摘要
針對膽脂瘤術後容易復發或殘存的特性以及改善聽力的目的，我們對膽脂瘤性慢性中耳炎216耳中的105耳（48.6%），施行階段性手術。所有病例在第1階段手術將膽脂瘤除去時，均採乳突腔開放後封閉的方式。今取其記錄完整的93耳作回溯性的研究。93耳中，在56耳（60.2%）在初次手術中主觀認定已將膽脂瘤清除乾淨，但在第2階段仍發現8耳（14.3%）有膽脂瘤殘存。懷疑殘留之35耳（37.6%）中，則在第2次手術時確定有11耳（31.4%）膽脂瘤殘存。容易殘存的部位，依序為上鼓室前方、卵圓窗及下鼓室近耳咽管處。93耳中計有21耳（22.6%）殘存膽脂瘤，若假設其餘施行單次手術者為較容易處理的病耳，無殘留可能，則總殘留率為9.7%。我們的病例中無鼓室竇殘存，乃因手術中將面神經嵴磨低之故。中耳腔完全癒著塌陷之膽脂瘤耳，不適合施行階段性手術，宜以開放式小中耳腔鼓室成形術為之。對於範圍，有殘存之虞的膽脂瘤，特別是鐙骨上半部已被破壞的病耳，只要中耳腔前方仍有良好的黏膜，階段性手術是極為合適的。
並列摘要
Staged surgery performed for cholesteatoma caters to the tendency of postoperative recidivism of this pathology and for the purpose of achieving better hearing result. In a period of 8.5 years, among 216 ears of middle ear cholesteatoma, 105 ears were operated upon in stages and 93 ears were included in this retrospective study. Open-closed technique was used in the first stage in which cholesteatoma was removed and the tympanomastoid space was reconstructed. Fifty-six ears (60.2%) assumed to be free of cholesteatoma after the first stage operation were found to have residual lesions in 8 ears (14.3%) in the second stage. However, in 35 ears (37.6%) in which the surgeon felt unsure in eliminating the pathology, it was found in 11 ears (31.4%) with residue. Residual choleateatoma was found more frequently in the anterior epitympanum, the oval window niche, and the hypotympanum near the tubal orifice. The incidence of residual cholesteatoma was 22.6% in the staged cases. We attribute the low incidence of residual cholesteatoma in the sinus tympanum to the open-closed technique in which the facial ridge was lowered down to a great extent. In those ears with complete atelectasis of the middle ear space, staged operation is not indicated. If only there is a ventilated space around the tubal orifice, staged operation is considered beneficial.