KISEP Special rticles 臨床耳鼻 : 第 13 卷 第 1 號 2002 J Clinical Otolaryngol 2002;13:30-35 유양동처치법 이상흔 이지은 이규엽 Management of Mastoid Cavity Sang Heun Lee, MD, Ji Eun Lee, MD and Kyu-Yup Lee, MD Department of Otolaryngology, School of Medicine Kyungpook National University, Daegu, Korea 서 - 론 - 개방형유양동삭개술 30
Mastoid air cells Eustachian tube ir spaces in peripheral cells Recovery of aeration Retraction of posterior wall Fig. 1. Ventilation and pressure regulation system. Table 1. Comparison between E-tube and transmucosal gas exchange E-tube ctive, quick Don t work during sleep Impaired by URI Transmucosal Gas exchange Passive, slow Work constantly, even during sleep Impaired by thickening of mucosa Mucosa preserved Fig. 3. Mastoid aeration recovery in preserved mucosa. Mastoid mucosa preserved, Epitympanum mucosa preserve. Recovery of aeration Retraction of posterior wall Fig. 2. Gas exchange in mastoid. Positive air space permits gas exchange, No exchange in negative space. C E - D Fig. 4. Common problem areas in CWD. Sinodural angle, nterior and lateral epitympanu, CHigh facial ridge, DMastoid tip cell, EInadequate matus. - 31
J Clinical Otolaryngol 2002;13:30-35 C Fig. 5. Method of meatoplasty. Fisch s method, Korner s method, CSieberman s method, DPortmann s method. - - - D 32 - - - -
- 폐쇄공동법유양동삭개술 - - - Questionnaires - - 16% 28% 7% 49% nt based Sup based Int based Post based Fig. 6. Type of musculoperosteal flap. 33
J Clinical Otolaryngol 2002;13:30-35 5% 3% 42% 36% 2% 12% Musculoperiosteal flap one Perichondrium Cartilage Temporalis fasia Hydroxyapetite Fig. 7. Used materials for obliteration. Fisch s Portmann s Siebermann s Korner s Others Fig. 8. Methods of meatoplasty. - - - 결 중심단어 REFERENCES 1) Lee SH. natomy and Physiology of the Eustachian Tube. J Clinical Otolaryngol 2000112189-96. 2) Holmquist J, ergstrom. The mastoid air cell system in ear surgery. rch Otolaryngol 1978104127-9. 3) Nadol J. Cause of failure of mastoidectomy for chronic otitis media. Laryngoscope 198595410-3. 4) Fisch U. Tympanoplasty, mastoidectomy and stapes surgery. Stuttgart/NewYork George Thieme1994. p.190. 5) Perkins R. Tympanomastoid reconstruction n operative procedure for anatomical and functional restoration of the radicalized ear. Laryngoscope 197585416-30. 6) Smith GDL, Dowe C. Cartilage canaloplasty. Laryngoscope 197181786-92. 7) Wehrs RE. Reconstructive mastoidectomy with homograft knee cartilage. Laryngoscope 1972821177-88. 론 34
8) Pou JW. Reconstruction of bony canal with autogenous bone graft. Laryngoscope 1977871826-32. 9) Wiet RJ, Harvey S, Pyle MG. Canal wall reconstruction newer implantation technique. Laryngoscope 1993103 594-9. 10) Estrem S, Highfill G. Hydroxylapatite canal wall reconstruction/mastoid obliteration. Otolaryngol Head Neck Surg 1999120345-9. 11) Wullstein SR. Osteoplastic epitympanotomy. Trans m Otol Soc LXII, 1974148-56. 12) Portmann M. Ear surgery for inflammation and infection alone. In the Ear and Temporal bone, masson1979. p.43-99. 13) Mosher HP. method of filling the excavated matoid with a flap from the back of the auricle. Laryngoscope 191121 1158-63. 14) Popper O. Periosteal flap grafts in mastoid operation. S fr Med J 1935977-81. 15) Palva T, Palva, Kaerjae. Musculoperiosteal flap in cavity obliteration. rch Otolaryngol 197295172-7. 