개방동 유양돌기 절제술에서 탈회된 골기질을 이용한 유양동성형술의 안정성 및 유용성 검증: 탐색적 연구
Safety and Efficacy of Mastoidoplasty With Demineralized Bone Matrix in Canal Wall Down Mastoidectomy: A Pilot Study
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background and Objectives The canal wall down mastoidectomy brings changes in theanatomy of the external auditory canal (EAC), causing potential problems, such as accumulat-ed crust, vertigo attacks, and difficulties in wearing hearing aids (HAs). The objective of thisstudy is to evaluate the safety and efficacy of mastoidoplasty using the demineralized bonematrix (DBM) to obliterate the mastoidectomized cavity and reconstruct EAC. Subjects and Method Medical records of patients with chronic otitis media with or withoutcholesteatoma who received mastoidoplasty using DBM by a single surgeon at Seoul St. Mary’shospital between 2014 and 2021 were reviewed retrospectively. Results A total of 27 patients were included in this study. None of the patients showed anyrecurrence of cavity problem, wound infection, or any other complications during their follow-up period of 13.07±37 months. The average air and bone conduction hearing level of puretone audiometry showed no significant change after surgery ( p=0.50, p=0.54, respectively). Five patients indicated for hearing rehabilitation could adopt canal type HAs after surgery; sixpatients used completely-in-the canal type HAs, and one patient used in-the-canal type HAs. None of the patients using HAs complained of acoustic feedback or any other problem inwearing HAs. Conclusion Mastoidoplasty using DBM seems to be a very safe and effective surgical pro-cedure that shows functionally acceptable EAC for hearing rehabilitation with canal type HAsand demonstrates no specific complication.
Abstract
Background and Objectives The canal wall down mastoidectomy brings changes in theanatomy of the external auditory canal (EAC), causing potential problems, such as accumulat-ed crust, vertigo attacks, and difficulties in wearing hearing aids (HAs). The objective of thisstudy is to evaluate the safety and efficacy of mastoidoplasty using the demineralized bonematrix (DBM) to obliterate the mastoidectomized cavity and reconstruct EAC. Subjects and Method Medical records of patients with chronic otitis media with or withoutcholesteatoma who received mastoidoplasty using DBM by a single surgeon at Seoul St. Mary’shospital between 2014 and 2021 were reviewed retrospectively. Results A total of 27 patients were included in this study. None of the patients showed anyrecurrence of cavity problem, wound infection, or any other complications during their follow-up period of 13.07±37 months. The average air and bone conduction hearing level of puretone audiometry showed no significant change after surgery ( p=0.50, p=0.54, respectively). Five patients indicated for hearing rehabilitation could adopt canal type HAs after surgery; sixpatients used completely-in-the canal type HAs, and one patient used in-the-canal type HAs. None of the patients using HAs complained of acoustic feedback or any other problem inwearing HAs. Conclusion Mastoidoplasty using DBM seems to be a very safe and effective surgical pro-cedure that shows functionally acceptable EAC for hearing rehabilitation with canal type HAsand demonstrates no specific complication.
참고문헌 (21)
- Brown JS, "A ten year statistical follow-up of 1142 consecutive cases of cholesteatoma: The closed vs. the open technique", Laryngoscope, 92(4), pp.390~396 (1982)
- Charachon R, "Closed versus obliteration technique in cholesteatoma surgery", Am J Otol, 9(4), pp.286~292 (1988)
- Karmarkar S, "Cholesteatoma surgery : The individualized technique", Ann Otol Rhinol Laryngol, 104(8), pp.591~595 (1995)
- Palmgren O, "Long-term results of open cavity and tympanomastoid surgery of the chronic ear", Acta Otolaryngol, 88(5-6), pp.343~349 (1979)
- de Veij Mestdagh PD, "Mastoid obliteration with S53P4 bioactive glass in cholesteatoma surgery", Acta Otolaryngol, 137(7), pp.690~694 (2017)
- Goel A, "Extended vascularized temporalis muscle-fascia flap", Br J Neurosurg, 8(6), pp.731~733 (1994)
- Maniu A, "Mastoid obliteration with concha cartilage graft and temporal muscle fascia", ORL J Otorhinolaryngol Relat Spec, 74(3), pp.141~145 (2012)
- Mehta RP, "Mastoid obliteration", Otolaryngol Clin North Am, 39(6), pp.1129~1142 (2006)
- Roberson JB Jr, "Mastoid obliteration : Autogenous cranial bone pAte reconstruction", Otol Neurotol, 24(2), pp.132~140 (2003)
- Yung MM, "Mastoid obliteration with hydroxyapatite--the value of high resolution CT scanning in detecting recurrent cholesteatoma", Clin Otolaryngol Allied Sci, 22(6), pp.553~557 (1997)
- Lee HJ, "Canal reconstruction and mastoid obliteration using floating cartilages and musculoperiosteal flaps", Laryngoscope, 127(5), pp.1153~1160 (2017)
- Dae Hwan Kim, "Matched Comparison of Fusion Rates between Hydroxyapatite Demineralized Bone Matrix and Autograft in Lumbar Interbody Fusion", 대한신경외과학회지, 59(4), pp.363~367 (2016), 대한신경외과학회
- Lee WS, "Mastoid and epitympanic obliteration in canal wall up mastoidectomy for prevention of retraction pocket", Otol Neurotol, 26(6), pp.1107~1111 (2005)
- Lee WS, "Canal wall reconstruction and mastoid obliteration in canal wall down tympanomastoidectomized patients", Acta Otolaryngol, 129(9), pp.955~961 (2009)
- Moffat DA, "Mastoid obliteration using bone pâté", Clin Otolaryngol Allied Sci, 19(2), pp.149~157 (1994)
- Kim JS, "External auditory canal reconstruction and mastoid obliteration using modified palva flap in canal wall down mastoidectomy with tympanoplasty", Ann Otol Rhinol Laryngol, 128(6_suppl), pp.69S~75S (2019)
- Lee WS, "Mastoid obliteration with bone paste and fat", Korean J Otorhinolaryngol-Head Neck Surg, 44(1), pp.26~31 (2001)
- Wiet RJ, "Canal wall reconstruction : A newer implantation technique", Laryngoscope, 103(6), pp.594~599 (1993)
- Ikeda M, "Canal wall down tympanoplasty with canal reconstruction for middle-ear cholesteatoma: Post-operative hearing, cholesteatoma recurrence, and status of re-aeration of reconstructed middle-ear cavity", J Laryngol Otol, 117(4), pp.249~255 (2003)
- Sioshansi PC, "Mastoid obliteration using autologous bone dust following canal wall down mastoidectomy", Otol Neurotol, 42(1), pp.68~75 (2021)
- Geerse S, "Hearing and hearing rehabilitation after obliteration of troublesome mastoid cavities", Eur Arch Otorhinolaryngol, 277(12), pp.3307~3313 (2020)