Canal wall down versus canal wall up surgeries in the treatment of middle ear cholesteatoma
Canal wall down versus canal wall up surgeries in the treatment of middle ear cholesteatoma
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DOI：
10.3906/sag-1904-109
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发表时间：
2019-01-01
影响因子：
2.3
通讯作者：
Bayazit, Yildirim Ahmet
中科院分区：
文献类型：
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作者：
Karamert, Recep;Eravci, Fakih Cihat;Bayazit, Yildirim Ahmet
背景/目的：为比较耳道壁向上（CWU）和耳道壁向下（CWD）技术治疗中耳乳突瘤的效果，材料与方法：回顾性分析2015年7月至2017年11月间因中耳乳突瘤行初次手术的76例患者的病历。结果：76例中耳炎患者中，40例（52.6%）行CWU，36例（47.4%）行CWD手术。术后，CWU的平均气导阈值明显优于CWD手术（P = 0.016）。镫骨的存在和所用重建材料的类型对听觉成功率没有显著影响（分别为P = 0.342和P = 0.905）。听力成功也受到中耳粘膜状态的影响。结论：中耳黏膜和外耳道的状态是影响中耳乳突瘤手术疗效的重要因素。当外耳道内的骨没有被疾病侵蚀时，CWU手术似乎适用于外耳道瘤的病例，而不是CWD手术。
Background/aim: To compare outcomes of canal wall up (CWU) and canal wall down (CWD) techniques in the treatment of middle ear cholesteatoma.Materials and methods: Medical records of 76 patients who had a primary surgery due to middle ear cholesteatoma between July 2015 and November 2017 were reviewed retrospectively. Hearing thresholds, speech discrimination scores (SDS), recurrences, and revision surgeries of CWU and CWD surgeries were compared.Results: Of 76 cholesteatoma cases, 40 (52.6%) had a CWU and 36 (47.4%) had a CWD operation. Postoperatively, the mean air conduction thresholds were significantly better in CWU compared to CWD surgeries (P = 0.016). The presence of the stapes and the type of reconstruction material used did not have a significant effect on auditory success rates (P = 0.342 and P = 0.905, respectively). Auditory success was affected by the status of the middle ear mucosa as well. The recurrence and revision rates did not differ between the surgical techniques (P > 0.05).Conclusion: Status of the middle ear mucosa and external auditory canal are important factors affecting the outcomes in cholesteatoma. Instead of a CWD surgery, a CWU surgery seems applicable in cases of cholesteatoma when the bone in the external auditory canal is not eroded by the disease.