Congenital Middle Ear Cholesteatoma: Experience from 26 Surgical Cases
Congenital Middle Ear Cholesteatoma: Experience from 26 Surgical Cases
复制标题
先天性中耳胆脂瘤26例手术经验
DOI：
10.1177/000348941312200505
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发表时间：
2013
期刊：
影响因子：
--
通讯作者：
H. Mineta
中科院分区：
文献类型：
--
作者：
T. Yamatodani;K. Mizuta;K. Hosokawa;Y. Takizawa;K. Sugiyama;H. Nakanishi;H. Mineta
目的：分析儿童先天性中耳乳突瘤的临床特点和手术方法。研究方法：我们研究了1998年1月至2009年12月期间接受先天性中耳乳突瘤手术的26例患者（26耳），重点关注中耳乳突瘤的位置和类型，涉及的外科手术以及获得的结果。排除了既往接受过耳科手术的患者。采用4阶段系统对中耳瘤进行分级。结果：后象限受累和开放型中耳瘤的发生率在更晚期增加。60%的III期和75%的IV期病例进行了二次探查手术;在20%的III期和75%的IV期病例中发现了残留的中耳炎。在手术前后评估的病例中，100%的I期和II期病例、86%的III期病例和50%的IV期病例显示听力功能改善。结论：该分期系统相对简单，同时能准确反映临床结果。然而，先天性中耳乳突瘤的前部和后部类型在手术入路和术后进展方面存在许多差异，这些差异未反映在分类系统中，需要进一步研究。此外，我们回顾了前象限病例的手术方法，并提出了一种改良的手术方法。
Objectives: We analyzed the clinical features and surgical techniques used in cases of childhood congenital cholesteatoma of the middle ear. Methods: We studied 26 patients (26 ears) who underwent surgery for congenital cholesteatoma between January 1998 and December 2009, focusing on the location and type of cholesteatoma, the surgical procedures involved, and the results obtained. Patients with prior otologic procedures were excluded. A 4-stage system was used to grade the cholesteatomas. Results: The frequency of posterior-quadrant involvement and open-type cholesteatomas increased in the more advanced stages. Second-look operations were performed in 60% of stage III and 75% of stage IV cases; and residual cholesteatomas were found in 20% of stage III and 75% of stage IV cases. Of the cases evaluated both before and after the operation, 100% of stage I and II cases, 86% of stage III cases, and 50% of stage IV cases showed improvement in hearing function. Conclusions: The staging system is relatively simple, while accurately reflecting clinical results. However, there are many differences between the anterior and posterior types of congenital cholesteatomas in surgical approach and postoperative progression that are not reflected in the classification systems and require further study. In addition, we reviewed the surgical procedures involved in anterior-quadrant cases, and propose a modified surgical procedure.
影响因子：
2.5
作者：
Kojima, Hiromi;Tanaka, Yasuhiro;Moriyama, Hiroshi
通讯作者：
Moriyama, Hiroshi