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KMID : 0390220000110020273
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Journal of Clinical Otolaryngology, Head and Neck Surgery
2000 Volume.11 No. 2 p.273 ~ p.279
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Epitympanoplasty with Mastoid Obliteration after Tympanomastoid Surgery : A Comparison of Three Different Methods in 95 Cases
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강명구/Myung Koo Kang
홍성화/김부민/한치성/김창근/배우용/박헌수/Sung Hwa Hong /Bu Min Kim/Chi Sung Han/Chang Gun Kim/Woo Yong Bae/Heon Soo Park
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Abstract
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Background and Objectives : We reported an epitympanoplasty with mastoid obliteration, a combined method
using the advantages of canal up and down techinques in cholesteatoma sugery. This procedure was originally
designed to prevent recurrence of the cholesteatoma by obliterating the mastoid cavity and reconstructing the
epitympanum. We could improve the surgical results by modification of the surgical techinques. Materials and
Method : From December 1994 to April 1999, we have operated 95 adult cases. Cholesteatoma, adhesive otitis
media, and chronic otitis media were 78, 9 and 8 cases respectively. Six cases of them had previous surgery. The
methods were class ified into 3 different sub method groups according to the material of reconstruction of the
epitympanum and obliteration of the mastoid cavity. Results : All cases had no recurrent cholesteatoma. There
cases of residual cholesteatoma in the mastoid cavity were detected only for group Ⅰ. Three cases of residual
cholesteatoma in the typainc cavity for group Ⅰ, and one cases for group Ⅱ were detected. There cases of
postoperative infections for group Ⅰ, and one case for group Ⅱ and Ⅲ were idenified separately. Conclusion :
During follow-up period, unpredictable patterns of resorption of bone past for the epitympanoplasty were
observed for groupⅠ. Resorption was not observed with using cartilage chips for the other two groups. In
addition, using cartilage chips for the group Ⅱ and Ⅲ, postoperative infection was much decresed comparing to
groupⅠ with bone paste. Mastoid obliteration with cartilage chips seemed to make it easy to approach to the
mastoid antrum in revision. For the group Ⅱ and Ⅲ, the mastoid cavity was completely separated from the
tympanic cavity by placing the fascia of perichondrium at the aditus and antrum in order to prevent the residual
cholesteatoma from extending into the mastoid cavity.
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KEYWORD
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