Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “TYMPANOPLASTY”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 307 records · Page 17Linked to original sources
PubMed2004

[Tympanoplasty with hybrid prostheses].

BACKGROUND: The retrospective study reviews the hearing results of partial and total ossicular replacement plasties with prostheses composed of a hydroxylapatite head and a trimmable shaft. PATIENTS AND METHODS: 71 patients underwent tympanoplasty type III between January 1996 and January 2002. The partial (PORP) (55 patients) and total ossicular replacement prostheses (TORP) (16 patients) were a composition of a hydroxylapatite head and a trimmable hydroxylapatite-polyethylene composite shaft (HAPEX ). Hearing results were evaluated according to the guidelines of the Committee on Hearing and Equilibrium. RESULTS: In cases with a PORP the residual air-bone gap could be reduced to < or = 20 dB in 73% of the patients. The mean air-bone gap improved from 28 dB preoperatively to 17 dB postoperatively. In cases with a TORP the residual air-bone gap could be reduced to < or = 20 dB in 62% of the patients. The mean air-bone gap improved from 32 dB preoperatively to 20 dB postoperatively. CONCLUSIONS: The hearing results with prostheses composed of a hydroxylapatite head and a trimmable shaft are good and comparable to the results of authors using other synthetic ossicular prostheses. These prostheses are time-saving because the trimmable shaft can be quickly cut and shortened to an individual length.

Audiometry, Pure-Tone↗
PubMed2003

Composite chondroperichondrial clip tympanoplasty: the triple "C" technique.

OBJECTIVES: The study goal was to assess the success rate and efficacy of a myringoplasty (tympanoplasty type I) technique using a composite chondroperichondrial graft in a combined overlay-underlay fashion. STUDY DESIGN: A retrospective analysis of patients subjected to the technique was conducted. METHODS: A sample of 15 patients who met the inclusion criteria were reviewed for surgical results. All patients were treated by a single surgeon. RESULTS: This transcanal technique provides minimal morbidity and excellent results in selected patients. CONCLUSIONS: The described technique provides an effective method of closing nonmarginal perforations of the tympanic membrane.

Adolescent↗
PubMed2000

Tympanoplasty with ionomeric cement.

Patients with isolated erosion of the long incus process suffer from severe hearing loss caused by lack of continuity of the ossicular chain. This study is a retrospective evaluation of the hearing results using two different surgical procedures. Since January 1993, 12 consecutive patients with isolated erosion of the long incus process have been treated with a new surgical technique in which the ossicular chain was rebuilt with ionomeric cement. The results in hearing performance (mean pure-tone average (PTA) 0.5, 1 and 2 kHz) were evaluated pre- and post-surgery, and compared to those in a group of 20 historical controls who underwent surgery in 1991 and 1992 using incus autograft interposition. Among the 12 index patients, 7 (58%) achieved improvement in PTA of > 10 dB, in 3 there was no difference and in 2 a slight decline. Among the 20 controls, 14 (70%) achieved improvement in PTA of > 10 dB, in 4 there was a slight improvement and in 2 a decline. The difference was not statistically significant. Hearing improvement using ionomeric cement in type II tympanoplasty was satisfactory. Reconstruction of the ossicular chain with ionomeric cement is recommended, as the procedure is easy to perform, presents less risk of damage to the stapes and cochlea, requires less extensive surgery and does not exclude other surgical methods in cases of reoperation.

Adolescent↗
PubMed1997

Overlay versus underlay tympanoplasty. Part II: the study.

This report compares two contemporary techniques of tympanic membrane repair. The prospective comparison study included 712 cases over 9 years. Whether the tympanic membrane was repaired by an underlay or an overlay technique, results were reliable. By making a postauricular incision, greater visibility of the operative site can be obtained. Larger perforations can be closed more reliably when greater exposure is obtained. The placement of the graft above or below the annulus is not the issue. Careful technique and precise work are the keys to successful tympanoplasty. Thus otologic surgeons should cultivate effective techniques, attempting to continuously improve their results to achieve perfection.

Adolescent↗
PubMed2001

Smoking and tympanoplasty: implications for prognosis and the Middle Ear Risk Index (MERI).

