Stapedectomyとその術後経過について--聴力回復パタ-ンを中心として (内藤儁教授退官記念論文集)
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In our procedure of stapedectomy, a superstructure of the stapes is removed and replaced mainly an artificial material such as a steel piston, but a polyethylene tube, a teflon piston or a gelform wire is occasionally employed as the substitute.The surgical outcomes were classified into four types according to the hearing acuity attained finally as well as the pattern of its recovery. Successful cases, in whom an air-bone gap disappeared was 36 out of 47 cases operated. In most of these cases, the closure of the air-bone gap was demonstrated within a month following the operation. However, ones whose air-bone gap remained for longer than a month, were often complicated by a sensory deafness as well though the cases of this complication were unknown. Even in the cases who had troubles during the operation, e. g. leakage of a large amount of perilymph and/or bleeding into perilymph, their surgical results were not always poor but occasionally fruitful. However, since the unsuccesful cases were more frequently encountered in the cases having had the troubles during the operation, the suction of perilymph and contamination of blood in it should be avoided to the best of one's ability.We had six cases whose hearing acuity got worse suddenly though their dysacusis had been improved by the operation. In four among these cases causes of their hearing deterioration were known and loss of hearing could be amoliorated by a reoperation in one case. The remaining two cases experienced the dysacusis just like a sudden deafness around one year after the operation. No apparent causal factor for their dysacusis was found in their surgical procedure, postoperative course or living conditions just before getting worse. It might be a so called postoperative sudden deafness, for which etiological mechanism is, however, obsqure.
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