Efficacy of mastoid cortex plasty for middle ear aeration in intact canal wall tympanoplasty for cholesteatoma
Efficacy of mastoid cortex plasty for middle ear aeration in intact canal wall tympanoplasty for cholesteatoma
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DOI：
10.1097/00129492-200207000-00005
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发表时间：
2002-07-01
影响因子：
2.1
通讯作者：
Yumoto, E
中科院分区：
文献类型：
--
作者：
Minoda, R;Yanagihara, T;Yumoto, E
目的：目的探讨乳突根治术后骨板封闭乳突皮质骨缺损的效果研究设计：这是一项前瞻性研究，设置：三级医疗中心，患者：35例乳突瘤侵入乳突腔的患者。干预：17例患者在一期手术中采用联合入路切除乳突瘤后，接受乳突皮质成形术、盾板成形术和硅胶片植入术。18例对照组患者只接受了盾板成形术与插入的硅橡胶片没有乳突皮质plasty.Main结果measurements：恢复中耳通气进行了评估与高分辨率计算机断层扫描前的第一阶段operation和第二阶段operation.Results：中耳通气的范围显着改善是否乳突皮质plasty进行。插入硅橡胶片的盾板成形术仅在改善上鼓室通气方面有效，而没有乳突皮质成形术。乳突皮质成形术加盾板成形术加硅胶片置入术对改善上鼓室和乳突腔通气有显著效果。在两组中，在一期手术前，约70%的患者中鼓室通气良好，并且在一期手术后中鼓室通气进一步改善。结论：乳突皮质成形术可明显改善乳突腔通气功能。
Objective: To determine the effect of closing the bone defect of the mastoid cortex using bone pate after mastoidectomy (mastoid cortex plasty) during the first-stage operation for the restoration of the mastoid cavity aeration.Study Design: This was a prospective study,Setting: Tertiary medical center,Patients: Thirty-five patients with cholesteatoma invading the mastoid cavity.Intervention: Seventeen patients received mastoid cortex plasty with scutum plasty and insertion of a Silastic sheet after removal of the cholesteatoma using a combined approach during the first-stage operation. The 18 control patients received only scutum plasty with the insertion of a Silastic sheet without mastoid cortex plasty during the first-stage operation.Main Outcome Measures: The restoration of the middle ear aeration was assessed with high-resolution computed tomography before both the first-stage operation and the second-stage operation.Results: The range of middle ear aeration ameliorated significantly whether or not mastoid cortex plasty was performed. Scutum plasty with the insertion of a Silastic sheet without mastoid cortex plasty was significantly effective only for the amelioration of the epitympanum aeration. Mastoid cortex plasty with scutum plasty with the insertion of a Silastic sheet was significantly effective for the amelioration of the epitympanum and also the mastoid cavity aeration. In both groups, before the first-stage operation, approximately 70% of the patients had good mesotympanum aeration, and the mesotympanum aeration ameliorated further after the first-stage operation., although this amelioration was not significant.Conclusions: Mastoid cortex plasty is statistically effective for the amelioration of mastoid cavity aeration after the first-stage operation.