中耳真珠腫に対する段階的鼓室形成術

Abstract

Forty-three ears that underwent planned staged tympanoplasty were compared with 52 ears that underwent one-stage tympanoplasty for cholesteatoma. Planned staged tympanoplasty was mainly performed in children, compared with one-stage tympanoplasty; The rate of planned staged tympanoplasty was 64% in children under 9 years, and 59% in teenagers, but it was only 30% in patients over twenty years old.Patients who underwent planned staged tympanoplasty generally had greater hearing loss than those who underwent one-stage tympanoplasty. Preoperative hearing was within 40 dB in 64% of those in the one-stage tympanoplasty group, but only in 29% of those in the planned staged tympanoplasty group.In one-stage tympanoplasty, the closed method was performed in two-thirds of the cases and open method was performed in remaining cases. In planned staged tympanoplasty, the open method was performed in two-thirds of the cases.Residual cholesteatoma was found in 13.2% at the second-stage operation, and it was found more frequently in children under 9 years (27.3%) than in patients over 10 years (7.4%). Residual cholesteatoma appeared in 8.0% treated by the open method and in 23.0% treated by the closed method.In patients followed for more than 1 year, postoperative hearing level was remained within 40 dB or showed a gain of over 20 dB in 75.0% of those receiving planned staged tympanoplasty and in 68.3% of those receiving one-stage tympanoplasty.