鼓室形成術における経外耳道的内視鏡下手術と顕微鏡下手術の比較

A comparative study of tympanoplasty with transendoscopic approach vs microscopic approach

はじめに

　1987年，Thomassinら^1）によって硬性内視鏡が耳科領域に持ち込まれて以来，内視鏡単独での手術の普及まで数十年を要した。本邦でもその有用性^2）が理解され，現在では死角が少なく低侵襲性な耳科手術として経外耳道的内視鏡下耳科手術^3,4）（transcanal endoscopic ear surgery：TEES）が広く行われるようになってきており，当科でも2012年から鼓室形成術に内視鏡を導入している。今回われわれは，内視鏡手術の導入初期での術後成績をTEES群と顕微鏡下耳科手術（microscopic ear surgery：MES）群とに分けて比較検討を行った。

　Currently in Japan, transendoscopic ear surgery（TEES）has been widely performed as a minimally invasive otological surgery with few blind spots. We have introduced TEES in 2012 and compared the postoperative results between the microscopic ear surgical（MES）group in 30 patients and the TEES in 29. This study was performed in the period immediately after introduction of the endoscope in our hospital, although there were the lack of the proper surgical instruments and the operator's inexperience. TEES was significantly less painful than MES and had a short hospital stay. Therefore TEES is considered to be a technique beneficial for patients.