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首页> 外文期刊>The Laryngoscope: A Medical Journal for Clinical and Research Contributions in Otolaryngology, Head and Neck Medicine and Surgery, Facial Plastic and Reconstructive Surgery .. >Intact canal wall mastoidectomy with tympanoplasty for cholesteatoma in children.
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Intact canal wall mastoidectomy with tympanoplasty for cholesteatoma in children.

机译：完整的乳腺腔壁乳突切除术与鼓室成形术治疗儿童胆脂瘤。

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OBJECTIVE/HYPOTHESIS: Cases of cholesteatoma in pediatric patients were reviewed to determine which factors influence the outcome of surgical treatment. Cholesteatoma is considered a more aggressive disease in children than in adults. The outcomes of intact canal wall (ICW) mastoidectomy and canal wall down (CWD) mastoidectomy were assessed, as comparisons of different surgical technique. STUDY DESIGN: A retrospective analysis of all cases of pediatric cholesteatoma treated at a single institution by the senior author (P.R.L.) over a period of 11 years was conducted. METHODS: Patient information was collected from an otology database, patient records, and audiology files. RESULTS: Sixty-six patients, aged 10 months to 18 years, were treated and followed for an average of 37.7 months (range 12.2 months to 12.5 y). ICW mastoidectomy with tympanoplasty was the primary surgical treatment in 41 patients. Nineteen percent had residual disease at a planned second stage surgery and 22% developed recurrent cholesteatoma for a total recidivism rate of 41%. A SRT of less than 30 dB HL was achieved in 75% of these patients. Seventeen patients underwent CWD mastoidectomy with tympanoplasty initially. Two patients (12%) had residual cholesteatoma found at a planned second state procedure, and no recurrent cholesteatoma was encountered. Seventy-two percent maintained a SRT of less than 30 dB HL. CONCLUSIONS: These results support the continued use of ICW mastoidectomy with tympanoplasty for pediatric cholesteatoma. If planned second stage surgery is necessary, the long-term results of an ear with useful hearing and few problems with chronic medical care are gratifying. For reasons of anatomy or in an only hearing ear, CWD mastoidectomy with tympanoplasty provides a safe ear and good hearing results. Mastoid cavity care must be maintained indefinitely in many cases.
机译：目的/假设：对儿科患者胆脂瘤病例进行回顾，以确定哪些因素影响手术治疗的结果。儿童胆脂瘤被认为比成人更具侵略性。评估完整的管壁（ICW）乳突切除术和管壁下（CWD）乳突切除术的结果，作为不同手术技术的比较。研究设计：回顾性分析了由资深作者（P.R.L.）在单一机构治疗11年的所有小儿胆脂瘤病例。方法：从耳科数据库，患者记录和听力学文件中收集患者信息。结果：对年龄在10个月至18岁的66例患者进行了治疗，平均随访37.7个月（范围为12.2个月至12.5年）。带鼓膜成形术的ICW乳突切除术是41例患者的主要手术治疗方法。在计划进行的第二阶段手术中，有19％的患者残留疾病，而22％的患者复发性胆脂瘤，其总复发率为41％。这些患者中有75％的患者达到了低于30 dB HL的SRT。最初有17例患者行鼓室成形术进行CWD乳突切除术。两名患者（12％）在计划的第二状态程序中发现了残留的胆脂瘤，并且未遇到复发性胆脂瘤。 72％的SRT保持低于30 dB HL。结论：这些结果支持ICW乳突切除术加鼓室成形术治疗小儿胆脂瘤。如果有计划的第二阶段手术是必要的，那么长期有益的耳朵听力和有益的长期医疗效果是令人满意的。出于解剖原因或仅在听觉上耳朵，采用鼓室成形术的CWD乳突切除术可提供安全的耳朵和良好的听力效果。在许多情况下，必须无限期维护乳突腔护理。

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