Attico-antro-mastoid reconstruction with a cartilage plate of the pinna.

概要

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We performed attico-antro-mastoidectomy and primary reconstruction with a conchal cartilage in patients with cholesteatoma (36 untreated ears and 7 ears treated by the open method). The use of a large cartilage plate realized the open-and-closed method rather than the open or closed method.1. Transmeatal opening of the attic and tympanum and selective antro-mastoidectomy made possible a wide operative view and efficient cleaning.2. A cartilage plate from the pinna proved to be an excellent material to reconstruct the opened cavities, since it could be sectioned as a large piece without any deformity, survived well and replaced the fragile ear drum as well as the bony annulus.3. Primary closure of the opened cavities was useful in shortening hospitalization and avoiding the postoperative complications of open mastoid cavities.4. In a few ears in which the technique and adaptation had not been completed there was residual cholesteatoma and persistent discharge. For success in the open-and-closed method, it seemed important to reconstruct the opened mastoid as a small cavity, to secure ventilation between the attic and the tympanum, and to avoid primary reconstruction in cases with marked inflammation.
耳鼻咽喉科臨床学会の論文