Treatment of early middle ear cholesteatoma by atticosinoplasty

BACKGROUND AND OBJECTIVES: Treatment of early cholesteatoma usually involves surgical modification of mastoid antrum and tympanum to prevent recurrence. Reconstruction of ossicular chain and the ear drum after complete elimination of cholesteatoma in tympanum improves hearing greatly. However, like in other fields of clinical medicine, treatment of early cholesteatoma is advancing through trial and errors, and many new surgical techniques are still being published until this time. Despite of continuing achievement and effort, there have been considerable controversies upon systematic approach and treatment method in middle ear surgery. These difficulties, however, will be overcome and development of such treatment methods will eventually increase operation of early cholesteatoma and revisional ear surgery. With its increasing importance, it will be meaningful to evaluate the role of atticosinoplasty in the treatment of early cholesteatoma, and to compare its effect in improving hearing with other techniques like mastoid obliteration and open cavity mastoidectomy. METHODS: Retrospective review was performed for 173 cases treated by atticosinoplasty in the period of 12 years between Mar 1995 and Feb 2007 in Department of Otolaryngology of Ajou University Medical Center. Of 156 cases with more than 6 months of follow up period, 120 cases of relatively small cholesteatoma on temporal bone tomography were comparatively analysed for hearing improvement with 35 cases of mastoid obliteration and 110 cases of open cavity mastoidectomy. We analysed results according to the type of cholesteatoma and ossiculoplastic materials. We also compared 40 cases with near-normal hearing before surgery in terms of types of cholesteatoma and ossiculoplastic materials. RESULT: When 120 cases of atticosinoplasty for early cholesteatoma were compared for hearing improvement with 35 cases of mastoid obliteration and 110 cases of open cavity mastoidectomy, patients treated by atticosinoplasty had significantly better results. In analysis by type of cholesteatoma, attic cholesteatoma had relatively better results. Comparison among ossiculoplastic materials showed malleus stapes strut gave relatively good results. In the cases of near-normal hearing group, better maintenance of hearing acuity was shown when ossiculoplasty was not performed. Analysis according to type of cholesteatoma showed better results in attic cholesteatoma. There were good results regardless of ossiculoplastic material used. CONCLUSION: Atticosinoplasty as an initial treatment choice for early cholesteatoma was certainly effective in improving hearing acuity with minimal complications. In the future, when a universal concept is introduced to surgical treatment of early cholesteatoma, atticosinoplasty will be a useful option in the systematic approach.

Author dc:creator

• 박, 승구

Contributors dc:contributor

• 박, 기현
• 대학원 의학과
• 199924547

• atticosinoplasty
• 초기 중이 진주종
• 유양동폐쇄술
• 개방공동 유양동삭 개술
• 이소골재건술
• 상고실진주종
• cholesteatoma
• open cavity mastoidectomy
• mastoid obliteration
• ossiculoplasty

Language dc:language

ko

Identifier

http://dcoll.ajou.ac.kr:9080/dcollection/jsp/common/DcLoOrgPer.jsp?sItemId=000000006535
000000006535

OAI identifier oai:identifier

oai:repository.ajou.ac.kr:201003/1468