水中内視鏡下耳科手術:システマティックレビュー
Sailesh Acharya1, Prakash Bahadur Thapa2, Deepa Adhikari2
1Kathmandu ENT Hospital, Kathmandu, Nepal. saileshemail@gmail.com.
まとめ
水中内視鏡下耳科手術(UWEES)は、聴力を改善し内耳を温存する、安全で効果的な低侵襲手技です。このアプローチは、様々な耳疾患に対して、術野の視認性を向上させ、手術時間を短縮します。
科学分野:
- 耳鼻咽喉科; 低侵襲手術; 外科技術
背景:
- 従来の耳科手術手技は、視認性および侵襲性によって制限される可能性があります。
研究 の 目的:
- 水中内視鏡下耳科手術(UWEES)の臨床的適応、手術手技、聴覚学的結果、手術効率、および安全性について包括的に評価すること。
主な方法:
- 2025年5月までの主要なデータベース(PubMed、Google Scholar、Cochrane Library)を対象としたシステマティック文献検索を実施しました。
- ヒトを対象とした UWEES に関する(3名以上の患者)、顕微鏡下または動物実験を除外した、オリジナルの英語論文を含めました。
- データの抽出と質的評価は PRISMA ガイドラインに従い、研究間の異質性のため定性的な統合を行いました。
主要な成果:
- 9件の研究が適格基準を満たし、耳道形成術、真珠腫、迷路 fistura 修復、および SCDS プラグ処置における UWEES を詳述しました。
- 感音難聴は温存され、航空骨伝導ギャップの閉鎖に有意な改善が見られました。
- UWEES は、手術時間の短縮、合併症発生率の低さ、および前庭症状の 90% 以上の改善を示しました。
結論:
- UWEES は、様々な耳疾患に対する安全で効果的かつ低侵襲な外科的選択肢です。
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