鼓室形成術における側頭筋膜採取方法による術後痛の程度

Among the various materials used for harvesting in tympanoplasty, the temporal fascia is a commonly-used material due to its accessibility and size. Surgeons can choose to use either the superficial or deep temporal fascia, or both. This study aimed to investigate the influence of the method used to harvest the temporal fascia on postoperative pain experienced by patients.

The medical records of 89 patients who underwent canal wall up mastoidectomy with tympanoplasty and ossiculoplasty, performed by a single surgeon between 2021 and 2024, were retrospectively reviewed. In group A, the superficial temporal fascia is harvested. In group B, both the superficial and deep temporal fasciae are harvested together, resulting exposed temporal muscle. In group C, only the deep temporal fascia is harvested and the exposed temporal muscle is sealed by suturing the superficial temporal fascia. Postoperative pain was measured using the visual analog scale (VAS) in 3 groups on postoperative days 1, 3, and 14.

The baseline characteristics are not significantly different in the 3 groups. VAS scores on postoperative days 1 and 3 showed a significant difference in 3 groups. Group B, which was supposed to have undergone most resection, exhibited the highest VAS scores, followed by group C and group A. The VAS scores on postoperative day 14 showed no difference among the 3 groups.

Resection of the superficial temporal fascia is thought to be important for postoperative pain due to its rich innervation. Postoperative pain and the properties of the superficial and deep temporal fasciae can be taken into account when otologic surgeons select a harvesting method.