본문 바로가기
KERD
논문KCI 등재

Transcanal Endoscopic Tympanoplasty for Pediatric Patients Under 15 Years of Age With Chronic Otitis Media

2

조회

0

다운로드

0

인용

0

참고문헌

키워드

초록

Objectives. To evaluate the results of transcanal endoscopic tympanoplasty for pediatric patients with chronic otitis media (COM) and compare them to that of the previously standard microscopic assisted tympanoplasty technique. Methods. The patients were divided into two groups based on the operative method. Group 1 underwent tympanoplasty with a totally endoscopic assisted technique (n=21, 24 ears), and group 2 underwent tympanoplasty with the conventional microscopic technique (n=14, 15 ears). We used a transcanal approach in group 1 and a postauricular approach in group 2. In group 1, there were 15 cases of simple COM and nine cases of adhesive otitis media. In group 2, only 15 cases of simple COM were present. We analyzed the outcomes in terms of the hearing gain according to the surgical method and COM type, operation time, hospital stay after surgery, and graft success rate. Results. Postoperative hearing gain results including air conduction (AC) thresholds and air-bone gap (ABG) were not significantly different between the two groups (P>0.05). In both the groups, significant improvement in the postoperative AC and ABG was observed compared to the preoperative hearing. The hospital stay after surgery was significantly shorter in group 1 than the group 2: 2.1±0.4 days and 4.8±0.9 days (P<0.001), respectively. The intact graft success rate was 91.6% in group 1 and 93% in group 2; the values were not significantly different (P>0.05). There was neither intra- nor postoperative complications. Conclusion. Transcanal endoscopic ear surgery technique is more conservative than microscopic approach and can be performed in pediatric patients under 15 years of age with COM. Moreover, it offers similar surgical results compared to traditional microscopic technique, and a shorter operative time and hospital stay after surgery are the advantages of this technique.

Abstract

Objectives. To evaluate the results of transcanal endoscopic tympanoplasty for pediatric patients with chronic otitis media (COM) and compare them to that of the previously standard microscopic assisted tympanoplasty technique. Methods. The patients were divided into two groups based on the operative method. Group 1 underwent tympanoplasty with a totally endoscopic assisted technique (n=21, 24 ears), and group 2 underwent tympanoplasty with the conventional microscopic technique (n=14, 15 ears). We used a transcanal approach in group 1 and a postauricular approach in group 2. In group 1, there were 15 cases of simple COM and nine cases of adhesive otitis media. In group 2, only 15 cases of simple COM were present. We analyzed the outcomes in terms of the hearing gain according to the surgical method and COM type, operation time, hospital stay after surgery, and graft success rate. Results. Postoperative hearing gain results including air conduction (AC) thresholds and air-bone gap (ABG) were not significantly different between the two groups (P>0.05). In both the groups, significant improvement in the postoperative AC and ABG was observed compared to the preoperative hearing. The hospital stay after surgery was significantly shorter in group 1 than the group 2: 2.1±0.4 days and 4.8±0.9 days (P<0.001), respectively. The intact graft success rate was 91.6% in group 1 and 93% in group 2; the values were not significantly different (P>0.05). There was neither intra- nor postoperative complications. Conclusion. Transcanal endoscopic ear surgery technique is more conservative than microscopic approach and can be performed in pediatric patients under 15 years of age with COM. Moreover, it offers similar surgical results compared to traditional microscopic technique, and a shorter operative time and hospital stay after surgery are the advantages of this technique.

참고문헌 (14)

  1. Wullstein H, "Theory and practice of tympanoplasty", Laryngoscope, 66(8), pp.1076~1093 (1956)
  2. Huang TY, "A comparative study of endoscopic and microscopic approach type 1 tympanoplasty for simple chronic otitis media", J Int Adv Otol, 12(1), pp.28~31 (2016)
  3. Ozgur A, "Endoscopic cartilage tympanoplasty in chronic otitis media", J Laryngol Otol, 129(11), pp.1073~1077 (2015)
  4. 김홍찬, "전음성 난청 환자에서 내시경을 이용한 시험적 고실개방술의 유용성", 대한이비인후-두경부외과학회지, 60(1), pp.7~12 (2017), 대한이비인후과학회[DOI]
  5. 최나연, "Comparison of Endoscopic Tympanoplasty to Microscopic Tympanoplasty", Clinical and Experimental Otorhinolaryngology, 10(1), pp.44~49 (2017), 대한이비인후과학회[DOI]
  6. Badr-el-Dine M, "Value of ear endoscopy in cholesteatoma surgery", Otol Neurotol, 23(5), pp.631~635 (2002)
  7. Thomassin JM, "Endoscopic-guided otosurgery in the prevention of residual cholesteatomas", Laryngoscope, 103(8), pp.939~943 (1993)
  8. Raine CH, "Tympanoplasty in children : a review of 114 cases", J Laryngol Otol, 97(3), pp.217~221 (1983)
  9. Black JH, "An analysis of the results of myringoplasty in children", Int J Pediatr Otorhinolaryngol, 31(1), pp.95~100 (1995)
  10. Aoki K, "Advantages of endoscopically assisted surgery for attic cholesteatoma", Diagn Ther Endosc, 7(3-4), pp.99~107 (2001)
  11. Karhuketo TS, "Tympanoscope-assisted myringoplasty", ORL J Otorhinolaryngol Relat Spec, 63(6), pp.353~357 (2001)
  12. James AL, "Endoscope or microscope-guided pediatric tympanoplasty? Comparison of grafting technique and outcome", Laryngoscope, 127(11), pp.2659~2664 (2017)
  13. Awad OG, "Endoscopic type 1 tympanoplasty in pediatric patients using tragal cartilage", JAMA Otolaryngol Head Neck Surg, 141(6), pp.532~538 (2015)
  14. Dundar R, "Endoscopic versus microscopic approach to type 1 tympanoplasty in children", Int J Pediatr Otorhinolaryngol, 78(7), pp.1084~1089 (2014)

관련 논문AI추천

이 간행물의 다른 논문 (14건)