Total Mastoid Obliteration in Staged Canal-Up Tympanoplasty for Cholesteatoma Facilitates Tympanic Aeration
Total Mastoid Obliteration in Staged Canal-Up Tympanoplasty for Cholesteatoma Facilitates Tympanic Aeration
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DOI：
10.1097/mao.0b013e3181b23698
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发表时间：
2009-09-01
影响因子：
2.1
通讯作者：
Hinohira, Yasuyuki
中科院分区：
文献类型：
--
作者：
Yanagihara, Naoaki;Komori, Masahiro;Hinohira, Yasuyuki
目的：评估在完整耳道壁（ICW）鼓室成形术的第二阶段使用骨板和羟基磷灰石进行全乳突闭塞术后中耳通气情况。研究设计：回顾性研究。设置：三级转诊医院。患者：42耳中耳乳突瘤患者接受了闭塞术。第二阶段手术前1周的计算机断层扫描（CT）显示中耳通气障碍。在这些病例的27耳，颞骨CT扫描后3年或更长的operation.Intervention：我们进行了第二阶段ICW鼓室成形术后1年的第一阶段运河了。乳突切除及听骨成形术后，用软骨瓣阻断鼓室与窦腔的交通，用骨瓣或骨瓣联合羟基磷灰石颗粒完全封闭窦腔及乳突腔。主要观察指标：耳显微镜及耳内镜下对鼓膜回缩进行分级。结果：在第二期ICW鼓室成形术中，乳突完全闭塞后，未出现术后并发症，也未出现残余中耳瘤。鼓膜回缩的发生率显着相关的等级鼓室aeration.Conclusion：在第二阶段ICW鼓室成形术完成的乳突完全闭塞是一个安全的程序，有利于鼓腔通气。在鼓膜通气恢复的耳朵中，回缩袋发展的可能性很低。相反，二期手术后鼓室通气不良的耳发生回缩袋的可能性较高。
Objective: To assess middle ear aeration after total mastoid obliteration using bone pate and hydroxyapatite performed at the second stage of intact-canal-wall (ICW) tympanoplasty.Study Design: Retrospective study.Setting: Tertiary referral hospital.Patients: Forty-two ears with cholesteatoma underwent the obliteration. Computed tomography (CT) scan 1 week before the second-stage operation showed disturbance of middle ear aeration. In the 27 ears of these cases, temporal bone CT scans taken 3 years or more after the operation were available.Intervention: We performed second-stage ICW tympanoplasty 1 year after the first-stage canal-up operation. After mastoidectomy and ossiculoplasty, communication between the tympanic cavity and antrum was blocked with cartilage flaps, and the antrum and mastoid cavity were obliterated totally with bone pate alone or combined with hydroxyapatite granules.Main Outcome Measures: Otomicroscopic and otoendoscopic assessment for ear drum retraction was graded. Tympanic aeration assessed with CT when available.Results: After the total mastoid obliteration in the second-stage ICW tympanoplasty, no postoperative complications nor residual cholesteatoma were encountered. The incidence of ear drum retraction was significantly correlated with the grade of tympanic aeration.Conclusion: The total mastoid obliteration done at the second-stage ICW tympanoplasty is a safe procedure that facilitates aeration of the tympanic cavity. In ears with restored tympanic aeration, the probability of a retraction pocket development is low. On the contrary, possibility of retraction pocket development is high in the ears with poor tympanic aeration after the second-stage operation.