16) Peer L. Loss of weight and volume in human fat grafts. Plast Recons Surg 19505217-30. 17) Wullstein HL. Operation am Mittelohr mit Hilfe des freien Spaltl-appen-Transplantates. rch Otorhinolaryngol 1952 161422-35. 18) Guilford FR. Obliteration of the cavity and reconstruction of the auditory canal in temporal bone surgery. Trans M cad Ophthalmol Otolaryngol 196165114-22. 19) Shea MC, Gardner G. Mastoid obliteration using homograft bone. rch Otorhinolaryngol 197092358-65. 20) Palva T. Operative technique in mastoid obliteration. cta Otolaryngol 1973754289-90. 21) East C, rough MD, Grant HR. Mastoid obliteration with the temporoparietal fascia flap. J Laryngol Otol 1991 1056:417-20. 22) Mahoney J. Tympanoacryloplasty. new mastoid obliteratory procedurepreliminary report. rch Otolaryngol 1962 75519-24. 23) Meuser W. Permanent obliteration of old radical mastoid cavities combined with tympanoplasty. J Otol Laryngol 1884 9831-5. 24) Shea JJ. Homasy C. The use of proplast in otologic surgery. laryngoscope 1097841875-9. 25) Grote JJ, Van litterswijk C. Hydroxyapatite ceramic as middle ear implant material animal experimental results. nn Otol Rhinol Laryngol 198695Suppl1231-12. 26) Corlieu P, D rc, Daculsi G, Sterkers JM. Mastoid cavity obliteration by hydroxyapatite-tricalcium phosphate granules. InTos M, Thomsen J, Peitersen E, eds. Cholesteatoma and mastoid surgery. msterdam Kurgler publications1988 p.935-8. 27) Takahashi S, Nakano Y. Tympanoplasty with mastoid obliteration using hydroxyapatite granule. InYanagihara N, Suzuki J, eds. Transplants and implants in otology II. msterdamkugler Publications1992. p.159-63. 28) Yang HS, Choe MS, Park SJ, Kim CG. method of the reconstruction of posterior canal wall and mastoid obliteration using cortical bone chips. Korean J Otolaryngol 1991 34904-12. 29) Lee DH, Lee SD, Kweon YW, Lee Y, Nam SY, Park JH. Mastoid obliteration using Palva flap and cortical bone dust. Korean J Otolaryngol 19913439-43. 30) Kwon YW, Wang DY, Lee SD, Nam SY, Lee Y, Park HJ. The effect of the mastoid obliteration using Palva flap and cortical bone dust. Korean J Otolaryngol 1993361155-61. 31) Park KH, Chun YM, Kang JW, Kwon OH, Kim MS. Healing process of mastoid obliteration using cortical bone chips analysis of 90 cases. Korean J Otolaryngol 199538 345-52. 32) Lee WS, Choi JY, Yang HD, Cho CH, Kim IS. Mastoid obliteration with bone paste and fat. Korean J Otolaryngol 200144126-31. 33) Jang CH, Kim JK, Choi TW, Kim JO. Mastoid obliteration using hydroxyapatite, cartilage and Schuknecht flap. Korean J udiol 199712190-5. 34) Min GM, Park P, Moon TO, Hong S. Partial mastoid obliteration using inferior based musculoperiosteal flap and autogenous conchal cartilage chips Korean J Otolaryngol 1999427843-8. 35) Kang MG, Hong SH, Kim M, Han CS, Kim CG, ae WY, et al. Epitympanoplasty with mastoid obliteration after tympanomastoid surgery comparison of three different methods in 95 cases. J Clinical Otolaryngol 2000112273-9. 36) lack. Prevention of recurrent cholesteatomause of hydroxyapetite plates and composite graft. m J Otol 199213 273-8. 37) Palva T, Palva, Salmivalli. Radical mastoidectomy with cavity obliteration. rch Otolaryngol 196888119-23. 35