鼓室成形術の諸問題

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Type 2 tympanoplasty showe astonishingly good results, because of the preservation of the large air space of the middleear cavity. The results of type 3 operation was rather poor in some cases with respect to hearing. But in the cases where inflammations are absent, the results have been good. Further the problem of drug-resistant bacteria has been emphazized. Generally speaking, the results of operation seemed to be poor in all plastic operations on the middle ear where drug-resistant bacteria are present.Ossicular repositioning is advocated to preserve the air space of the middle ear cavity and insure more adequate transmission of sound to the stapedial footplate. Ossicular repositioning will convert a type 3 into a incudostapediopexy or malleolosta-pediopexy. We make it a rule not to introduce foreign bodies or free autobone graft into the inflammatory middle ear, due to the occurrence of vigorous tissue reactions. However in the absence of pathological condition, we can introduce polyethylene tubing to insure ossicular continuity or to create a artificial columella.
社団法人日本耳鼻咽喉科学会の論文