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PubMedDate not supplied

The fate of homologous nasal septal cartilages in tympanoplasty.

We have used homologous nasal septal cartilage for tympanoplasty for the last 8 years and obtained satisfactory results. In order to demonstrate the fate of homograft cartilage implanted into the middle ear, mucopolysaccharides have been studied by means of enzyme digestion. The matrix of normal septal cartilage was divided into three regions: 1) pericellular region; chondroitin sulfate B, 2) distal interstitial region; hyaluronic acid and chondroitin sulfates, 3) peripheral interstitial region; collagen. In preserved cartilage, chondroitin sulfate B was lacked out, but hyaluronic acid and collagen remained intact though the amount of mucopolysaccharides diminished slightly when compared with normal septal cartilage. Homograft cartilages evidenced depletion of mucopolysaccharides. Homograft cartilages should be used for the purposes mentioned, though not as material for columella, nor for reconstruction of large bone defect.

Alcian Blue↗
PubMed1990

Eustachian tube function in tympanoplasty.

Prognostic value of preoperative Eustachian tube function was examined in 77 ears subjected to type 1 tympanoplasty. Eustachian tube function was evaluated by positive and negative pressure equalization tests, and clearance test. Based on the results of these three tests, the ears were classified into four grades. The outcome of the ear surgery was judged by postoperative hearing, presence of otorrhea, atelectasis and perforation of the eardrum. Results of the positive pressure equalization and clearance tests of the tube were correlated with the outcome of ear surgery, although the negative pressure equalization test had no correlation with it. The percentage of unsuccessful outcomes increased with the grade of tubal dysfunction, indicating that tubal function is closely associated with the outcome of ear surgery. Thus, it was revealed that the preoperative tubal function test including positive pressure test and clearance test are useful for predicting the prognosis of ear surgery.

Adolescent↗
PubMed2004

[Tympanoplasty on only hearing ears].

The management of only hearing ears remains controversial because of the risk of postoperative hearing deterioration. We reviewed 12 cases of hearing ears alone operated on at the Hyogo College of Medicine Department of Otolaryngology from 1999 to 2002. All ears were dry at the final examination. Postoperative hearing results were evaluated based on the guideline of the Japan Otological Society (2000). An air bone gap within 15 dB was found in 9 cases (75%), hearing gain exceeding 15 dB was found in 6 cases (50%), the hearing level was within 30 dB in 4 cases (33.3%), and total successful cases numbered 10 (83.3%). Eight patients wore hearing aids before surgery, and 4 patients (50%) did not need them after the surgery. We suggest that tympanoplasty by skillful surgeons should be done to obtain a dry ear, to avoid a progressive hearing loss, to preserve or improve hearing, and to improve the quality of life. We also suggest that handling of ossicles should minimized in chronic otitis media and cholesteatoma.

Adult↗
PubMed1996

[Fates of bone defects in the mastoid cavity studied from the findings of two-stage tympanoplasty].

The incidence and prognosis of bone defects occurring in the mastoid cavity were investigated in 205 ears of 197 patients who underwent planned two-stage tympanoplasty by the intact canal wall technique. Bone defects found at the first stage had spontaneously closed by the second stage in 43 of 62 ears at the mastoid tegmen, in 13 of 15 ears at the posterior wall of the mastoid cavity and in 2 of 17 ears at the posterior wall of the external ear canal. Twenty two ears developed bone defects at the ear canal between the first and second operations, despite the canal wall having been primarily preserved. Of the 6 ears with closure of the labyrinthine fistula using temporalis fascia at the first stage, the defects were obliterated with regenerated bone in 5 ears at the second stage. Bone defects at the facial canal were recognized in 67 ears at the first stage, 21 of which were no longer seen at the second stage.

Adolescent↗
PubMed1996

[Tympanoplasty on only hearing ears].

Tympanoplasty on only hearing ears was performed on 11 patients in Osaka University Hospital and Osaka Rosai Hospital during 1986 1994; this was 0.68% of all cases of middle ear surgery. The patients consisted of 5 with cholesteatoma, 5 with chronic otitis media and 1 with cholesterin granuloma. The mean age was 47.6 years (13-68 years) and the mean follow-up period was 2 years and 7 months (6 months-4 years). Postoperative hearing results was obtained in 9 patients (81.8%) according to the criteria of Otology Japan (1987), and all ears were dry at the final examination. Compared with the preoperative hearing level, postoperative hearing level showed improvement in 3 cases, not in 7 cases (within difference of 5 dB) and deterioration by 10-15 dB in 1 case. Although indications for surgery on only hearing ears are still controversial, we suggest the following: 1) patients with cholesteatoma should be operated on in the ordinary way; 2) patients with chronic otitis media should be operated on only by myringoplasty; 3) all patients must be operated on very carefully by skillful surgeons.

Adolescent↗
PubMed1999

[The formation of the middle ear cavity in primary tympanoplasty].

