연골을 이용한 방패형 제3형 고실성형술의 임상적 유용성
Clinical Efficacy of Cartilage Shield Type III Tympanoplasty in Medialized Malleus Handle
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Background and Objectives：Many types of cartilage tympanoplasty have been used in various middle condi-tions effectively. The purpose of this study is to evaluate the efficacy of type III cartilage shield tympanoplasty. Subjects and Methods：We adopted a carvum conchal cartilage shield tympanoplasty for 3 cases of cholestea-toma, 6 adhesive otitis media, and 6 chronic otitis media of near-total perforation. Malleus handle was medialized but intact before surgery in all the 15 cases. For the hearing outcome evaluation, we set control group of conven-tional type III tympanoplasty with cartilage capping partial ossicular reconstruction using partial ossicular recon-struction prosthesis. Air-bone gap (ABG) was compared between the study group and control group before and after surgery, and postoperative neo-drum status and complication was evaluated. Results：None of the study ears showed reperforation or any complication at minimum 9 months of follow-up. Two cases were found to have an- terosuperior partial retraction of neo-drum. The average ABG was 27.2±9.4 dB preoperatively and 19.0±11.6 dB postoperatively in study group, and 39.58±18.92 dB preoperatively, 20.76±21.36 dB postoperatively in con-trol group. No statistical difference of ABG was found between study and control group (p＞0.05). Conclusions：Cartilage shield type III tympanoplasty was safe and effective in high risk of failure group such as large perfora-tion, atelectasis, adhesive otitis media, and cholesteatoma with medialized malleus.
Abstract
Background and Objectives：Many types of cartilage tympanoplasty have been used in various middle condi-tions effectively. The purpose of this study is to evaluate the efficacy of type III cartilage shield tympanoplasty. Subjects and Methods：We adopted a carvum conchal cartilage shield tympanoplasty for 3 cases of cholestea-toma, 6 adhesive otitis media, and 6 chronic otitis media of near-total perforation. Malleus handle was medialized but intact before surgery in all the 15 cases. For the hearing outcome evaluation, we set control group of conven-tional type III tympanoplasty with cartilage capping partial ossicular reconstruction using partial ossicular recon-struction prosthesis. Air-bone gap (ABG) was compared between the study group and control group before and after surgery, and postoperative neo-drum status and complication was evaluated. Results：None of the study ears showed reperforation or any complication at minimum 9 months of follow-up. Two cases were found to have an- terosuperior partial retraction of neo-drum. The average ABG was 27.2±9.4 dB preoperatively and 19.0±11.6 dB postoperatively in study group, and 39.58±18.92 dB preoperatively, 20.76±21.36 dB postoperatively in con-trol group. No statistical difference of ABG was found between study and control group (p＞0.05). Conclusions：Cartilage shield type III tympanoplasty was safe and effective in high risk of failure group such as large perfora-tion, atelectasis, adhesive otitis media, and cholesteatoma with medialized malleus.
참고문헌 (17)
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