VESTIBULOTOMY

抄録

The author presented the personal experiences with four cases of vestibulotomy in chronic otitis media and reviewed the cases appeared in the literature.
It is the most important to protect the labyrinth against occ urrence of post-operative labyrinthitis after opening the oval window.Better results may be obtained both by immediate obliteration of the opened window and by massive use of antibiotic.In the cases of antibiotic sensitive infection, the function of the labyrinth was not impaired after vestibulotomy.They showed the marked improvement in hearing.
On the other hand, the post-operative labyrin thitis occurred, resulting in deaf, in other two cases with antibiotic resistant infection.So the author is of opinion that an ear with antibiotic resistant infection is acontraindication for vestibulotomy.
In all our cases, the stapes was removed accidentally, and the oval window was immediately obliterated with a connective tissue plug.After completing a radical operation, the plug was removed and the opened window was permanentally covered with a temporal fascia graft.The second operation was all carried out as type IV.Reviewing the literature, most authors, except for Weichselbaumer(1965), seem to perform an one-stage operation, in which a type lll was often obtained by creating a columella.The author discussed the value of such one-stage operation.