鼓室成形術に関する臨床的研究―岡大耳鼻科における自昭和31年至昭和37年719例の手術成績の検討

The author investigated the results of 719 cases of tympanoplasty performed at Okayama University Hospital during the seven-year period from 1956 to 1962. The results of the study are briefly presented in the following. As for the postoperative hearing, success was attained in average of 46% of all types of tympanoplasties; namely, 55% in types Ⅰ and Ⅱ, 42% in type Ⅲ, 24% in type Ⅳ and 30% in the cases in which diseased ossicles, polyethylene tubes or tantalum wire were used as columellae. In this study success means the postoperative hearing within 30 db or gain of more than 11 db. The postoperative hearing fluctuated with the lapse of time in about half of all the cases, but most of them became stable within one year postoperative. For the indication of tympanoplasty, the author has concluded as follows. The case with perforation of Shrapnell's membrane need be operated as early as possible even if the hearing is good. In the case with central perforation, conservative treatments are to be recommended provided that the hearing is good, and operation is indicated for the case with moderate hard of hearing. Pedicle flap method results in better postoperative hearing and incurs less perforation of new ear drum than free graft.