Shinkawa A, Sakai M, Tamura Y, Takahashi H, Ishida K
Department of Otorhinolaryngology, School of Medicine, Tokai University, Kanagawa, Japan.
Tokai J Exp Clin Med. 1998 Mar;23(1):19-23.
We operated on 54 ears using the canal-down procedure consisting of one-stage tympanoplasty with mastoid obliteration for non-cholesteatoma otitis media with lesions in the ossicular chain and compared the results with those of patients treated with the canal-up procedure. Complications, such as mastoid problems, which have been observed in surgery with the simple canal-down procedure, were not observed in operations combining mastoid obliteration. The success rate for our procedure as evaluated by postoperative hearing levels, according to the standards established by the Japan Society of Clinical Otology, Committee on Nomenclature 1987, was 77.4% with tympanoplasty (ceramic P type) with reconstruction of the ossicular chain; 70.6% with reconstructive surgery using T type ceramic; and 50.0% with reconstructive surgery using the patient's own bone. Overall, the success rate was 72.2%. Our procedure seems to be superior to the canal-up procedure with respect to improvement of hearing levels in the treatment of patients with chronic otitis media associated with lesions in the ossicular chain.
我们采用耳道下径路对54耳进行了手术，该径路包括一期鼓室成形术并乳突填塞术，用于治疗伴有听骨链病变的非胆脂瘤性中耳炎，并将结果与采用耳道上径路治疗的患者进行比较。在单纯耳道下径路手术中观察到的诸如乳突问题等并发症，在联合乳突填塞术的手术中未观察到。根据日本临床耳科学会命名委员会1987年制定的标准，通过术后听力水平评估，我们的手术成功率在采用陶瓷P型听骨链重建的鼓室成形术（陶瓷P型）中为77.4%；在使用T型陶瓷进行重建手术中为70.6%；在使用患者自身骨进行重建手术中为50.0%。总体而言，成功率为72.2%。在治疗伴有听骨链病变的慢性中耳炎患者时，就听力水平改善而言，我们的手术似乎优于耳道上径路手术。
