小児の鼓室形成術—59耳の検討

Tympanoplasty in Children:A Review of 59 Cases

　はじめに

　小児の慢性中耳炎の病態については議論が多い^1〜13）。これまでにも手術成績に関して成人と比較した報告は数多いが，一致した見解は得られていない。今回，15歳以下の鼓室形成術症例の手術成績を評価し，検討を加えたので報告する。

Fifty-nine tympanoplasties in children under 15 years of age were reviewed. Staged tympanoplasty or revision surgery was performed in 31 ears with cholesteatoma. The results of surgeries were satis-factory. The ears with preoperative discharge became dry postoperatively in 95% of the ears, and intact grafts were achieved in 96% of the ears, and improvement of hearing in 86% of the ears. The total incidence of residual or recurrent choles-teatomas at the 2nd stage or revision was 32%, with no significant difference in incidence between the open and closed methods. These findings suggest that surgery can be performed at any age not only for cholesteatoma but also for chronic otitis media, and that closed tympanoplasty is preferable when possible since it improves patients' quality of life.