NHÂN 2 TRƯỜNG HỢP CHỈNH HÌNH CHUỖI XƯƠNG CON TỰ THÂN 1 THÌ Ở BỆNH NHÂN CHOLESTEATOMA BẨM SINH VÀ MẮC PHẢI TẠI BV TMH SÀI GÒN

Abstract

Objective: Learning from diagnosis, preoperative consultation and treatment experience. Proposing the combination of instruments for more convenience in lesion solvage. Using the autograft for recovering the nature hearing and economizing on money for patient.

           Results: Case 1: Moderately – severe hearing loss while the tympanic mambrane is intact, however, a middle ear lesion is suspected due to a bulging, thickened, opaque tympanic membrane. Ossicular chain discontinuity on CT scan results. 3 weeks postoperative follow-up: PTA 33,5 dB (improving 24 dB), ABG: 23,75 dB (reducing 15 dB for ABG).  Ct scan clean lesion, prosthesis in the proper place. No complication. Case 2: Mild hearing loss (I) without incus/Ct scan (inappropriate between audiogram and Ct scan) and multiple abnormalities/endoscopy. More than 3 years postoperative follow-up: Normal tympanic membrane, scutum and epitympanum region/endoscope, PTA 20 dB (improved 13.75 dB), ABG: 12.25 dB (4 dB narrowing). CT scan: No recurrence of cholesteatoma, newly linked ossicular chain. No complications.

Conclusion: The combination of endoscopic image, audiogram and Ct scan giving exactly diagnosis and orientating to proper treatment. Combination of endoscope and microscope giving a safe and good lesion solvage with effectively restoring of the hearing function at the same time in deal with acquired and congenital cholesteatoma. Ossicular chain reconstruction could be done conveniently with autograft, recovering the nature hearing and economizing on money for the patient.