中耳保存的根治手術の小驗

　緒言

　慢性化膿性中耳炎に対する手術的療法としてのZaufal又はStackeの中耳根治手術は病巣除去のために聽骨，鼓膜を犠牲にするため術後難聽が増惡するのは当然である．從つて近時聽力保存の目的のために，小耳骨及び鼓膜を可及的保存し且病巣の完全除去を計る方法が種々案出されている．

　私は最近6例の中耳化膿症に対し，数種の保存的根治手術を施行し，色々教えられる所があつたのでここに報告し諸賢の御批判を乞う次第である．

Komori maintains that, when radical mastoi-dectomy is performed with the object of con-servation of hearing, it is highly desirable that the lateral wall of recessus epitympanicus should be thoroughly removed even when, the infec-tious focus be limited to a circumscribed portion of the epitympanic space. The degree of tho-roughness much depends upon the last step of the removal at the region of tympanic perfora-tion. Likewise, he stresses the need of ample and careful protection to the tympanic mem-brane, which must be needed, both, during thecourse of operation and in that of the after-treatment. And lastly, regarding the object of this operation, he emphasizes the fact that, despite the degree of deafness which may re-main with the patient or the small amount of aural discharge that may still linger from a low grade secondary infection of mucous membranes, after the operation, if and when, some conserva-tion of hearing has been accomplished by it in addition to the stop placed on gradual progress of the disease to worsening conditions which may hold the life per se in jeopardy, the oper-ator should be contended with the results he had, thus, obtained.