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At least 235 records · Page 13Linked to original sources
PubMed1977

[Development from skin- to fascia- and to cartilage tympanoplasty (epitympanon-antrum-mastoidplasty) (author's transl)].

Experiences with 8029 endaural tympanoplastes show interruption of the self-cleaning process of the endaural epithelium after 366 tympanoplasties with skin grafts. The self-cleaning process may be preserved after fascia temporalis (2325) and cartilage (5338) plasties, because of overgrowth with local epithelium. 16 years after combined fascia temporalis and cartilage tympanoplasty the pieces of cartilage are almost unchanged but the fascia temporalis is more or less thinned to atrophic scars and according to tubal function it shows adhesive retraction pockets or bulging. For 7 years we have not been using fascia any more, but ear cartilage for the tympano-epitympano-antrum-mastoidplasty. Cartilage material not used is kept in a cartilage bank. Recurrence of cholesteatoma will press the cartilage plasty into the external auditory canal, whereas after osteoplasty of the endaural canal wall the patient runs to an uncertain percentage the same risk as before the operation.

Cartilage↗
PubMed2003

Tympanoplasty using conchal cartilage graft.

Cartilage has been used successfully as a graft in middle ear surgery. It used to be reserved for advanced pathology because of its possible detrimental effect on postoperative hearing. Recent papers however failed to prove this effect. The present study describes the authors' experience in 161 cases of conchal cartilage tympanoplasty. In tympanoplasty type I postoperative pure tone average air-bone gap was within 20 dB in 88.4% of the cases. If combined with ossiculoplasty when the stapes was intact, 72% was within 20 dB and when the stapes was absent, 54.5% was within 20 dB. Taking rate of the graft was 95.6% (154/161) with 22% (36/161) representing revision surgery. At present the author uses cartilage graft as a first choice in tympanoplastic procedures.

Adolescent↗
PubMed2004

[Evaluation of safety on the noise of drills in the tympanoplasty].

OBJECTIVE: To investigate the effect of noise generated by the otologic drills and suctions on the cochlear of the operated and nonoperated ear. METHOD: To examine the noise generated by the different kind of drills and suctions in tympanoplasty, the ND10 Sound Level Meter (Beijing) was used. The bone-conduction thresholds was measured before and one month after operation respectively in both ears. RESULTS: Sound pressure levels for the otologic drills and suctions were 82-106 dB and 71-84 dB, respectively. There was no statistically significant difference between pre-noise and one-month post-noise bone-conduction thresholds in both operated and nonoperated ears. CONCLUSION: It is safety to use otologic drills and suctions for the patients. There is no apparent harmful effect on the function of cochlear in both ears for the noise of using drills and suctions in tympanoplasty.

Evaluation Studies as Topic↗
PubMed2004

[Results of myringoplasty and type I tympanoplasty with the use of fascia, cartilage and perichondrium grafts].

Since the publication of Miodoński, Zollner and Wullstein different methods and grafting materials have been promoted in tympanoplasty. The purpose of this study was to demonstrate the anatomical and functional results of tympanoplasty in comparison with the material used. The studies included a selected group of 142 patients who were operated on because of perforation of tympanic membrane. The analysed group consisted of 112 patients when perichondrium and cartilage were used to reconstruct the tympanic membrane. The comparison group consisted of 30 patients when fascia of the musculus temporalis was used to close a defect of the eardrum. In all cases before and after operation there was made tonal audiometry with indication for air and bone conduction within range from 500 to 4000 Hz, verbal audiometry after operation with indication of speech detection and speech reception threshold using mono-syllable NLA-93 test, tympanometry after operation and evaluation of anatomical results after surgery. The comparison of operation results showed that there was no significant difference between the two groups.

Adolescent↗
PubMed2004

[Introduction of middle ear surgery "aimed at hearing improvement" by Jan Miodoński--tympanoplasty at the centenary of his birthday].

