中耳真珠腫の手術法

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書誌事項

タイトル別名
  • Middle-Ear Cholesteatoma Surgery
  • 中耳真珠腫の手術法--いかに個別治療を選択するか
  • チュウジ シンジュ シュ ノ シュジュツホウ イカニ コベツ チリョウ オ センタク スル カ
  • ―いかに個別治療を選択するか―
  • —The Need of Individualized Therapy—

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The goal of middle-ear cholesteatoma surgery is two-fold—a safe, dry, trouble-free ear and good hearing. No single surgical strategy is optimal in all cases, however, necessitating an individualized approach—and a standard for surgical selection.<br> We reviewed middle-ear ventilation and tympanoplasty techniques. Cholesteatoma recurrence is a major problem following closed tympanoplasty, requiring ventilation created from the mesotympanum to the mastoid cavity and promoting mastoid reaeration. If a ventilation route cannot be constructed posto-peratively, open tympanoplasty should be considered.<br> In attic and antrum aeration in preoperative computed tomography (CT), we selected closed tympanoplasty. For such cases without attic and antrum aeration, planned tympanoplasty was selected. In those older than 60 years or with poor Eustachian tube function, open tympanoplasty with or without soft-wall external ear canal reconstruction was selected rather than planned staged tympanoplasty. Postoperative residual cholesteatoma was seen in 19 of 185 ears (10.3%), but no recurrent cholesteatoma.<br> Individual hospital staffs should thus prepare and review a standard individualizing cholesteatoma surgery.<br>

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