Vein graftによる鼓膜形成の経験

MYRINGOPLASTY BY MEANS OF A VEIN GRAFT AN EXPERIENCE IN SHEA'S METHOD

　1952年Wullstein^7），Zöllnerら^8）が，skin graftを使用した鼓膜形成術を発表して以来，graftの材料について多くの検討がなされてきた。

　その結果，体表面から移殖した皮膚は組織学的にも，生理的にも鼓膜とは異なり，腺，毛を有する事，また皮膚は外耳道内に移植されても長くその性質を持続する事から再穿孔の原因となる事，また体表面の皮膚はmigrationがない事からdesquamationを生じ，炎症やcystやcholesteatomaの原因となり易い事などから，筋膜，骨膜，軟骨膜などの結合織や静脈などを鼓膜形成術の材料として使用するのが一般的な傾向となつてきた。

　In 1960 Shea reported a new method by which he accomplished the closure of the dry perforation of the tympanic membrane by means of autogenous vein graft. Therafter, many surgeons have approved of this method.

　The author report the result of using similar technic on 16 patients as follows:

　1) The perforation was successfully closed in 14 cases; it failed in 2.

　2) Improvement in air conduction for speech frequency was less than 20 db in 14 cases.

　3) The reasons for the failure of the closure appeared to be as follows: 1. When the size of the graft is too small as compared to that of the perforation.

　2. When the perforation is found at the marginal portion of the ear drum.

　3. When the drum is sclerotic and provided with a poor vascular network.