OBJECTIVES/HYPOTHESIS: The objectives of this study are to review the effects of smoking on preoperative middle ear disease severity, long-term surgical outcome, type and extent of surgery required, the need for ossicular chain reconstruction, and the long-term hearing results. STUDY DESIGN: A retrospective chart review. MATERIALS AND METHODS: The charts of 74 smokers and non-smokers who underwent over-under tympanoplasty were reviewed. An analysis of the disease severity (using the Middle Ear Risk Index [MERI]) at presentation and type of surgery was performed. A review of graft take and delayed failure (late perforation or atelectasis after 6 mo) and audiologic data were performed. RESULTS: Fifteen patients smoked a mean of 20 cigarettes daily for a mean of 15 years. The MERI was well matched for both groups. There was a trend toward smokers having a higher incidence of otorrhea preoperatively and requiring a more extensive surgical procedure. All patients had full take of the tympanic membrane graft at 6 months; however, delayed surgical failure was seen in 20% of non-smokers compared with 60% of smokers (P = .050). No statistically significant difference was seen in hearing outcome. CONCLUSIONS: Cigarette smoking is associated with more severe middle ear disease preoperatively. More extensive surgery is often needed in smokers to eradicate the disease. Most significantly, smoking is associated with a threefold increase in the chance of long-term graft failure. Based on the results of this study, the MERI has been revised to include smoking as a risk factor.

Adolescent↗
PubMed1984

Five-year evaluation of reconstructive tympanoplasty using a goblet prosthesis.

This article reviews tympanoplasty using a stainless steel goblet alloplastic prosthesis with a repositioned incus and presents a five-year follow-up report on 51 patients who had this kind of ossicular chain reconstruction. The five-year evaluation shows a better than average success rate compared with other allographic and alloplastic materials.

Chronic Disease↗
PubMed2002

Preoperative topical ofloxacin solution for tympanoplasty: a randomized, controlled study.

OBJECTIVE: To establish the efficacy of immediate preoperative ototopical ofloxacin eardrops in eradicating middle ear pathogens and improving operative outcome. STUDY DESIGN: Single-blind, randomized control study. SETTING: Tertiary referral center, ambulatory clinic, and hospital setting. PATIENTS: Consecutive patients with chronic suppurative otitis media for Type I tympanoplasty (myringoplasty). INTERVENTIONS: The patients were randomly assigned to 3 groups: Group A underwent 10-minute daily treatments with eardrops for 2 weeks before surgery, Group B underwent 3-minute daily treatments for 2 weeks before surgery, and Group C underwent no treatment. MAIN OUTCOME MEASURES: Preoperative and perioperative bacteriology and success of the surgery as defined by an intact tympanic membrane in the eighth week postsurgery. RESULTS: There were 101 patients entered in the study. The preoperative, perioperative, and postoperative observation of discharge and quantity of the discharge were compared, and no differences were found among the groups (Kruskal-Wallis test). The perioperative culture results were analyzed and 18/21 (86%) became culture negative in Group A, 23/27 (85%) became culture negative in Group B, and 3/21 (14%) became culture negative in the control group (Group C versus Group A or Group B, chi(2) tests p < 0.001). The success rates of surgery as defined by an intact tympanic membrane showed no difference: 28/33 (85%), 27/33 (82%), and 31/35 (89%) in Groups A, B, and C, respectively. The preoperative positive bacteriology rate in the surgical failures was 10/15 (67%), compared with 16/76 (21%) for the successful procedures (p < 0.001). CONCLUSION: Our study has shown that ofloxacin successfully eradicates most bacterial flora preoperatively. We cannot, however, confirm the benefits of its preoperative usage in improving the graft success rate.

Adult↗
PubMed2005

Usefulness of delayed postcontrast magnetic resonance imaging in the detection of residual cholesteatoma after canal wall-up tympanoplasty.

