{"created":"2023-06-19T10:21:48.669348+00:00","id":779,"links":{},"metadata":{"_buckets":{"deposit":"785fc700-f467-4d5c-9f92-979181fa46c8"},"_deposit":{"created_by":12,"id":"779","owners":[12],"pid":{"revision_id":0,"type":"depid","value":"779"},"status":"published"},"_oai":{"id":"oai:saitama-med.repo.nii.ac.jp:00000779","sets":["9:7:126"]},"author_link":["2611","2614","2605","2609","2607","2604","2603","2606","2610","2608","2613","2612"],"item_10001_biblio_info_7":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2021-03","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"2","bibliographicPageEnd":"89","bibliographicPageStart":"82","bibliographicVolumeNumber":"47","bibliographic_titles":[{"bibliographic_title":"埼玉医科大学雑誌"},{"bibliographic_title":"Journal of  Saitama Medical University ","bibliographic_titleLang":"en"}]}]},"item_10001_description_5":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"背景:鼓膜穿孔の閉鎖のために様々な手術が開発されてきた.一般に普及した方法として,湯浅によって開発された鼓膜形成術接着法(以下接着法)がある.穿孔縁を新鮮化したのちに結合組織を中耳側から組織接着剤で固定する方法である.従来の鼓室形成術と比較して,接着法のメリットはその低侵襲性にある.接着法の欠点は結合組織が鼓室側へ脱落することであり,結果的に約20%に再穿孔が生じる.接着法の聴力改善率は約80%と報告されている.方法:我々は,接着法を改変し,新しい方法「鼓膜形成術重層留置法」を開発し2011年より実施してきた.この手術法は,組織接着剤を必要とせず,鼓室内に十分な量の結合組織を重層的に留置し鼓膜裏面に十分接着させ,鼓室側への脱落が起きないように工夫することで,良好な結果が得られてきた.本研究では,術後成績の詳細な評価を行うために2015年1月から2015年12月までに手術を行い,1年以上の観察を行った61例68耳をレトロスペクティブに検討した.結果:鼓膜穿孔閉鎖率と聴力改善率はそれぞれ96%と94%であった.この成功率は,接着法などの従来法と比べ同等以上であった.さらに,この術式では,大穿孔の症例も高率に閉鎖した.術後CTでは留置した結合組織が縮小し,最終的に吸収されていた.術後の聴力の改善も良好で,本術式は,鼓室腔の含気と聴力に悪影響を及ぼさないことが明らかとなった.結論:鼓膜穿孔に対し,鼓膜形成術重層留置法という極めて単純な鼓膜形成の術式を開発し,良好な鼓膜穿孔閉鎖率と聴力改善率が得られた.本術式は大穿孔例での同時手術も可能,組織接着剤は不要といった利点がある.(著者抄録)\n\nBackground: Various surgical techniques have been developed for the treatment of tympanic membrane perforation. One of the most common procedures is simple underlay myringoplasty with fibrin glue (SUM) developed by Dr. Yuasa. Compared to conventional tympanoplasty, SUM is less invasive. The drawbacks of SUM are medialization and dislocation of the underlying connective tissue. These two complications can lead to re-perforation, of which the incidence has been previously reported to be about 20％. The hearing improvement rate of SUM has been reported to be around 80％. We have developed a modified SUM, namely ＂multi-layered connective tissue underlay myringoplasty（MCUM）”. This new, technique does not require fibrin glue derived from homologous human blood. Also, our preliminary study showed it has even higher success rates because properly placed the multiple-layered connective tissue does not cause dislocation. Method: In the present study, we retrospectively examined 61 patients＇ 68 ears operated by MCUM between January 2015 to December 2015 who had more than a one-year follow-up period. Results: The tympanic membrane perforation closure rate and hearing improvement rate was 96％ and 94％, respectively. These success rates were equivalent to or higher than that of the previously reported conventional methods such as SUM. Moreover, this study also revealed that even large perforations could be successfully closed. The follow-up CT scans and audiometry revealed the volume of underlaid connective tissue has been reduced and eventually absorbed, and did not cause any harmful effect to the tympanic cavity aeration and hearing outcomes. Conclusion: We have developed MCUM and this new technique brings high perforation closure rate and hearing improvement rate. MCUM can be applied to large sized perforation without using fibrin glue.","subitem_description_type":"Abstract"}]},"item_10001_publisher_8":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"埼玉医科大学医学会"}]},"item_10001_relation_17":{"attribute_name":"関連サイト","attribute_value_mlt":[{"subitem_relation_name":[{"subitem_relation_name_text":"埼玉医科大学雑誌"}],"subitem_relation_type_id":{"subitem_relation_type_id_text":"http://www.saitama-med.ac.jp/jsms/vol47/jsms47_082-089.pdf","subitem_relation_type_select":"URI"}}]},"item_10001_source_id_11":{"attribute_name":"書誌レコードID","attribute_value_mlt":[{"subitem_source_identifier":"AN0009506X","subitem_source_identifier_type":"NCID"}]},"item_10001_source_id_9":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"0385-5074","subitem_source_identifier_type":"ISSN"}]},"item_10001_text_24":{"attribute_name":"記事区分","attribute_value_mlt":[{"subitem_text_value":"原著 / original"}]},"item_10001_version_type_20":{"attribute_name":"著者版フラグ","attribute_value_mlt":[{"subitem_version_resource":"http://purl.org/coar/version/c_970fb48d4fbd8a85","subitem_version_type":"VoR"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"中嶋, 