Tolga KANDOĞAN, Gürol GÜLTEKİN, Levent OLGUN, Zafer ERYILMAZ, Uğur ÇERÇİ, Levent AYDAR

Attik kolesteatomlu olgularda fonksiyonel cerrahinin uzun dönem sonuçları

Amaç: Attik kolesteatomlu hastalarda fonksiyonelcerrahinin uzun dönem sonuçları değerlendirildi.Hastalar ve Yöntemler: Bu çalışmada Ocak 19921998 tarihleri arasında attik kolesteatom nedeniyleameliyat edilen ve tamamına fonksiyonel cerrahi uygulanan 81 olgunun sonuçları sunuldu. Tüm olgular en azbeş yıl süreyle izlendi.Bulgular: Olguların büyük bir kısmında hastalığıneradikasyonu için canal wall-down tekniği ile timpanoplasti gerekti. Dört olgu dışında tüm olgulardaameliyat sonrasında istatistiksel olarak anlamlı birişitme kazancı elde edildi. Ameliyat sonrası kontrollerde, beş hastada nüks kolesteatom, altı hastada ise greft perforasyonu gözlendi. Kavite temizliğine bağlı sorunlar nedeniyle iki olguya revizyonmeatoplasti uygulanması gerekti.Sonuç: İşitme sonuçlarının oldukça tatminkar olmasıyanı sıra saucerization ve meatoplasti yöntemlerininkendi kendini temizleyebilecek bir mastoid kavitesioluşturabildiği görüldü. Açık teknik uygulanan olgularda residüel ya da nüks kolesteatom oranının son derece düşük olması, bu tekniğin olguların büyük bir kısmında uygulanmasında önemli bir etkendir

Anahtar Kelimeler:

Kolesteatom/komplikasyon/cerrahi, kulak kanalı/cerrahi, kulak, orta/patoloji/cerrahi, timpanoplasti/yöntem

Long-term results of functional surgery for attic cholesteatoma

Objectives: We evaluated the long-term results of functional surgery for attic cholesteatoma.Patients and Methods: İn this study, we presented the results of 81 patients 42 males 39 females; mean age 34 years; range 8 to 59 years who undervvent functional surgical techniques for attic cholesteatomas between January 1992 and January 1998. AH the patients were followed-up for at least five years.Results: For eradication of attic cholesteatoma, canal wall-down technique tympanoplasty was required in the majority of the patients. After surgery there was a statistically significant hearing improve- ment in ali but four cases. İn the postoperative period, residual cholesteatoma and graft perforation were found in five and six patients, respectively. Two patients required revision meatoplasty for problems related with cavity clearence.Conclusion: Apart from satisfactory hearing improvement with functional surgery, a successful self-clearance was obtained in mastoid cavities with saucerization and meatoplasty. Canal wall- down tympanoplasty is associated with very low incidences of residual or recurrent cholesteatoma in the majority of patients.

Keywords:

Cholesteatoma/complications/surgery, ear, canal/surgery, middle/pathology/surgery, tympanoplasty/methods,

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