제I·II형 고실성형술의 결과와 예후에 미치는 인자: 고실의 염증 정도에 따라

Background & Objectives: Type I · II tympanoplasty is highly incident surgery in otology field, however there are still much argues about the prognostic factors of this operation. And till now, there was not the discussion about the relationship between the histopathologic findings of middle ear mucosa and the success rate of that. So author reviewed the existing known prognostic factors, and investigated the relationship of the success rates and inflammation degree of trimming tissue of tympanic membrane perforation. Materials and Methods: Retrospective review was done about 341 cases, 353 ears of tympanoplasty type I · II performed by one senior surgeon and followed up about 12 – 18 months after operation. And the results according to the various factors influencing take-up rate and audiologic result were investigated. Results: Normal take-up rate of grafting drum was 93.9% and reperforation was about 3.5%. There were no significant relationship between the take- up rate and gender, age, status of opposite ear, status of middle ear mucosa, auditory tube status. However take- up rate was significantly lower in the cases of total drum perforation and purulent discharge in the middle ear cavity. And about 80% of all patients have got satisfactory hearing, however 5.3% had worse, which was dominant in male. Hearing improvement was seen in the younger, and total perforation cases was got worse hearing improvement than partial perforation cases. Conclusion: Tympanoplasty type I · II should be done after dry up of middle ear cavity and thorough post-operative care should be performed. This operation could be done at any age and get higher take-up rate and better hearing. For obtaining this good results, the first need would thought abundant knowledge and enough experience of the surgeon. (J Clinical Otolaryngol 2009;20:182–193)