Storage of the incus in the mastoid bowl for use as a columella in staged tympanoplasty
Storage of the incus in the mastoid bowl for use as a columella in staged tympanoplasty
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DOI：
10.1016/j.anl.2006.05.018
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发表时间：
2007-03-01
影响因子：
1.7
通讯作者：
Hakuba, Nobuhiro
中科院分区：
文献类型：
--
作者：
Gyo, Kiyofumi;Hato, Naoto;Hakuba, Nobuhiro
目的：目的：探讨二期鼓室成形术中保留颞骨于乳突碗内的中耳乳突瘤患者的颞骨能否耐受长期植入，并在二期鼓室成形术中用于听骨重建。在第一阶段，在去除砧骨以根除中耳疾病后，将其放回乳突碗并储存在那里，直到第二阶段使用。结果：第二期手术中，所有病例均能辨认出砧骨，其中10个被一层薄薄的粘膜覆盖，12个被纤维或肉芽组织覆盖，2个与周围骨质连接。残留中耳瘤6耳，分别位于上鼓室（3耳）和鼓室窦（3耳）。在保留了砧骨的乳突碗中从未发生过这种情况。在19例病例中，砧骨可用作听骨重建的短小柱。其余5例因镫骨上部结构在二期手术中缺失，采用羟基磷灰石、听骨作为长鼻小柱进行重建。在一种情况下，存储的砧骨进行了显着的stages.Conclusion之间的吸收：保存在乳突碗的砧骨是一个有效的选择，在计划的两个阶段的鼓室成形术，当砧骨被认为是有用的听骨重建在第二阶段。(C)2006爱思唯尔爱尔兰有限公司保留所有权利。
Objective: To evaluate whether the incus of the cholesteatomatous ear preserved in the mastoid bowl during the first stage of planned two-stage tympanoplasty can tolerate long-term implantation and be used in ossicular reconstruction during the second stage.Methods: The study group included 24 ears of 23 patients who underwent staged tympanoplasty for the treatment of middle ear cholesteatoma. At the first stage, after removing the incus to eradicate the middle ear disease, it was returned to the mastoid bowl and stored there until use at the second stage. The average interval between the two stages was 8.3 months (range 6-12 months).Results: The incus was identified in all cases at the second stage: 10 incudes were found to be covered with a thin mucosa layer, 12 were buried in fibrous or granulation tissue, and 2 were joined to the surrounding bone. Residual cholesteatoma was found in six ears, either in the attic (three ears) or tympanic sinus (three ears). It never occurred in the mastoid bowl where the incus had been preserved. In 19 cases, the incus was available as a short columella for ossicular reconstruction. The remaining five cases were reconstructed using a hydroxyapatite, ossicle as a long columella, since the stapes superstructure was missing at the second stage. In one case, the stored incus underwent remarkable absorption between stages.Conclusion: Preservation of the incus in the mastoid bowl is an effective option in planned two-stage tympanoplasty, when the incus is considered useful for ossicular reconstruction at the second stage. (C) 2006 Elsevier Ireland Ltd. All rights reserved.