상고실성형술과 유양동폐쇄술：283예에서의 평균 38개월 추적 결과
Epitympanoplasty with Mastoid Obliteration Technique：38 Months Follow-Up Results of 283 Cases
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Abstract
Background and Objectives：There have been heated controversies over the choice of the canal wall down mastoidectomy and canal wall up mastoidectomy, which are operational methods used to eliminate the lesion of chronic otitis media including cholesteatoma. Combining the advantages of both methods, we devised a new operational method in 1994. This study reports the surgical results of the epitympanoplasty employing the mastoid obliteration technique after a follow-up 38 months in 283 cases. Subjects and Method：A retrospective review was made of 283 cases (273 patients) on which this technique was performed by the first author between Dec. of 1994 to Mar. of 2004. The follow-up period varied from 8 to 104 months, with the average period of 38 months. We analyzed postoperative complications including cavity problems, the recurrent cholesteatoma, residual cholesteatoma cases in the mastoid cavity, residual cholesteatoma in the tympanic cavity and postoperative otorrhea and hearing results. Results：The overall incidence of postoperative complications was 21.9%. The results of postoperative complications in the above listed order were 0%, 0%, 1.0%, 4.3% and 5.7%, respectively. Air-bone gap (ABG) closure was 4.73 dB HL and the statistical analysis revealed that the postoperative ABG was significantly lower than the preoperative ABG (p=0.0023). Conclusion： The present study suggests that this procedure prevents the cavity problem, helps reduce recurrence and effectively manages the residual cholesteatoma. Also, this procedure achieves good audiologic results.
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