鼓室形成術IV型を施行した耳小骨奇形の3例

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  • 北村 貴裕
    独立行政法人国立病院機構大阪医療センター耳鼻咽喉科・頭頸部外科 八尾市立病院耳鼻咽喉科
  • 長谷川 太郎
    長谷川耳鼻咽喉科
  • 西村 洋
    独立行政法人国立病院機構大阪医療センター耳鼻咽喉科・頭頸部外科

書誌事項

タイトル別名
  • Three Cases of Ossicular Anomalies Treated by Type IV Tympanoplasty
  • コシツケイセイジュツ Ⅳ カタ オ シコウ シタ ジショウコツ キケイ ノ 3レイ

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<p>In case of ossicular chain malformations, the preoperatively predicted prognosis sometimes differs from the prognosis signaled by histopathology. Flexible adoption of operative procedures, such as type III or IV tympanoplasty, or stapes surgery is necessary. Performance of type IV tympanoplasty is rare and there are few reports of the use of this procedure. We analyzed three cases of ossicular malformations treated by type IV tympanoplasty. The malformations were classified as type I in all three cases, according to Funasaka classification. Hearing improvement was successfully obtained in all three cases. In all three cases, type IVi tympanoplasty was performed. Ossicular stability was considered as having been obtained by fixing the columella to the malleus and incus, and good hearing improvement was maintained. The findings on middle ear and temporal bone CT before surgery are useful to determine the surgical procedures; the findings allow the surgical strategy to be predicted to some extent. However, there are some deformities that cannot be detected by CT, and the final decision on the procedure depends on the surgical findings. We think flexible adoption of surgical procedures and acquisition of informed consent from the patients are important.</p>

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