Swing-Door Overlay Tympanoplasty: Surgical Technique and Outcomes

박소영; 이혁재; 심명주; 김동기; 서병도; 박시내

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자료유형: 학술저널

저자정보: 박소영 이혁재 심명주 김동기 서병도 박시내

저널정보: 대한이비인후과학회 Clinical and Experimental Otorhinolaryngology Clinical and Experimental Otorhinolaryngology 제11권 제3호

발행연도: 2018.1

수록면: 186 - 191 (6page)

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Objectives. The classical overlay tympanoplasty is technically difficult with some disadvantages and thus less popular. However, it is particularly useful for large, anterior perforations. In this study, we describe the technique of a modified overlay graft in the tympanoplasty coined as the swing-door overlay tympanoplasty and report its outcomes. Methods. Retrospective review of patients undergoing the swing-door overlay tympanoplasty at a tertiary referral center between 2003 and 2016 was performed. Patient who had ossicular abnormality, previous tympanoplasty, and profound hearing loss were excluded. The surgical technique is described in detail. The outcomes were evaluated by the graft success rate, complication rate, and hearing results. The hearing level was determined by four pure-tone average at 0.5, 1, 2, and 4 kHz. Air-bone gap closure was mainly assessed. Results. A total of 306 patients (110 males and 196 females) were included. The mean age was 49.1±16.6 years. Follow-up periods ranged from 6 to 108 months with an average of 18.4 months. The overall graft success rate reached 98.4%. Five graft failures occurred with reperforation in three cases and lateralization in two cases. Postoperative complications occurred in 12 cases (3.9%). Air-bone gap changes (closures) were 7.8±12.8, 5.2±12.2, 5.7±10.2, and 6.0±12.8 dB at 0.5, 1, 2, and 4 kHz, respectively (all P<0.001) with an average improvement of 6.2 dB. Postoperative air-bone gap was closed to ≤20 dB in 86.9%. Conclusion. The swing-door overlay tympanoplasty is a highly successful surgical technique suitable for all types of tympanic membrane perforations. This approach is technically easier than classical overlay tympanoplasty and affords an excellent graft success rate with satisfying hearing results.

참고문헌 (17)

참고문헌 신청

Briggs RJ / 1994 / Chronic ear surgery: a historical review / Am J Otol 15(4):558~567

Kartush JM / 2002 / Over-under tympanoplasty / Laryngoscope 112(5):802~807

Farrior JB / 1983 / The anterior tympanomeatal angle in tympanoplasty: surgical techniques for the prevention of blunting / Laryngoscope 93(8):992~997

Jung TT / 2005 / Mediolateral graft tympanoplasty for anterior or subtotal tympanic membrane perforation / Otolaryngol Head Neck Surg 132(4):532~536

Schwaber MK / 1986 / Postauricular undersurface tympanic membrane grafting: some modifications of the "swinging door" technique / Otolaryngol Head Neck Surg 95(2):182~187

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