抄録
We analyzed 14 cases of postoperative recurrent cholesteatoma based on the viewpoint of the ventilation of the middle ear using the CT images and findings during the revision surgeries. Aeration of the mastoid was not observed in any of 14 cases, whereas aeration of the tympanic cavity was observed in 10 out of 14 cases; this correlated well with tubal function. In 12 out of 14 cases, a mastoidectomy had been performed at the first operation. In the other 2 cases, the mastoid air cells had been partially resected. During the first operation, the posterior canal walls had been preserved in 12 out of 14 cases, and had been reconstructed in 12 cases. One case was reconstructed by the hard tissue, the other is only by the soft tissue. The eustachian tubes were obstructed in 3 out of 14 cases, but were not obstructed in the other 11. In 8 cases, the pathway through which the recurrent cholesteatoma had extended into the mastoid was the epitympanum and in another 5 cases it was through a small bony defect in the posterior canal. In the remaining one case, the recurrent cholesteatoma had entered into the mastoid through the osteo-cartilaginous junction of the posterior external auditory canal.
These results suggested that a decrease in the gas exchange function of the mastoid might disturb the postoperative recovery of aeration in the mastoid, and thus might have led to a recurrence of the cholesteatoma.
