本邦の中耳真珠腫手術治療の現況

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  • 山本 裕
    東京慈恵会医科大学耳鼻咽喉科学教室

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  • Current Status of Surgical Treatment for Middle Ear Cholesteatoma in Japan
  • ホンポウ ノ チュウジ シンジュ シュ シュジュツ チリョウ ノ ゲンキョウ

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<p>The current status of surgical treatment for middle ear cholesteatoma in Japan is discussed based on results of a national survey conducted in reference to the “Staging and classification criteria for middle ear cholesteatoma proposed by the Japan Otological Society.” In regard to the types of cholesteatoma, the pars flaccida type was the most common, accounting for 63.4% of all cases.</p><p>As for the stage of cholesteatoma, stage II was the most common stage among patients with the pars flaccida type and tense type of cholesteatomas, whereas, stage I disease was the most frequently encountered among patients with the secondary acquired type and congenital type of cholesteatomas. For the early stages of the disease, tympanoplasty without mastoidectomy and canal wall up mastoidectomy were commonly performed.</p><p>As the disease advanced, the rate of adoption of canal wall down mastoidectomy increased. The recurrence rate of cholesteatoma was 7.1%. There were no significant differences in the recurrence rates among patients treated by different surgical procedures. The postoperative hearing success rate according to the criteria of the Japanese Otological Society was 63.0%. It is necessary, via conducting global large-scale multi-institutional research, to promote optimization and standardization of treatment for middle ear cholesteatoma.</p>

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