鼓室形成再手術例の検討

A Follow-Up Study on Reoperation of the Middle Ear

　はじめに

　慢性中耳炎に対し再手術を行う場合，初回手術と同じく耳漏の停止，聴力改善，真珠腫の除去を目的に行う。しかし，前回手術時の鼓室内所見が不明であることや瘢痕，癒着，組織の増生などの術後の器質的変化のため，これらの目的の達成が困難な症例にしばしば遭遇する^1〜5）。再手術においては聴力改善が期待できない要因が初回手術に起因する場合もあり，初回手術時の所見が非常に重要となる。今回われわれは主として耳漏と聴力改善の面から再手術耳の術後成績を評価し，再手術耳からみた初回手術の問題点についても考察を加えたので報告する。

We studied 89 ears underwent re-operation for chronic otitis media between 1992 and 1995. Otorrhea was found in 63 ears before re-operation, but in only 3 ears after re-operation. Hearing was improved in 43 of 79 ears, excluding 10 ears in which profound deafness was present prior to re-opera-tion. In 36 ears hearing was not improved following re-operation, although in 27 ears, no improvement of hearing were due to the problems derived from the previous surgeries including fistula of the foot-plate of the stapes, loss of mobility of the stapes, defect of the annules, and other conditions.