The author recalls the introduction of the functional surgery of the Middle Ear--tympanoplasty by Miodoński and reminds of Miodoński's types of surgical reconstruction of the sound conducting mechanism: 1. "Ecranisatio" of the Round Window--the formation of the Small Middle Ear--Myringoplatinopexy (1949); 2. "Columellisatio" of the "Small Middle Ear--the formation of the Middle Ear with one ossicle--the Columella Effect--Myringostepedopexy" (1949); 3. "Columellisatio I-III"--the connection of the malleus with the stapes--Ossiculoplasty--Malleostapedopexy (1955). A comparison of Miodoński's solution in the range of functional surgery of the Middle Ear with present reconstructive Middle Ear techniques leads us to the conclusion that most of the tympanoplasty are only various modifications of Miodoński's principles.

History, 20th Century↗
PubMed2002

[Postoperative morbidity of graft tympanic membrane in tympanoplasty and the relevant factors].

OBJECTIVE: To investigate the morbidity and configuration of graft (temporalis fascia) tympanic membrane as well as their pertinent factors in different stages after tympanoplasty so as to find out the measures to improve the graft morbidity. METHOD: 120 ears undergone tympanoplasty with medial graft techniques were observed. The postoperative grafts were followed up in 2 weeks, 1-3 months, 4-6 months, 6-24 months and over 2 years respectively. The pertinent factors influencing the grafts growths and its functions were analyzed. RESULT: There were 4 grafts occurred crannies after 2 weeks, 2 cases occured infection in middle ear and had reperforation after 1-3 months, 24 cases with catheterization were found ineffective after 4-6 months and 13 grafts were found atrophy after 6 months to 2 years followed up after operation respectively. There were total 10 (8.33%) ears developed perforation again in 2 years. CONCLUSION: The cranny in anterioinferior border of the grafts is one of the main risky factor for the reperforation in new tympanic membrane in the early stage. The cases with severe pathosis in mucosa in tympanic cavity should be followed up intimately. Eustachian catheterization was one of the effective methods to the tubal dysfunction. The graft tympanic membrane function and configuration will become stabilized in three months postoperatively.

Adolescent↗
PubMed2004

Cartilage and tympanoplasty.

This study analyzes the morphological and hearing results obtained with cartilage tympanoplasty in retraction pocket, blunting and tympanic membrane lateralization, and cholesteatoma surgeries. Results obtained 3 years postoperatively in 80 patients operated on with cartilage reinforcement of the tympanic membrane (TM) were compared with those obtained 3 years postoperatively in 100 patients operated on with fascia or perichondrium TM reinforcement. Retraction pocket recurrence was found in the patients operated on with fascia or perichondrium in 24% of cases and only in 8% of cases in patients operated on with partial tympanic membrane cartilage reinforcement. No recurrence was found in patients operated on with a total reinforcement of the TM. Cartilage tympanoplasty with skin graft covering the bony external auditory canal (EAC) was performed in 6 cases of severe blunting and/or tympanic membrane lateralization. 3 years post-operatively, good morphological and functional results were obtained in 3 cases. One or two staged ICW procedures were performed in 390 adult patients (416 ears) suffering from a non operated middle ear cholesteatoma. Recurrent and residual cholesteatoma rates were evaluated. Cholesteatomas were operated on with removing the malleus, reinforcing all the tympanic membrane with cartilage and performing an ossiculoplasty with hydroxylapatite prosthesis. The results were compared to those obtained in ICW cholesteatoma surgery with preserving the malleus manubrium, partially reinforcing the eardrum with cartilage and predominantly using an ossicle to perform the ossiculoplasty. Removing the malleus and reinforcing the whole tympanic membrane with cartilage statistically reduced the cholesteatoma recurrence rate for the ICW procedure. This technique, using hydroxylapatite prosthesis for ossiculoplasty gives good hearing results.

Adult↗
PubMed2006

[Results of chorda tympani nerve application or no in tympanoplasty].