正人"},{"creatorName":"ナカシマ, マサト","creatorNameLang":"ja-Kana"}],"nameIdentifiers":[{"nameIdentifier":"2603","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"松田, 帆"},{"creatorName":"マツダ, ハン","creatorNameLang":"ja-Kana"}],"nameIdentifiers":[{"nameIdentifier":"2604","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"新藤, 晋"},{"creatorName":"シンドウ, ススム","creatorNameLang":"ja-Kana"}],"nameIdentifiers":[{"nameIdentifier":"2605","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"上條, 篤"},{"creatorName":"カミジョウ, アツシ","creatorNameLang":"ja-Kana"}],"nameIdentifiers":[{"nameIdentifier":"2606","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"加瀬, 康弘"},{"creatorName":"カセ, ヤスヒロ","creatorNameLang":"ja-Kana"}],"nameIdentifiers":[{"nameIdentifier":"2607","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"池園, 哲郎"},{"creatorName":"イケゾノ, テツオ","creatorNameLang":"ja-Kana"}],"nameIdentifiers":[{"nameIdentifier":"2608","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"Nakashima, Masato","creatorNameLang":"en"}],"nameIdentifiers":[{"nameIdentifier":"2609","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"Matsuda, Han","creatorNameLang":"en"}],"nameIdentifiers":[{"nameIdentifier":"2610","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"Shindo, Susumu","creatorNameLang":"en"}],"nameIdentifiers":[{"nameIdentifier":"2611","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"Kamijo, Atsushi","creatorNameLang":"en"}],"nameIdentifiers":[{"nameIdentifier":"2612","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"Kase, Yasuhiro","creatorNameLang":"en"}],"nameIdentifiers":[{"nameIdentifier":"2613","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"Ikezono, Tetsuo","creatorNameLang":"en"}],"nameIdentifiers":[{"nameIdentifier":"2614","nameIdentifierScheme":"WEKO"}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2021-10-28"}],"displaytype":"detail","filename":"jsms47_2_082-089.pdf","filesize":[{"value":"959.5 kB"}],"format":"application/pdf","licensetype":"license_11","mimetype":"application/pdf","url":{"label":"埼玉医科大学雑誌47巻2号82-89頁","url":"https://saitama-med.repo.nii.ac.jp/record/779/files/jsms47_2_082-089.pdf"},"version_id":"b8ef316a-e361-4013-87a1-7965f8309ca4"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"*鼓膜形成術","subitem_subject_scheme":"Other"},{"subitem_subject":"聴覚","subitem_subject_scheme":"Other"},{"subitem_subject":"鼓膜穿孔(外科的療法)","subitem_subject_scheme":"Other"},{"subitem_subject":"後向き研究","subitem_subject_scheme":"Other"},{"subitem_subject":"治療成績","subitem_subject_scheme":"Other"},{"subitem_subject":"ヒト","subitem_subject_scheme":"Other"},{"subitem_subject":"幼児(2〜5)","subitem_subject_scheme":"Other"},{"subitem_subject":"小児(6〜12)","subitem_subject_scheme":"Other"},{"subitem_subject":"青年期(13〜18)","subitem_subject_scheme":"Other"},{"subitem_subject":"成人(19〜44)","subitem_subject_scheme":"Other"},{"subitem_subject":"中年(45〜64)","subitem_subject_scheme":"Other"},{"subitem_subject":"高齢者(65〜79)","subitem_subject_scheme":"Other"},{"subitem_subject":"高齢者(80〜)","subitem_subject_scheme":"Other"},{"subitem_subject":"男","subitem_subject_scheme":"Other"},{"subitem_subject":"女","subitem_subject_scheme":"Other"},{"subitem_subject":"chronic otitis media","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"multi-layered connective tissue underlay myringoplasty (MCUM)","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"tympanic embrane perforation closure rate","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"hearing improvement rate","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"cost-effectiveness","subitem_subject_language":"en","subitem_subject_scheme":"Other"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"jpn"}]},"item_resource_type":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"resourcetype":"journal article","resourceuri":"http://purl.org/coar/resource_type/c_6501"}]},"item_title":"新しい鼓膜形成術(重層留置法)の検討","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"新しい鼓膜形成術(重層留置法)の検討"},{"subitem_title":"A novel method for myringoplasty: multi-layered connective tissue underlay technique","subitem_title_language":"en"}]},"item_type_id":"10001","owner":"12","path":["126"],"pubdate":{"attribute_name":"公開日","attribute_value":"2021-10-28"},"publish_date":"2021-10-28","publish_status":"0","recid":"779","relation_version_is_last":true,"title":["新しい鼓膜形成術(重層留置法)の検討"],"weko_creator_id":"12","weko_shared_id":-1},"updated":"2023-06-19T10:29:43.320049+00:00"}