耳内法で外耳道拡大術を行いリティンパ^®による鼓膜再生療法が可能となった1例

抄録

Regenerative treatment for tympanic membrane (TM) perforation with Retympa^® (RT-TMP) began to be covered by the National Health Insurance program in Japan in November 2019. Although this novel treatment has obviated the need for elevating a meatal flap and harvesting graft material, the indication is limited to cases without a narrow external ear canal.

In this report, we present a case of TM perforation in a patient with external auditory canal stenosis. Because of the stenosis, we could initially not access the TM with the endoscope. Therefore, we enlarged the external bony canal by the endaural approach, which allowed us to access the TM perforation. Accordingly, we treated the perforation by RT-TMP. After the treatment, the perforation closed completely, and the patient reported hearing improvement.

In cases where the TM cannot be reached with the endoscope because of external auditory canal stenosis, enlargement of the external bony canal prior to RT-TMP could be a solution.