OBJECTIVES/HYPOTHESIS: Imaging takes an increasing place in the follow-up of patients who have undergone surgery for cholesteatoma, with computed tomography (CT) as the first line imaging technique. However, in case of complete opacity of the tympanomastoid cavities, CT is not able to differentiate residual cholesteatoma from postoperative scar tissue. The aim of this study was to assess the usefulness of magnetic resonance imaging (MRI) using delayed postcontrast T1-weighted images for the detection of residual cholesteatoma after canal wall-up tympanoplasty (CWU) in cases where CT was not conclusive. STUDY DESIGN: Prospective study. METHODS: MRI, with delayed postcontrast T1-weighted images (30-45 minutes after contrast injection), was performed before revision surgery in 41 consecutive patients who had undergone CWU for cholesteatoma and presenting with a nonspecific complete opacity of the mastoid bowl on CT. In all the cases, imaging results were compared with operative findings at surgical revision. RESULTS: A residual cholesteatoma was found in 19 of 41 patients at revision surgery and was correctly detected on MRI in 17 patients. In the two remaining cases, cholesteatoma pearls smaller than 3 mm were not seen. There was no false-positive case. Statistics were as follows: sensitivity 90%; specificity 100%; positive predictive value 100%; negative predictive value 92%. CONCLUSION: When postoperative CT is not conclusive because of complete opacity of the tympanomastoid cavities, MRI with delayed postcontrast T1-weighted images is a reliable additional technique for the detection of a residual cholesteatoma when its diameter is at least 3 mm.

Adolescent↗
PubMed1978

Tympanoplasty and tuberculosis of the middle ear.

This report concerns 6 cases of middle ear tuberculosis. Typical clinical signs for this infection nowadays consist in a pale-coloured mucosa, spontaneous facial paresis, pneumatization of the mastoid and in a changing performation of the tympanic membrane. These signs can occur single or in combination. Under a specific chemotherapeutic treatment even in tuberculous infection of the middle ear tympanoplasty can be performed without danger for the newly transplanted tympanic membrane. One should consider tuberculous infection especially in cases when for apparently inexplicable reasons necrosis of the transplant occurs postoperatively.

Adult↗
PubMed1978

Importance of en bloc homograft in intact canal wall tympanoplasty.

The incidence of cholesteatoma recurrence using intact canal tympanoplasty has been compared in 2 series of operations. The first group represents cases treated with the conventional conservative technique for attic and middle ear surgery. The second group represents cases on which the concept of 'radical attic and middle ear surgery' has been applied and an en bloc homograft has been used for reconstruction. A preliminary survey has shown a much lower incidence of cholesteatoma recurrence in ears belonging to the second group. The advantages of this surgical technique are discussed.

Cholesteatoma↗
PubMed1978

Another look at Daggett's 1948 tympanoplasty.

It is important that we look critically at the results of conservative tympanoplasty in the presence of cholesteatoma. Lessons and observations taught many years ago by earlier otologists may give us valuable leads. A method of conservative surgery for chronic suppurative ear disease devised by Dr William Daggett in London in the late 1940s is described and evaluated in the light of current technical expertise.

Adult↗
PubMed1980

Silicone disc for myringoplasty-tympanoplasty.

A sterile, fenestrated, circular disc of silicone for use on the outer surface of the graft during myringoplasty-tympanoplasty is described. It allows effective firm packing in the canal without distortion, displacement or lateralization of the graft.

Fascia↗
PubMed1981

The use of Silastic in tympanoplasty surgery.

Silastic has a relatively high incidence of late complications when used as a middle ear liner in unstaged tympanoplasty procedures. This does not seem to be the case in staged procedures when it is removed at the second operation or in cases where small pieces are used to prevent refixation of the malleus or stapes. At the present time, the use of gelfilm seems to be the most acceptable alternative.

Humans↗
PubMed1982

Calculation of hearing results after tympanoplasty.

At present there is no universally accepted method for calculating hearing results after chronic ear surgery. In this study the methods most frequently used have been applied to a material of 105 tympanoplasties and compared to each other. In addition a comparison between pre- and post-operative bone conductions (BC) thresholds for calculating post-operative air-bone gaps has been performed using multiple regression analysis. The results lend support to the conclusion that BC thresholds will improve with surgery in successful cases and that the post-operative BC threshold is a closer approximation of the cochlear function than the pre-operative one and consequently should be used for gap calculations. However, until the masking procedures in audiometry are standardized, hearing gain may be regarded as the most satisfactory alternative for describing hearing results as it is based on the air conduction thresholds only. This method requires a careful description of pre-operative air and bone conduction thresholds.

Audiometry↗
PubMed1992

Underlay tympanoplasty with the graft lateral to the malleus handle.

