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진주종과 육아조직을 동반한 만성중이염의 측두골 전산화 단층촬영 및 수술소견의 비교

Title
진주종과 육아조직을 동반한 만성중이염의 측두골 전산화 단층촬영 및 수술소견의 비교
Other Titles
(THE) STUDY OF THE CORRELATION WITH THE TEMPO RAL BONE CT AND OPERATIVE FINDING IN CHRONIC OTITIS MWDIA WITH CHOLESTEATOMA AND GRANULATION TISSUE
Authors
김성민
Issue Date
1991
Department/Major
대학원 의학과
Keywords
진주종육아조직만성중이염측두골전산화단층촬영
Publisher
이화여자대학교 대학원
Degree
Master
Abstract
전산화 단층촬영술(Computed tomography, 이하 CT로 약함)은 골변화와 연부 종괴를 동반한 진주종의 수술전 진단 및 예후 판정에 있어 가장 정확한 방법으로 각광을 받고 있다. 이에 저자는 최근 3년간 이화여자대학교 의과대학 부속병원 이비인후과에서 수술로 확인된 진주종과 육아조직을 동반한 만성중이염 환자 20명을 대상으로 수술전 CT소견과 수술소견을 비교 분석하여 다음과 같은 결론을 얻었다. 1. 연령별 및 성별 분포는 6세에서 40세로 이 중 21세에서 30세가 11례로 가장 많았고, 남녀 성비는 같았다. 2. 증상 및 증후는 난청 14례, 이루 12례, 두통 3례, 이명 2례, 현훈과 이통이 각각 1례로 나타났다. 3. 진주종은 수술소견상 중이강내에서 10례, 유양동내에서 17례 발견되었으며 CT상에서는 각각 9례, 13례로 나타났고 진단적 예측도는 중이강과 유양동에서 모두 85.0%이어서 중이강과 유양동에서의 진주종이 가장 발견하기 쉬웠다. 4. 이소골의 미란은 CT상 7례에서 보였고, 수술소견상 침골 미란 10례, 추골 미란 6례, 등골 미란 2례였고 전 이소골 소실이 3례에서 나타났으며 진단적 예측도는 65.0%이었다. 5. 고막의 상태는 CT상 천공 7례, 유착 1례, 함몰 6례였으며, 수술소견상 천공 15례, 유착 2례, 함몰 1례로 진단적 예측도는 천공 55.0%, 유착 95.0%, 함몰 75.0%로 천공은 CT상 잘 관찰되지 않았다. 6. 주위 골조직의 파괴 상태는 수술소견상 상고실 측벽의 골파괴가 6례, 후벽 골파괴가 1례였으며, 외이도가 육아조직으로 좁아진 경우가 2례로 CT에서도 같은 소견을 보여 주었다. 7. 안면신경관의 미란은 CT상 수평 분절에 2례, 수직 분절에 1례 있었다. 8. 경막판의 열개상태는 수술시 2례였으나 CT상에서는 발견할 수 없었다.;The advent and the technical development of Computed Tomography (CT), it has proved to be the most effective for detecting the bony erosion associated with cholesteatomatous mass. Author has studied retrospectively 20 cases which were diagnosed chronic otitis media with cholesteatoma and granulation tissue by operation and they have done preoperatively temporal bone CT at the department of Otolaryngology of Ewha Womans University Hospital during the past 3 years from Jan. 1989 to Dec. 1991 and the following results were obtained. 1. The range of age was 6 years to 40 years old and highest frequency of age was 3rd decade, as 11 cases and male : female ratio was same. 2. The sign and symptom of chronic otitis media were hearing loss as 14 cases, otorrhea as 12 cases, headache as 3 cases, tinnitus as 2 cases, dizziness as 1 case, otalgia 1 case. 3. The cholesteatoma was detected in the middle ear cavity as 10 cases, mastoid antrum as 17 cases in operative findings and 9 cases, 13 cases each other in the CT. The diagnostic accuracy was in middle ear cavity as 85.0%, in mastoid antrum as 85.0%. 4. There were detected erosion of the ossicles as 7 cases in CT and erosion of incus as 10 cases, malleus as 6 cases, stapes as 2 cases in operative findings. The diagnostic accuracy was 65.5%. 5. The state of drum was detected perforation as 7 cases, adhesion as 1 case, retraction as 1 case in CT and detected perforation as 15 cases, adhesion as 2 cases, retraction as 1 case in the operative findings. The diagnostic accuracy was perforation as 55.0%, adhesion as 95.0%, retraction as 75.0%. 6. The destruction of surrounding bony structure was observed lateral attic wall as 6 cases, posterior bony wall was destruction as 1 case in the operative findings. The narrowing of the external auditory canal by the granulation tissue was 2 cases in the CT and operative findings. 7. The erosion of the facial canal was detected tympanic segment as 2 cases, mastoid segment as 1 case. 8. The dural plate bony dehiscence was detected 2 cases in the operative findings but was not detected in the CT.
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