제1형 고실성형술에 동반된 유양돌기절제술이 65세 이상 고령 만성 중이염 환자의술후 청력에 미치는 영향
The Effect of Mastoidectomy Combined with Tympanoplasty Type I on Postoperative Hearing in Chronic Otitis Media Patients Older than 65 Years
1
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
Background and Objectives Although canal wall up mastoidectomy (CWUM) has been performed frequently as a treatment for chronic otitis media (COM), the necessity of CWUM for non-cholesteatomatous COM (NCCOM) is still controversial. Since elderly people often have systemic problems, there is a high likelihood of side effects after general anesthesia, so it is important to judge the necessity of mastoidectomy. The purpose of this study was to investigate the effect of CWUM for the treatment of NCCOM in patients over 65 years of age. Subjects and Method Forty-two cases of CWUM with tympanoplasty type I performed as a treatment for NCCOM from 2007 through 2016 were reviewed retrospectively. Pure tone audiometry was performed preoperatively and postoperatively, and preoperative temporal bone CT was used to evaluate the mastoid status. The valsalva maneuver (VM) was used to evaluate the eustachian tube function. Results The total number of patients was 42 and the success rate of eardrum repair was 92.8%. Comparison of hearing results taken preoperatively and postoperatively showed significant hearing improvement in both air conduction and air-bone gap. When hearing results were compared according to the mastoid status and the response of VM, there were no significant differences. Conclusion Mastoidectomy combined with tympanoplasty type I showed a high success rate of ear drum repair and good hearing improvement, with no critical side effects. Therefore, mastoidectomy does not need to be limited by one’s old age. Adequate mastoidectomy after proper consideration of the mastoid status will be helpful in the treatment of the disease. Korean J Otorhinolaryngol-Head Neck Surg 2017;60(12):626-32
Abstract
Background and Objectives Although canal wall up mastoidectomy (CWUM) has been performed frequently as a treatment for chronic otitis media (COM), the necessity of CWUM for non-cholesteatomatous COM (NCCOM) is still controversial. Since elderly people often have systemic problems, there is a high likelihood of side effects after general anesthesia, so it is important to judge the necessity of mastoidectomy. The purpose of this study was to investigate the effect of CWUM for the treatment of NCCOM in patients over 65 years of age. Subjects and Method Forty-two cases of CWUM with tympanoplasty type I performed as a treatment for NCCOM from 2007 through 2016 were reviewed retrospectively. Pure tone audiometry was performed preoperatively and postoperatively, and preoperative temporal bone CT was used to evaluate the mastoid status. The valsalva maneuver (VM) was used to evaluate the eustachian tube function. Results The total number of patients was 42 and the success rate of eardrum repair was 92.8%. Comparison of hearing results taken preoperatively and postoperatively showed significant hearing improvement in both air conduction and air-bone gap. When hearing results were compared according to the mastoid status and the response of VM, there were no significant differences. Conclusion Mastoidectomy combined with tympanoplasty type I showed a high success rate of ear drum repair and good hearing improvement, with no critical side effects. Therefore, mastoidectomy does not need to be limited by one’s old age. Adequate mastoidectomy after proper consideration of the mastoid status will be helpful in the treatment of the disease. Korean J Otorhinolaryngol-Head Neck Surg 2017;60(12):626-32
참고문헌 (16)
- Brackmann DE, "Tympanoplasty with mastoidectomy: canal wall up procedures", Am J Otol, 14(4), pp.380~382 (1993)
- McGrew BM, "Impact of mastoidectomy on simple tympanic membrane perforation repair", Laryngoscope, 114(3), pp.506~511 (2004)
- Kanonidou Z, "Anesthesia for the elderly", Hippokratia, 11(4), pp.175~177 (2007)
- Ruhl CM, "Role of aerating mastoidectomy in noncholesteatomatous chronic otitis media", Laryngoscope, 109(12), pp.1924~1927 (1999)
- Eliades SJ, "The role of mastoidectomy in outcomes following tympanic membrane repair: a review", Laryngoscope, 123(7), pp.1787~1802 (2013)
- Albu S, "Usefulness of cortical mastoidectomy in myringoplasty", Otol Neurotol, 33(4), pp.604~609 (2012)
- Ramakrishnan A, "Cortical mastoidectomy in surgery of tubotympanic disease. Are we overdoing it?", Surgeon, 9(1), pp.22~26 (2011)
- Banakis Hartl RM, "Drill-induced cochlear injury during otologic surgery:intracochlear pressure evidence of acoustic trauma", Otol Neurotol, 38(7), pp.938~947 (2017)
- Kazikdas KC, "Sensorineural hearing loss after ossicular manipulation and drill-generated acoustic trauma in type I tympanoplasty with and without mastoidectomy: a series of 51 cases", Ear Nose Throat J, 94(9), pp.378~398 (2015)
- Javia LR, "Ossiculoplasty", Otolaryngol Clin North Am, 39(6), pp.1177~1189 (2006)
- Sato H, "Eustachian tube function in tympanoplasty", Acta Otolaryngol Suppl, 471, pp.9~12 (1990)
- Lin AC, "Pediatric tympanoplasty: factors affecting success", Curr Opin Otolaryngol Head Neck Surg, 16(1), pp.64~68 (2008)
- Priya K, "Evaluation of Eustachian tube function in chronic suppurative otitis media (tubotympanic type) with reference to its treatment outcome", Indian J Otol, 18(4), pp.179~183 (2012)
- 김용현, "제1형 고실성형술의 예후인자로서 이관 기능과 유돌부 함기화", 대한이비인후과학회지 두경부외과학, 55(5), pp.284~289 (2012), 대한이비인후과학회[DOI]
- Sakagami M, "Long-term observation on hearing change in patients with chronic otitis media", Auris Nasus Larynx, 27(2), pp.117~120 (2000)
- Ahn JH, "Postoperative results of tympanoplasty with mastoidectomy in elderly patients with chronic otitis media", Ann Otol Rhinol Laryngol, 121(3), pp.168~173 (2012)