유일청 및 양청이(Only/Better Hearing Ears)에서상고실성형술과 유양동폐쇄술의 유용성

Abstract

Background and Objectives：Sensorineural hearing loss is one of serious complications caused after the operation of chronicear disease. In only/better hearing ears, it is important to minimize the chances of developing a severe hearing loss and to stopthe progression of disease. We report the results of performing epitympanoplasty with mastoid obliteration in the only/betterhearing ear with cholesteatoma. Subjects and Method：From February 11, 1996 to April 16, 2003, epitympanoplasty andmastoid obliteration was performed for 6 patients with the only hearing ear and 2 with a better hearing ear. In the only/better hearingears, 7 cases had cholesteatoma and 1 case had adhesive otitis media. The other ears of the 5 cases had previously receivedcanal wall down mastoidectomy, 2 cases sensorineural hearing loss and 1 case both epitympanoplasty and mastoid obliteration.The observation period ranged from 7 to 99 months, with the average of 45 months. Results：One-staged operation was performedon all 8 patients. Four cases got total ossicular replacement prosthesis, 3 cases received partial ossicular replacement prosthesis,and 1 case received autologous cartilage short columellization. After each operation, all patients obtained a dry, safe,self-cleansing ear and recurrence did not occur. The hearing results in this series showed that the air conduction thresholds, boneconduction thresholds and air-bone gaps were preserved in 7 cases, but became worse in one patient. Two patients did not needto use hearing aids, five patients used an hearing aid of in-the-canal (ITC) type, one patient used a hearing aid of completely-inthecanal (CIC) type. Conclusion：Epitympanoplasty with mastoid obliteration in the only/better hearing not only can stop theprogression of cholesteatoma, but also can preserve hearing of patients.