OBJECTIVE: To demonstrate the effect of chorda tympani nerve used in tympanoplasty. METHOD: One hundred and forty-one cases (154 ears) were divided into 3 groups: (1) chorda applying group (CA) 35 cases (41 ears): had perforation in pars tensa but chorda nerve still exist, the nerve were applied to spring and press a PORP or TORP prosthesis which were made by auto-osseous tissue and had a fine groove for nerve inlay. (2) residual pars tensa applying group (RTP) 67 cases (72 ears): residual pars tensa was used to spring and press prosthesis. (3) no applying group. (NA) 39 cases (41 ears). The effect measurement: ABG over 30 dB as excellent over 15 dB as effective; less than 10 dB as noneffective. Three groups were analyzed by S- t test. RESULT: Excellent, effective and noneffective ears (%): CA group: 29.3%, 51.2%, 19.5%; RPT group: 22.2%, 50.0%, 27.8%; NA group: 19.5%, 36.6%, 43.9%; the previous two groups contrast with NA group, P < 0.01. Pre- and post-operation ABG odds and paired contract: CA and NA, P < 0.05; RTP and NA, P < 0.05. In CA group only one ear had taste letdown temporarily and another ear had delayed and mild facial paralysis, both were auto-recovered within two weeks. CONCLUSION: Chorda tympani nerve applied in tympanoplasty for spring and press prosthesis can make PORP or TORP prosthesis more steady and improve hearing.

Adolescent↗
PubMed2006

[Evaluation of tympanoplasty with reconstruction of the external canal after mastoidectomy for cholesteatoma].

OBJECTIVE: To investigate the method to repair the deletion of external canal and opened mastoid space after mastoidectomy. METHOD: One stage tympanoplasty with reconstruction of the external canal with temporal cortex was completed in 58 cases (58 ears) with cholesteatoma. RESULT: During the follow-up ranging from one to three years, there was only one relapse. The configuration of external canal was almost normal and pneumatic mastoid space was maintained. Hearing was improved over 30dB in five ears, 20 to 29 dB in 11 ears, 10 to 19 dB in 30 ears, less 10 dB in eight ears and hearing wasn't improved in four ears. CONCLUSION: One stage tympanoplasty with reconstruction of the external canal after mastoidectomy for cholesteatoma is a practical way to improve hearing and decrease recurrence.

Adolescent↗
PubMed2006

[Comparison between tympanoplasties with cartilage-perichondrium composite graft and temporal fascia graft in terms of hearing levels and healing].

OBJECTIVES: We compared the extent of healing and hearing improvement following tympanoplasties performed with the use of cartilage-perichondrium composite grafts and temporalis muscle fascia grafts. PATIENTS AND METHODS: Fifty consecutive patients (22 males, 28 females; mean age 30+/-14 years; range 11 to 63 years) with chronic otitis media were divided into two groups to receive cartilage-perichondrium composite grafts or temporal muscle fascial grafts. All the patients were evaluated by pure-tone audiometry and otomicroscopic examination in the 1st, 3rd, 6th, and 12th months. RESULTS: At the end of the first year, graft survival was 92% in the cartilage group, and 85% in the fascia group. Hearing levels improved at the end of the first year; however, the two groups did not differ significantly in terms of hearing improvement and graft survival. Hearing gains were greater in central and subtotal perforations. In comparison with a steady increase in the cartilage group, hearing levels remained unchanged after the sixth month in the fascia group. CONCLUSION: Cartilage-perichondrium composite grafts may be easily and safely used in type I tympanoplasties, with successful results including hearing improvement.

Adolescent↗
PubMed1991

[Recurrent cholesteatoma after combined approach tympanoplasty: pathogenesis and prevention].

Over the last few years, we have increasingly reduced the use of open techniques in favour of combined approach tympanoplasty by adopting a strategy enabling the prevention of genuine recurrences of cholesteatoma. Recurrences due to the development of a residual cholesteatoma moving outwards towards the meatus can be considerably reduced by a careful eradication at the time of exeresis, and by early screening and exeresis of the residual cholesteatoma by a practically systematic second-look operation (two-stage tympanoplasty). To prevent further penetration of the skin into the new middle ear, an effective barrier has to be created between the skin and the mucosa (repair of the wall of the attic, reconstruction of the tympanum by a xenograft (Parmatymp), and proper drainage and airing the new cavity must be assured. To help with the proper regeneration of the mucosa and the maintenance of the drainage and airing pathways within the cavity, the use of silastic proved to be fundamental. This new strategy has enabled us to treat, with the combined approach, 84% of the 1,465 cases of cholesteatoma operated upon between 1975 and 1989.

Adult↗
PubMed1990

[The open technique of tympanoplasty with obliteration using the Palva flap: technical details and indications].

