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진주종성 중이염 환자에서 인공이소골을 사용한 이소골성형술

Ossiculoplasty Using PORPs and TORPs in Chronic Otitis Media with Cholesteatoma

계명의대논문집 1994년 13권 1호 p.84 ~ 91
지병준, 안병훈, 손수상,
소속 상세정보
지병준 (  ) - 계명대학교
안병훈 (  ) - 계명대학교
손수상 (  ) - 계명대학교

Abstract


Since cholesteatomas are locally invasive, producing serious complications by erosion of the temporal bone, the primary goal of therapy remains permanent eradication of the disease. Most vulnerable are the middle ear ossicles and an attempt to
restore
hearing acuity is made by ossicular reconstruction. Autogenous ossicles have always been the best material for the reconstruction in our hands, but they are not readily available and not advisable to use it, especially in cases of extensive
cholesteatoma.
The present study reports the results of 83 ossiculoplasties for aural cholesteatomas, using alloplastic TORPs(38) and PORPs(45). The difference between pre-and post operative air-bone gap was 12dB in average. Of 38 TORPs 12 cases (31.5%) were
within
30dB of post-operative air-bone gap and the post-operative mean hearing gain was 10dB. Of 45 PORPs 16 cases(35.5%) were within 30dB of post-operative air-bone gap and the post-operative mean hearing gain was 15dB. The causes of reconstruction
failure
were recurrent cholesteatoma, extrusion of the alloplasts, and graft failure in the order of frequency.
The surgical management of cholesteatoma should be individualized for selecting the most appropriate operative procedure. Because of an unacceptable high extrusion rate and redicivism, it seems to be justified to look for further alternative
solutions
and to study the long-term postoperative results.

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