Mastoid obliteration combined with soft-wall reconstruction of posterior ear canal
Mastoid obliteration combined with soft-wall reconstruction of posterior ear canal
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DOI：
10.1007/s00405-007-0273-5
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发表时间：
2007-08-01
影响因子：
2.6
通讯作者：
Funabiki, Kazuo
中科院分区：
文献类型：
--
作者：
Takahashi, Haruo;Iwanaga, Tetsu;Funabiki, Kazuo
为探讨改良软壁重建法结合乳突根治术的有效性，对96例（98耳）年龄5 ~ 82岁的乳突根治术患者，平均51.3耳，其中慢性中耳炎合并中耳炎62耳，非中耳炎性中耳炎18耳，术后耳腔问题14耳，粘连型中耳炎4耳，方法：对例乳突切除术后以骨粉为主行外耳道软壁重建及乳突闭塞术的患者，术后1年以上进行随访。总的成功率为76.5%（75/98），新鲜病例的成功率（84.8%）高于有多次手术史的病例（69.2%）。在不成功的病例中，观察到大多数（9只耳朵）结痂和/或碎屑积聚，其次是持续潮湿状态（7只耳朵）和闭塞材料暴露（5只耳朵），而只有两只耳朵显示出回缩袋形成。在随访超过2年和3年的患者中，成功率几乎保持不变（分别为46/61，75%和21/28，75%）。在术后听力评估的60耳中，41.7%的耳显示气骨导差（ABG）小于15 dB，61.7%的耳显示ABG小于20 dB。应用骨粉乳突腔封闭术结合外耳道软壁重建术是一种有效的乳突腔封闭术，尤其是预防术后耳袋形成的方法。
To clarify the usefulness of modified soft-wall reconstruction method by combing with mastoid obliteration, 96 patients (98 ears) with their age ranging from 5 to 82 (average 51.3), including 62 ears with chronic otitis media (COM) with cholesteatoma, 18 ears with non-cholesteatomatous COM, 14 ears with postoperative cavity problem, and 4 ears with adhesive-type COM, who had soft-wall reconstruction of the posterior ear canal and mastoid obliteration using mainly bone powder following mastoidectomy, were evaluated their postoperative conditions more than a year after surgery. Overall success rate was 76.5% (75/98), and fresh cases showed better success rate (84.8%) than those with a history of multiple surgeries (69.2%). Among unsuccessful cases, crust and/or debris accumulation was observed most (nine ears), followed by persistent wet condition (seven ears), and exposure of the obliterated material (five ears), while only two ears showed a retraction pocket formation. The success rates remained almost the same among those who were followed for more than 2 and 3 years (46/61, 75% and 21/28, 75%, respectively). In 60 ears on which postoperative hearing was assessed, 41.7% showed less than 15 dB of air-bone gap (ABG), and 61.7% showed less than 20 dB of ABG. Mastoid obliteration with bone powder in combination with soft-wall reconstruction of the posterior ear canal appeared a useful method for obliterating mastoidectomized cavity especially for prevention of postoperative pocket formation.