成人の後天性真珠腫の治療成績

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  • Surgical Outcomes in Adult Patients with Acquired Cholesteatoma
  • セイジン ノ コウテンセイ シンジュ シュ ノ チリョウ セイセキ

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<p>We retrospectively reviewed the data of 190 adults (206 ears) with acquired cholesteatoma who had undergone tympanoplasty at our department between July 2010 and December 2021. The cholesteatoma stages, surgical strategies adopted, recurrence rate, and hearing improvement success rate were analyzed. The extent of cholesteatoma was classified into stages according to the Classification and Staging of cholesteatoma proposed by the Japan Otological Society in 2010. Stage II was the most common in both patients with pars flaccida cholesteatoma and pars tensa cholesteatoma. A canal wall-down mastoidectomy with canal reconstruction using auricular cartilage was performed for ears with stage II/III disease. Staged tympanoplasty was selected for 22.0% of patients with pars flaccida cholesteatoma and 9.1% of patients with pars tensa cholesteatoma. Residual cholesteatoma was observed in 30.0% of patients with pars flaccida cholesteatoma and 50.0% of patients with pars tensa cholesteatoma treated by staged tympanoplasty at the second operation. Three patients (1.6%) with pars flaccida cholesteatoma developed recurrence; all of them were diagnosed as having retraction cholesteatoma. One patient (4.5%) with pars tensa cholesteatoma had a residual cholesteatoma. The hearing improvement success rate was 75.1% in patients with pars flaccida cholesteatoma and 71.4% in patients with pars tensa cholesteatoma. These results indicate the usefulness of canal wall-down mastoidectomy with canal reconstruction using auricular cartilage for minimizing the risk of residual cholesteatoma and retraction cholesteatoma, without compromising on hearing.</p>

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