Creation of the middle ear cavity in primary tympanoplasty in patients with chronic purulent epi- and epimesotympanitis is made in the end of the operation after the sanative measures. The destroyed chain of the auditory ossicles is repaired using tephlon daisy-shaped graft or its modifications. The graft is covered with a thin cartilaginous plate while the membraneous defect is filled with the temporal fascia. Lateral attic wall and posterior wall of the external acoustic meatus are made of cartilaginous plates, the cavity in the mastoid process is filled with fragments of the allogenic cartilage. The fragments and cartilaginous plates are employed in creation of the artificial antrum. The above tympanomastoidoplasty has been performed in 50 patients with a persistent antiinfection result in 90% of them. The number of patients with adequate hearing increased from 21 (42%) before the operation to 36 (72)% after it. Primary tympanomastoidoplasty is the operation of choice in patients with destructive otitis media purulenta chronica.

Chronic Disease↗
PubMed1999

Tympanoplasty in geriatric patients: surgical considerations.

The outcomes of tympanoplasty in the elderly are generally no different from those in the young. Although some reports suggest that hearing results were not as good in patients older than 60, the instance of graft failure in these patients did not differ greatly by age. Patients older than 65 do have the highest incidence of perioperative death or complications, with elderly men being at a greater risk than elderly women. The risk is also higher in patients who have concomitant diseases, such as coronary artery disease, congestive heart failure, myocardial infarction, diabetes mellitus, hypertension, renal disease, chronic obstructive pulmonary disease, cerebral vascular disease, dementia, and peripheral vascular disease. The presence of coexisting disease is more important than age itself, although physiologic age is more important than chronological age.

Aged↗
PubMed2000

[Tympanoplasty: problems and realization].

The authors describe how to provide safety and effectiveness of tympanoplasty, the principle of standard preparation and performance of the operation. They think it necessary to thoroughly assess stability of intralabyrinthine pressure and retrochochlear functions, to normalize humoral immunity and rheological blood properties, function of the acoustic tube, to choose optimal preserver and technique of reconstruction, how to evaluate postoperative outcome. Adequate use of the techniques widens the spectrum of reparative operations on the middle ear applied in practice.

Ear Diseases↗
PubMed2000

[Tympanoplasty and Sourdille].

In his article published earlier in 1929, Maurice Sourdille proposed two innovations in middle ear surgery: the tympanomeatal flap and surgery of chronic otitis. Those events were not only the starting point of a new era of modern tympanoplasty but also led to the way to the development of middle ear exploration with purposeful resection of the tympanic framework for accessing to the windows and for sealing a perforated tympanic membrane.

Chronic Disease↗
PubMed2001

[Tympanoplasty for patients with destruction of the stapes].

Mode of tympanoplasty allowing reconstruction of the drum and erosioned malleus handle is described. For this purpose an autoossicle fragment of the lengthened shape was inserted into the blind channel created in fascia transplant which "dressed" on the handle's remnant for the osseous fragment and remnants of the handle to appear in one fascia channel. This method was applied in 11 patients with subtotal drum perforation and erosion of the hammer's handle. In 9 of them 0.5-2 years later the defect of the drum fully disappeared. In 7 patients the handle resumed normal length while the drum became conic. The average pure air conduction threshold in frequencies 0.5-2 kHz has become 25.5 +/- 3.5 dB (before the operation 38.2 +/- 2.3 dB; p > 0.01), the average bone conduction threshold 14.3 +/- 2.6 dB (before operation 13.9 +/- 2.4 dB; p < 0.05).

Ear Ossicles↗
PubMed1975

Tympanoplasty of the radical operated middle ear.

A type of tympanoplasty is described to restore hearig at patients who had a radical mastoidectomy. The technique of middle ear reconstruction was first studied at the testanimal. It was found that a certain resonance frequency could be of use to get an extra hearing gain. Furtheron amplitude and fase-difference between the round and oval window are explored. The results of 16 patients 5 years after operation are discussed.

Adolescent↗
PubMed1975

[Tympanoplasty after previous mastoidectomy (author's transl)].

Suppuration in ears suffering from a central perforation of the ear drum can frequently be stopped by mastoidectomy. This previous operation prepares ears for later tympanoplasty. 64 ears (55 patients) were treated by this way. Suppuration ceased in 47 ears. Spontaneous closure of the perforation could be seen in 7 cases. 23 ears underwent tympanoplastic procedures, always during a second intervention, 17 patients did not want further operations after the suppuration of their ears had stopped. Another 17 ears continued to reveal suppurative secretion in spite of mastoidectomy, mostly because of severe infection (resistant bacteria) or of insufficient mastoidectomy.

Adolescent↗
PubMed1975

[10 years of tympanoplasty in the hands of an ear, nose and throat surgeon. An analysis of successes and failures (author's transl)].

The successful performance of a tympanoplasty by an otologist working for the health service is guaranteed when the operative results are systematically checked and critically evaluated against clinical-scientific advances. Certain criteria are discussed, based on an experience of 827 tympanoplastics, such as preoperative treatment, assessment of the pathological-anatomical conditions, restoration of sound conduction, tubal function, the problem of the drum transplant, reconstruction of the meatal wall and especially attocotomy which proved very satisfactory in 72 cases.

