The favourable or unfavourable effect of tympanoplasty may be decided almost by a pathologic condition of mastoid bone wall covered by skin flap. The author picked the mastoid bone wall on the tympanoplasty, and compared the histo-pathologic condition with the progress of mastoid wound and hearing restoration.
The bone walls of 98 cases are investigated histologically, distinguished in two part of periostium and bone substance.
The pathologic condition of the periostium showed especially (1) inflamatory change in 78 cases, (2) gland proliferation change in 29 cases, (3) cholesterin granulomatous change in 15 cases, and the condition of the bone substance showed, (1) change of bone structure in 86 cases, (2) change of bone density in 64 cases, (3) fatt degeneration in 31 cases.
The cases of strong inflamatory change showed the unfavourable progress of mastoid wound and in 50% the hearing restoration, the cases of mild inflamatory change showed thefavourable progress and the hearing restoration is effectivelly in 75%. The cases of strong gland proliferation change showed the more unfavourable progress than the progress on the strong inflamatory change and the effect of hearing restoration is in 52%. The cholesterin granuloma is investigated in 15 cases and showed the effect of hearing restoration only in 40%, but has not influence on the progress of mastoid wound. The strong change of bone structure showed unfavourably for the progress of mastoid wound and low for hearing restoration. The change of bone density is not influence on the progress of wound, but the strong change showed low the hearing restoration. The fatt deneneration of bone is irrelevant to the prognosis of tympanoplasty.
These pathological changes are combined almost with two or three changes, without solitude. Therefore, the author recognized that the summary is not absolutely right, and it's need, further more to observation.
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