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Korean Journal of Otorhinolaryngology-Head and Neck Surgery > Volume 32(6); 1989 > Article
Korean Journal of Otorhinolaryngology-Head and Neck Surgery 1989;32(6): 1036-45.
Clinical Analysis of Middle Ear Operation(I)
Yong Hee Do, MD, Chong Ho Kim, MD, Chang Su Ahn, MD, Dong Hyuk Lee, MD, Yong Ki Jang, MD, Bum Gyu Cho, MD, Chong Ae Kim, MD, and Won Yong Lee, MD
Department of Otolaryngology, Wallace Memorial Baptist Hospital, Pusan, Korea
중이수술에 대한 임상적 고찰(I)
도용희 · 김종호 · 안창수 · 이동혁 · 장용기 · 조범규 · 김종애 · 이원용
부산 침례병원 이비인후과
ABSTRACT

Recently, the frequency of chronic otitis media has gradually decreased, but it is still a relatively important disease in the otologic department. Although there are new surgical procedures, many problems remain. Therefore much research in this area is necessary. Two hundred and forty six operative cases of chronic otitis media from the department of otolaryngology of Wallace Memorial Baptist Hospital during the past five years from Jan. 1984 to Dec. 1988 ard reviewed. And the following results were obtained. 1) Male to female ratio was 1.03 : 1 and age distribution showed predilection for age of 20 to 29 with 246 cases(44.7%). 2) Site incidence of operated cases ; Rt. side were 138 cases(56.1%), Lt. side were 108 cases(43.9%). 3) Subjective complaints in order of frequency were follows ; otorrhea 243 cases(98.8%), hearing loss 196 cases(79.7%), tinnitus 77 cases(31.3%), headache, vertigo, otalgia etc. 4) Duration of disease since onset, showed predilection for duration of 6 years to 10 years(45.1%). 5) Character of otorrhea ; Dry states were 190 cases(77.2%), serous states were 15 cases(6.1%), mucoid states were 9 cases(3.7%), purulent states were 32 cases(13.0%). 6) Duration of dry state of otorrhea showed predilection for duration of 1 month(27.6). 7) Site of drum perforation showed predilection for large-total perforation(39.0%). 8) X-ray findings of temporal bone were 143 cases(58.1%) in sclerotic, 19 cases(7.7%) in diploic, 17 cases(6.9%) in pneumatic. 9) Degree of preoperative hearing loss in order of frequency were follows ; mild(34.9%), moderate(25.6%), moderate severe(25.2%), normal(8.2%), severe, profound. 10) Types of preoperative hearing loss showed predilection for conductive hearing loss(76.8%). 11) Condition of eustachian tube function ; Good were 136 cases(53.3%), fair were 58 cases(23.6%), poor were 52 cases(21.1%). 12) Type of anesthesia were 223 cases(90.7%) by general anesthesia. 13) The route of approach were 190 cases(77.2%) in postauricular, 50 cases(20.4%) in transmeatal, 6 cases(2.4%) in endaural. 14) Conditions of middle ear mucosa were 170 cases(69.2%) in diseased, 76 cases(30.8%) were intact. 15) Condition of ossicles ; 111 cases(45.1%) were intact, 135 cases(54.9%) were destructed. Destructed ossicles showed predilection for destruction of malleus and incus. 16) Extent of cholesteatoma were 31 cases(12.6%) in attic-antrum-middle ear, 28 cases(11.4%) in attic-antrum, 14 cases(5.7%) in attic and 6 cases(2.4%) in attic-middle ear. 17) Type of operation were 38 cases(15.4%) in open cavity mastoidectomy, 97 cases(39.4%) in mastoidectomy with tympanoplasty, 71 cases(28.9%) in tympanoplasty without mastoidectomy, 7 cases(2.9%) in revision, 33 cases(13.4%) in ossicular reconstruction. 18) Incidence of surgical accident were 8 cases(3.3%) in dural exposure, 4 cases(1.6%) in facial canal exposure, 3 cases(1.2%) in lateral sinus exposure, 2 cases in horizontal canal fistula, 2 cases in oval window fistula. 19) Silastic sheet were inserted in 88 cases(35.8%). 20) Preoperative complication were 9 cases(3.6%) n facial nerve palsy, 6 cases in intracranial complication, 5 cases in retroauricular abscess, 1 cases in Bezold's abscess. Postoperative complication were 4 cases(1.7%) in facial nerve palsy, 2 cases in labyrinthitis, 1 cases in perichondritis. 21) The recurrence rate of otorrhea was 5.7%. 22) Postoperative status of T-M graft were 161 cases(86.3%) in relatively well graft state, 25 cases(13.7%) in failure. 23) Postoperative status of A-B gap was 45.7% in gain over 10 dB, 9.1% in loss over 10 dB. 

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