재발한 진주종에 대한 재수술 결과
Surgical Outcome of Revision Operation for Recurrent Aural Cholesteatoma
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Background and Objectives To investigate surgical outcomes of revision operation for recurrentcholesteatoma. Subjects and Method From 1989 to 2018, 5245 cases of middle ear surgeries were performedat Kangdong and Hallym University Sacred Heart Hospital. A total of 138 clinical records of thesubjects who underwent revision cholesteatoma surgery, and whose follow-up durations weremore than 3 months, were reviewed. Hearing outcomes were analyzed in accordance with the2005 Korean otology society guideline. Postoperative perforation was defined to be present ifperforation exists after three months of surgery. Postoperative infection or recurrence was definedif patients were treated with intravenous antibiotics or underwent reoperation. Results Among 138 cases, surgical approaches used were canal wall up mastoidectomy in 38(28%), canal wall down mastoidectomy in 89 (64%), and exploratory tympanotomy in 11 (8%). Air conduction and air bone gap showed statistically significant differences before and after thesurgery. The number of patients who met at least 1 criteria was 70, accounting for 51%. Patientswere classified into four groups according to the Postoperative ABG grade, where 43% of patientswere included in “Excellent” or “Good” results group. When the results were comparedaccording to the surgical method, canal wall up group showed significantly higher hearingsuccess rate compared to CWDM group. Patients without postoperative perforation, infectionor recurrence were considered successful and there were 122 such cases, accounting for 88%. Conclusion CWDM more frequently underwent revision than CWUM and ET, and showedworse hearing results than other groups. These analyses can be used for preoperative counseling.
Abstract
Background and Objectives To investigate surgical outcomes of revision operation for recurrentcholesteatoma. Subjects and Method From 1989 to 2018, 5245 cases of middle ear surgeries were performedat Kangdong and Hallym University Sacred Heart Hospital. A total of 138 clinical records of thesubjects who underwent revision cholesteatoma surgery, and whose follow-up durations weremore than 3 months, were reviewed. Hearing outcomes were analyzed in accordance with the2005 Korean otology society guideline. Postoperative perforation was defined to be present ifperforation exists after three months of surgery. Postoperative infection or recurrence was definedif patients were treated with intravenous antibiotics or underwent reoperation. Results Among 138 cases, surgical approaches used were canal wall up mastoidectomy in 38(28%), canal wall down mastoidectomy in 89 (64%), and exploratory tympanotomy in 11 (8%). Air conduction and air bone gap showed statistically significant differences before and after thesurgery. The number of patients who met at least 1 criteria was 70, accounting for 51%. Patientswere classified into four groups according to the Postoperative ABG grade, where 43% of patientswere included in “Excellent” or “Good” results group. When the results were comparedaccording to the surgical method, canal wall up group showed significantly higher hearingsuccess rate compared to CWDM group. Patients without postoperative perforation, infectionor recurrence were considered successful and there were 122 such cases, accounting for 88%. Conclusion CWDM more frequently underwent revision than CWUM and ET, and showedworse hearing results than other groups. These analyses can be used for preoperative counseling.
참고문헌 (14)
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