Cavity problemを伴う追加手術困難症例に対する自己洗浄フィードバック法の導入経験

抄録

Cavity problems can occur after the open method of treatment of cholesteatoma (mastoidectomy with removal of the whole canal wall [modified radical or radical mastoidectomy]), which is generally preferred for the prevention of cholesteatoma recurrence. In general, conservative treatment for infected mucosa and granulation in the mastoid cavity is performed at the outpatient clinic; however, otorrhea from an infected open mastoid wound may trouble patients for a long period of time after surgery, even if treatment is performed continuously. Therefore, revision surgery is needed for radical treatment in such cases. However, it is sometimes difficult for older adults, patients with severe medical complications and those under pressure at their place of work, to undergo the surgical treatment, which requires several days of hospitalization, general anesthesia and invasive procedures.

To address the above-mentioned problem, we developed a self ear-cleaning doctor-patient feedback method for intractable cavity problems. This method consists of patients cleaning their own ears in their own homes, coupled with observation by an otologist at the outpatient clinic, who may then suggest adjustments to the patient’s cleaning method. In the current study, the effectiveness of the self ear-cleaning doctor-patient feedback method, as well as its safety, was investigated.

Five patients, with a mean age of 51.4 years, were included in the study. All subjects had infections with otorrhea that improved with this method and the treatment could be completed safely in all the patients.

The present study demonstrates the effectiveness and safety of the self ear-cleaning doctor-patient feedback method. We believe that this method may be a viable option for the treatment of cavity problems, especially in older adults, patients with severe medical complications, and those under pressure at work.