保存強膜(Sclera)を用いた鼓室形成術

概要

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Homograft sclera was used as a supporting scaffold for the tympanic membrane and a reinforcement material for the fascia in forty-three tympanoplasty operations. They were classified to Type I (19 cases), Type III (12 cases), Type IV (2 cases) and staged operation (10 cases). Fresh sclera, collected in the eye bank in the Ophthalmology Department of the School of Medicine of Keio University, was preserved in 70% alcohol after being stripped of uveal tissue. The sclera was cut as an interdigited method in grafting technique and transplanted in such a way that the lateral process and the upper part of the manubrium of the malleus were exposed. Then the fascia was placed on the sclera to cover the exposed malleus. Twenty-four cases have been surveyed for more than six months and ten cases for three to six months after surgery. Although the results were not sufficient for the long-term follow-up there were no recognizable complications so far, and this suggests that this technique can reduce the complications of lateral healing and anterior blunting. The postoperative closure rate of the nerforation was 90% in all the cases except Type IV (two cases).
社団法人日本耳鼻咽喉科学会の論文