外耳道後上壁の再建
Combined approach with lateral tympanotomyの手術所見から
1994 年 4 巻 2 号 p. 162-167
詳細
1994 年 4 巻 2 号 p. 162-167
The combined approach of lateral tympanotomy with reconstruction of defective posterosuperior wall of the external auditory canal was performed in 150 ears, regardless to the complications' of cholesteatoma. The following findings were obtained.
1) Satisfactory prognosis was confirmed in 90% of the total cases operated on, and this technique was considered to heve a wide indication.
2) Occlusion of the anterior tympanic isthmus along a ventilating route, caused either by granulation or cholesteatoma, was found in all cases with poor prognosis during the exploratory reoperations. Thorough anterior tympanotomy should, therefore, be made in order to prevent possible postoperative ventilatory failure.
3) Cartilage plate was considered more suitable for the reconstructive material than a piece of cortical bone, because the reconstructive operations were easily done with the combination of cartilage plate and fibrin glue, whereas an interstice was even tually developed between a piece of cortical bone and the external auditory canal.
4) Recurrence of cholesteatoma was observed postoperatively in 3 of 27 cases of cholesteatoma in the pars tensa. Accordingly, the indication of this technique should be deliberately considered for the surgical treatment of cholesteatoma in the pars tensa.
