이소골 성형술의 치료성적 및 청력개선에 미치는 영향 인자

Background and Objectives: Hearing gain is basically the final purpose in the middle ear surgery. Ossiculoplasty is the surgical method that reconstructs the ossicular chain to get hearing gain, but the result of ossiculoplasty can be different according to the various factors such as eustachian tube function, ossiculoplatic materials, and surgeon’s technique. The purpose of this study is to evaluate hearing results of ossicular chain reconstruction and to analyze its affecting factors. Materials and Method: Five hundred and thirty five cases of ossiculoplasty done at the Department of Otolaryngology in Ajou University Hospital from June 1994 to December 2000 were included in this retrospective study and we reviewed the formulated operation note and OPD chart including pre- and post-operative audiogram. We analyzed the results of hearing gain according to patient, disease, and operation factors. A successful hearing gain was defined as a post-operative air-bone gap of <20 dB, and we classified ossiculoplasty by using that of Japan Otology Society (2000). Results: Overall successful hearing gain in our series was noted in 40.9%. Young patients had more successful result than old patients. Patients with chronic otitis media had poorer result than patients with other diseases. Of course, patients with patent E-tube had better hearing result than patients with non-patent E-tube. Patients without mastoidectomy had better hearing result than patients with mastoidectomy. In cases with mastoidectomy, patients with intact canal wall mastoidectomy had better hearing result than patient with open cavity mastoidectomy. Patients with stapes suprastructure had better hearing result than patient without stapes suprastructure. Also, hearing result of ossiculoplasty was slightly different according to its materials. Senior surgeons had better hearing result than junior surgeon. Conclusion: We could confirm that successful hearing gain of ossiculoplasty was affected by the E-tube orifice status, surgeon’s technigue, and existence of stapes suprastucture and mastoidectomy. (J Clinical Otolaryngol 2003;14:105–112)