Technical details of obliteration tympanoplasty with Palva flap are given with the 2 possibilities: 2 stages and 1 stage tympanoplasty. This technique is very convenient for adult cholesteatomas developed in a sclerotic mastoid with an extension limited to mesotympanum and attic, to the children cholesteatomas developed in the mesotympanum with a sclerotic mastoid, for the correction of retraction pockets after a closed technique, rehabilitation of radical mastoidectomies, fibroadhesive otitis and some idiopathic glue tympanic membrane with a large cholesterol granuloma.

Adult↗
PubMed1990

Homograft tympanoplasty: the Iowa experience.

Homograft tympanic membranes have been used in tympanoplasty for nearly 30 years. Reported anatomical success rates vary from 50 to 100 percent. One hundred and one homograft tympanoplasty procedures were performed at the University of Iowa over the 10-year period of July 1978 through June 1988. The anatomical success rate was 76 percent. Hearing results were satisfactory in 86 percent of cases. The homograft tympanic membrane, with or without ossicles, has proven to be a highly satisfactory modality for the reconstruction of the severely ravaged middle ear.

Adolescent↗
PubMed1989

[Personal experience with the use of auditory ossicle transplantation in tympanoplasty].

For improvement of the mechanism of transmission of sound we use in tympanoplasty transplants of ossicles obtained from subjects who died accidentally. For preservation we use a 0.5% formaldehyde solution. In 68 patients with chronic suppurative epytympanic inflammation of the middle ear tympanoplasty was performed with transplantation of the complex of auditory ossicles: articulated incus and stapes. Positive functional results were achieved in 59 patients. Transplantation of the ossicles thus may become the method of choice; it must be, however, further improved.

Ear Ossicles↗
PubMed1987

[Functional plastic surgery of inflamed cavities: the fascination of tympanoplasty].

Reconstructive middle ear surgery was introduced in the early fifties. Kley was one of the first to investigate the applicability of grafts and the functional restoration of the middle ear transformer. He also practiced a combined approach with anterior tympanoplasty and posterior mastoidectomy. On the occasion of his 65th birthday it can be said that his achievements such as the use of fascia for tympanic membrane reconstruction, the systematic stapes elevation etc. have contributed to the success of tympanoplasty.

Cholesteatoma↗
PubMed1986

Tympanoplasty in children. An analysis of late results.

The late results of tympanoplasty were analyzed three to fifteen years postoperatively in 124 ears of children aged 2 to 14 years with noncholesteatomatous chronic otitis. The primary graft take rate was 92% and only 4% of the ears had perforations at follow-up. The hearing results were very good. The overall results are similar in children operated on at the ages of two to seven years and in children operated on at the ages of 8 to 14 years. We recommend tympanoplasty in children of all ages, including preschool age.

Acoustic Impedance Tests↗
PubMed1985

"Three cartilages" technique in intact canal wall tympanoplasty to prevent recurrent cholesteatoma.

Residual cholesteatoma is the consequence of leaving squamous epithelium in the mastoid and middle ear cleft. It has been demonstrated that the only effective way to reduce the risk of epidermoid cyst neoformation is meticulous and radical removal of cholesteatoma matrix and staging of the operation, regardless of whether a closed or open mastoid cavity tympanoplasty technique has been performed. Recurrent cholesteatoma usually occurs after intact canal wall tympanoplasty secondary to middle ear, attic, and mastoid retraction of the graft, especially in cases with destruction of the scutum or absence of malleus and incus; this is still considered a major problem with this surgical technique. During the last five years we have been performing a procedure we have developed to avoid this retraction. Concave autogenous cartilage from the upper part of the concha auriculae trimmed in three pieces to protect attic, mastoid, and middle ear for graft retraction has been successfully used in 106 surgical procedures. This study describes the surgical technique and analyzes the anatomic and hearing results.

Cartilage↗
PubMed1983

[Overview of functional results of tympanoplasty].

The postoperative functional results of 448 tympanoplasties of Type 1-4, among them the late results, were reviewed via computer for the 1968-1977 decade. The average air-bone-gap decreased from 30.7 to 25.0 dB. There were no significant changes in the bone conduction of single frequencies in the long-term results. The proportion of social hearing increased from 35 per cent (pre-operative) to 52 per cent (post-operative) and to 55 per cent in the long-term results. In 27 patients (6 per cent) residual conditions were seen as in spontaneous tympanoplasty. The results reported in literature are discussed in detail.

Adolescent↗