自家骨使用によるコルメラ形成手術とその成績

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In cases where stapes at the oval window could not be found, Wullstei type IV tympanoplasty has been performed, but this method does not always give the best surgical results. Recently many operative procedures using polyethylene tube as a columella, in order to change type IV into type III, are reported. However, the author has found the autotransplantation of ossicle as a columella more preferable way than using foreign bodies.The authrors method is as follows : ossicle as a columella is fixed upright to the skin graft with fine thread and the other end of this ossicle is placed at the oval window. Seven such operations have been experienced. In 5, malleus was used, in another case, incus and in the last, ossicle made from mastoid bone tip into adequete shape was used.Results of these operations : One case did not show any hearing improvement, but this was believed to be a good result because his hearing loss was at the same level, 25db, before and after operation. Other 6 cases showed improvement of more than 20db, 5 cases among 7 kept a better than 30db post-operative hearing acuity, and all cases better than 35db. None of them has shown perforation of transplanted tympanic membrane and ear discharge up to date.
社団法人日本耳鼻咽喉科学会の論文