evaluate techniques in current use for the treatment of chronic suppurative otitis media. Part I concerns the incidence of cholesteatomatous complications following combined approach tympanoplasty (CAT). Residual and Recurrent cholesteatoma occurred much more frequently than had been expected or reported elsewhere. Although the incidence of Recurrent cholesteatoma has been markedly reduced by technical modifications, Residual cholesteatoma was discovered inadvertently in one out of every seven previously cholesteatomatous ears in which a second operation for ossicular reconstruction was performed. In at least one-third the disease had been left in the epitympanum. Although many cholesteatomatous cysts might lie dormant for years, and possibly never give rise to serious consequences, it can no longer be claimed that CAT provides a satisfactory means of eradicating cholesteatoma unless re-exploration operations were continued until eventually the tubotympanic cleft could be shown free of cholesteatoma.
本次调查旨在评估目前用于治疗慢性化脓性中耳炎的技术。第一部分涉及联合进路鼓室成形术（CAT）后胆脂瘤并发症的发生率。残余和复发性胆脂瘤的发生频率比预期或其他地方报道的要高得多。尽管通过技术改进，复发性胆脂瘤的发生率已显著降低，但在每七只先前患有胆脂瘤且接受了第二次听骨重建手术的耳朵中，就有一只无意中发现了残余胆脂瘤。至少三分之一的病例中，上鼓室仍残留病变。尽管许多胆脂瘤囊肿可能潜伏数年，且可能永远不会引发严重后果，但除非持续进行再次探查手术，直到最终咽鼓管鼓室裂无胆脂瘤，否则不能再声称CAT提供了一种令人满意的根除胆脂瘤的方法。
