Clinical study of middle ear surgery

2015年10月から2018年12月まで,山口労災病院耳鼻咽喉科で手術を施行した,鼓膜形成術,鼓室形成術,アブミ骨手術症例141耳を検討した.男性67耳(47.5%),女性74耳(52.5%),年齢は5歳から76歳,平均34.2歳であった.鼓膜形成術は38耳(27.0%),鼓室形成術は93耳(65.9%),アブミ骨手術は10耳(7.2%)であり,鼓室形成術が最も多かったが,鼓膜形成術症例数が徐々に増加傾向を認めた.鼓膜形成術38耳の中で局所麻酔での日帰り手術が10耳(26.3%),全身麻酔での短期入院手術が28耳(73.7%)であった.術後穿孔閉鎖の有無が確認できたものは53耳であった.この53耳中で穿孔が閉鎖したものは48耳であり,鼓膜穿孔閉鎖率は90.6%だった.鼓膜穿孔閉鎖に用いられた術式は,接着法,インレイ法の2種類であり,接着法は比較的小さな穿孔に適応されていた.両術式間で閉鎖率に有意な差を認めなかった.一方,聴力改善を目的としたものは78耳であり,術後確認できた68耳について聴力改善率を検討した.68耳中,日本耳科学会による｢伝音再建後の術後聴力成績判定基準(2010)｣を満たす症例は57耳,83.8%であった.鼓膜穿孔率,聴力改善率は過去の報告と遜色なく,これらのデータは術前の患者へ提供する情報として有用なものと考えた.

We evaluated the outcome of 141 ears underwent myringoplasty, tympanoplasty, or stapes surgery at Yamaguchi Rosai Hospital between October 2015 and December 2018. The patients’mean age was 34.2 years, with a range of 5-76 years, 67 ears were male(47.5%),and 74 ears were female(52.5%).Classification of the surgical method showed myringoplasty in 38 ears(27%),tympanoplasty in 93 ears(65.9%),and stapes surgery in 10 ears(7.2%),and the number of myringoplasty was gradually increased. In myringoplasty, 10 ears were performed day surgery with local anesthesia and 28 ears were performed short stay surgery with general anesthesia. Postoperative closure rate of the tympanic membrane perforation was 90.6%. Closure of tympanic membrane perforation was done by myringoplasty or in-lay method. Myringoplasty was adopted for relatively small tympanic membrane perforation and there was no significant difference in closure rate between two groups. The success rate of postoperative hearing improvement was 83.8%. These results were comparable to previous reports, and were thought to be helpful information for preoperative patients.

鼓膜形成術

鼓室形成術

アブミ骨手術

接着法

インレイ法