In conventional underlay tympanoplasty the graft is placed medial to the malleus handle. The present study evaluates the results of a modification of this technique, in which the graft is placed lateral to the malleus handle, which has been dissected from the drum remnants. 39 ears with predominantly large or anterior pars tensa perforations were operated upon in this manner. After a median observation time of 20 months one ear was found to have a small reperforation. All ears had normal tympanomeatal angles, but 12 ears showed a small degree of laterofixation of the graft from the malleus handle. Analysis of the hearing showed good hearing improvement and no adverse effects attributable to the dissection of the ossicular chain. It is concluded that the technique is a good alternative to conventional underlay myringoplasty in ears with perforations involving the area anterior to the malleus handle.

Adolescent↗
PubMed1995

Myringoplasty and tympanoplasty--results related to training and experience.

The results of surgery in a series of 452 ears having either myringoplasty (281 ears) or tympanoplasty (171 ears) were studied in relation to the experience of the surgeons. The trainees received an annual course in temporal bone dissection and were given daily surgical instruction in the operating theatre. The 142 ears operated by them showed less disease than those operated upon by the programme chairman (114 ears) and by the faculty (196 ears). The performance of the trainees was safe, and as to healed tympanic membrane and hearing results all studied parameters were statistically equal to those of the faculty. Repair of anterior perforations proved to be the most difficult and the overall results of both the faculty and trainees left place for improvement. On-line recording of surgical data and annual evaluation of an individual surgeon's results is suggested as a necessary means for continuous post-graduate training.

Education↗
PubMed2005

How we do it: free conchal cartilage revisited for primary reconstruction of attic defects in combined approach tympanoplasty.

Keypoints * There are concerns over the efficacy of free cartilage autografts in attic reconstruction (scutumplasty) for combined approach tympanoplasty (CAT). * Our operative technique uses free conchal cartilage autografts and an additional piece of conchal cartilage to buttress the reconstruction. * Of the 16 cases where this technique was used, there were two cases (13%) of failure of the attic reconstruction and a keratin pearl (residual disease) in one case (6%). This compares favourably with comparable series using a variety of reconstruction techniques.

Cholesteatoma, Middle Ear↗
PubMed2005

Effects of sevoflurane and desflurane on cytokine response during tympanoplasty surgery.

BACKGROUND: This study was devised to compare the effects of sevoflurane and desflurane anaesthesia on the cytokine response. METHODS: Sixty ASA I-II patients, scheduled for tympanoplasty, were randomly allocated to be anaesthetized with either sevoflurane or desflurane at maintenance inspiratory concentrations of 1-1.5 MAC of either agent. Blood samples were taken for plasma tumour necrosis factor alpha (TNFalpha), interleukin 1beta and interleukin-6 assay before induction of anaesthesia, before surgery, and at the end of surgery. Alveolar cells were obtained after induction of anaesthesia and at the end of surgery. RESULTS: Plasma TNFalpha was greater with desflurane than sevoflurane both before surgery (45.1 +/- 3.5 pg ml(-1) for desflurane vs. 23.2 +/- 2.5 pg ml(-1) for sevoflurane, P < 0.01) and (62.0 +/- 5.3 pg ml(-1) vs. 35.5 +/- 4.6 pg ml(-1), P < 0.001). Interleukin 1beta was similarly greater with desflurane than sevoflurane before (39.3 +/- 4.0 pg ml(-1) vs. 17.4 +/- 3.0 pg ml(-1); P < 0.01) and after surgery (46.0 +/- 3.4 pg ml(-1) vs. 23.3 +/- 3.2 pg ml(-1), P < 0.001). There were similar results for interleukin 6 before (42.3 +/- 3.5 pg mls(-1). 29.0 +/- 2.6 pg ml(-1), P < 0.001) and after surgery (86.0 +/- 4.5 pg ml(-1) vs. 45.9 +/- 6.3 pg ml(-1), P < 0.001). Alveolar cell TNFalpha concentrations after surgery were also greater with desflurane than sevoflurane (96.3 +/- 12.4 pg ml(-1) vs. 64.8 +/- 10.1 pg ml(-1), P < 0.001), as were interleukin 1beta (75.4 +/- 6.2 pg ml(-1) vs. 32.0 +/- 8.3 pg ml(-1), P < 0.001) and interleukin 6 concentrations (540.1 +/- 65.3 pg ml(-1) vs. 363.6 +/- 29.2 pg ml(-1), P < 0.001). CONCLUSION: Desflurane appears to cause a greater systemic and intrapulmonary pro-inflammatory response than sevoflurane during anaesthesia for ear surgery.

Adult↗