Bone Conduction↗
PubMed1975

[Tuberculosis of the middle ear and tympanoplasty (author's transl)].

The clinical picture of tuberculous otitis media is described. Nowadays the desease usually appears as a infection of the mucous membrane. The problems concerning the diagnosis of this specific infection by histological or bacteriological methods are discussed. Special questions about the performance of a tympanoplasty in a tuberculous otitis media are considered.

Adult↗
PubMed2000

[Reconstruction acusticus back wall and tympanoplasty with homograft costal cartilage].

OBJECTIVE: To eliminate the back wall defect of external canal and opened mastoid cavity which was remained from radical mastoidectomy. METHOD: We performed the operation on 17 cases after radical mastoidectomy by using reconstruction of the canal wall and fill-in opened mastoid cavity and ossicular replacement prostheses made of homograft costal cartilage. The tympanoplasty had been made operated for all patients, 8 ears were PORP, the others were TORP. RESULT: All cases were followed-up for 6 months-2 years. The external canal of all patients are normal in appearance. The total effective rate of gain (> 15 dB) was 14 ears (82.4%). Only one patient whose tympanic membrane was perforated postoperation 3 months. CONCLUSION: Reconstruction of acusticus back wall and hearing after radical mastoidectomy with homograft costal cartilage is effective to prevent mastoid cavity infection and improve hearing.

Adult↗
PubMed1999

[Observation of curative effect of radical mastoidectomy with rebuilding back wall of external and defect tympanoplasty].

OBJECTIVE: To manage the back wall defect of external acoustic canal and opened mastoid cavity which was remained from radical mastoidectomy. METHOD: 31 ears with cholesteatomatous otitis media and 3 ears with skeletal ulcer were treated by primary operation which consisted of radical mastoidectomy with rebuilding back wall of external canal and tympanoplasty. RESULT: All cases were followed up for 5 years. And all of external anditory canal are normal in appearance. Sixteen ears reached auditory level for social interaction and another 16 for functional audition. CONCLUSION: The Primary operation that we mentioned above may resolve some problems such as mastoid cavity or big external canal which were remained from radical mastoidectomy. It is effective to improve hearing.

Adolescent↗
PubMed1999

[The use of autogeneic residual auditory ossicles, allogeneic auditory ossicles and the allogeneic nasoseptal cartilage in tympanoplasty].

OBJECTIVE: In search of ideal substance(s) for middle ear reconstruction, various materials were used and investigated in tympanoplasty. METHOD: Up to may 1996, three kinds of materials were be used to reconstruct the ossicular chain: 1. Auto-ossicular residue reposition, 153 ears; 2. Homo-ossicle transplantation, 119 ears; 3. Homo-chondroseptum transplantation, 93 ears. We analysed and compared the middle and long-term results in these three groups. RESULT: 1. In auto-ossicular residue reposition group, 86.3% was satisfied 10 years postoperation; 2. The satisfaction rate was 76.5% in homo-ossicle transplantation group; and 3. In the group of homo-chondroseptum graft, 77.4% of satisfaction rate was reached. CONCLUSION: Auto-ossicular residue reposition is a better choice for ossicular chain reconstruction. That is responsible for its convenient, free of rejection, and better long-term results.

Adolescent↗
PubMed2002

[Application of lateral attic wall reconstruction and sealing of attic cell in tympanoplasty].

OBJECTIVE: To observe the effects of lateral attic wall reconstruction and sealing of attic cell in prevention of recurrence of cholesteatoma and limitation of ossicular chain after tympanoplasty. METHODS: 150 cases of chronic tympanitis and mastoiditis were studied. Forty patients with intact ossicular chain after opening mastoidectomy underwent lateral attic wall reconstruction with autologous cartilage of auricular concha (n = 15) or "bone cement plate" made of autologous bone cortex powder adhered by glue of fibrinogen and thrombin (n = 25). Eighty-nine of the 110 cases with damaged ossicular chain underwent reconstruction of ossicular chain and sealing of tympanic cavity with bone powder and glue of fibrinogen and thrombin and fascia of temporal muscle was used to restore the tympanic membrane in 21 of them. Follow-up was conducted for 3 to 5 years to observe the recovery of tympanic membrane, hearing, and whether cholesteatoma recurred. RESULTS: No recurrent cholesteatoma and serious retracted tympanic membrane were found. Eardrum re-perforated in 8 cases (5.33%). The patients with lateral attic wall reconstruction obtained a significant hearing improvement (97.5%). Hearing was improved among 80.8% of the cases that underwent sealing of attic cell and ossiculoplasty. CONCLUSION: Lateral attic wall reconstruction and sealing of attic cell prevent the recurrence of cholesteatoma. Reconstruction of lateral attic wall provides a new space for vibration of ossicular chain.

Cholesteatoma↗