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At least 505 records · Page 28Linked to original sources
PubMed1994

Middle ear transmission disorders--tympanic membrane vibration analysis by laser-Doppler-vibrometry.

Laser-Doppler-vibrometry is a useful method to measure vibrations of the tympanic membrane. It is suitable to objectively diagnose the middle ear. In comparison to tympanometry, laser-Doppler-vibrometry has greater sensitivity. Temporal bone specimens were specially prepared to simulate middle ear disorders like middle ear effusion, fixation of the malleus head, fixation of the stapes footplate and removal of the incus. A correlation between the displacement function of the umbo and the experimentally produced middle ear disorders could be demonstrated. For the first time it was possible to measure the vibration of the tympanic membrane by using a laser-Doppler-vibrometer in a healthy 25-year-old male.

Adult↗
PubMed1997

Experimental sensorineural hearing loss following drill-induced ossicular chain injury.

In a guinea pig model, a standardized drill-induced injury to the body of the incus was applied, and the effects on hearing were characterized by electrocochleography. Drilling resulted in a threshold shift within seconds, and after 15 min it averaged 35.7 dB for clicks, 35 dB nHL for 4 kHz bursts, 36.7 dB nHL for 6 kHz bursts and 39 dB nHL for 8 kHz bursts. The deterioration of the threshold shift remained stable throughout the 5-week post-operative observation period. In five animals a disarticulation of the incudostapedial joint was performed prior to drilling, but this did not reduce the threshold shift. Caution is mandatory during drilling around an intact ossicular chain to avoid a permanent sensorineural hearing loss, and disarticulation of the incudostapedial joint prior to drilling has no protective value.

Animals↗
PubMedDate not supplied

First audiometric results with the Vibrant soundbridge, a semi-implantable hearing device for sensorineural hearing loss.

The Vibrant soundbridge is a semi-implantable hearing device. The implanted electromagnetic transducer is attached to the incus and it is linked by telemetry to the externally worn audio processor. In Nijmegen, this device has been applied to seven patients with moderate or severe sensorineural hearing loss (PTA between 43 and 71 dB HL) who could not tolerate ear moulds. As the amplification of the device depends on the input level (amplifier with wide dynamic range compression), loudness scaling measurements were performed. The gain as a function of input level was determined from aided and unaided loudness growth curves. The mean gain was 21 dB at an input level of 40 dB SPL. The mean gain decreased to 5 dB at an input level of 90 dB SPL. Measured gain values were lower than target values prescribed by the FIG6 method, mainly however for the low-frequency range and for low-level sounds. It was concluded that this device is very promising for patients who cannot tolerate an ear mould.

Adult↗
PubMedDate not supplied

Middle ear cholesteatoma: characteristic CT findings in 64 patients.

BACKGROUND: High resolution computerized tomography (HRCT) is valuable for detection of early erosive changes suggestive of cholesteatoma. The aim of our study was to determine characteristic CT findings in patients with middle ear cholesteatoma. METHODS: We conducted a retrospective review of CT scans and surgical and histopathological reports in 64 patients with middle ear cholesteatoma (35 male, 29 female; age range, 7-80 years, median age, 22 years). CT scans were evaluated for the presence of intra-tympanic non-dependent soft tissue density, the extent of middle ear involvement, bone expansion and thinning, and bone erosions involving the ossicles and adjacent structures. RESULTS: Middle ear cholesteatoma was more common in male patients and in patients aged 20-35 years. All patients had soft tissue density in the middle ear. Fifty-nine (92%) had expansion of the aditus and mastoid antrum, 59 (92%) had erosions of the ossicles, with involvement of the long process of the incus in 48 (75%), 55 (86%) had an eroded scutum, 55 (86%) an eroded facial nerve canal, 57 (89%) an eroded Koerner's septum, which was totally destroyed in 19 (27%), 48 (75%) had tegmen erosion, and 63 (98%) had erosions of the antral walls. The correlation of pre-operative CT with surgical and histopathological findings was 97%. CONCLUSION: Middle ear cholesteatoma is a distinct clinical entity with characteristic findings that may be suggested by CT imaging. These findings should alert the clinician to the possibility of cholesteatoma, which will guide in the surgical approach and treatment plan.

Adolescent↗
PubMed2001

[One-stage surgery of middle ear cholesteatoma in adults: apropos of 180 cases].

OBJECTIVES: In order to evaluate the results of tympanoplasty in one stage middle ear cholesteatoma surgery, a retrospective study of 180 consecutive cholesteatomas operated on was undertaken. METHODS: 150 single procedures and 30 revision surgeries realized between 1992 and 1997 were analysed by studying anatomical and functional results with a mean follow-up of 24 months. RESULTS: Among the 150 adult patients, 85 (57%) were previously operated on in other centres and presented a recurrence of cholesteatoma. Closed technique was performed in 110 cases (61%) and opened one in the remaining cases (41%). Ossiculoplasty was made in 101 cases (56%) with different materials (15 incus autografts, 14 teflon prosthesis, 35 hydroxyapatite (HA) composite prosthesis and 37 all in HA prosthesis): 91 cases in a one-stage procedure but 10 worse functional results required a closed revision procedure. Twenty cases were also revised after one year of follow up at least: six recurrences of cholesteatoma were operated on by using canal down mastoidectomy (4%), 14 limited residual cholesteatomas (9.3%) had a revision closed technique procedure. CT Scan followed up all the patients operated on by a closed technique. Postoperative air-bone gap (ABG) was 20 +/- 11.3 dB and 27 +/- 10.1 dB in closed and opened techniques, respectively (p < 0.05). ABG was 20 +/- 9.2 dB and 26 +/- 13 dB in type II and type III tympanoplasty, respectively (p < 0.05). CONCLUSION: If the tympanic and posterior cavities are reasonably safe, middle ear cholesteatoma in adults can be well cured by a one-stage procedure including ossicular chain reconstruction with hydroxylapatite prosthesis covered with cartilage graft who achieved a valuable hearing restoration.

Adult↗
PubMedDate not supplied

[The first appearance of Meckel's cartilage in the fetus].

Meckel's cartilage plays an important role in the topographical organisation and in the differentiation of the facial structure during the embryonal and even much later during the foetal period. Our observations on serial sections carried out in two human foetuses aged 12 and 16 weeks indicate that the two dorsal (tympanic) and ventral (mandibular) branches of Meckel's cartilage are perfectly defined at 16 weeks. In the dorsal branch, the primordia of the incus and of head of the malleus are still composed on non-ossified cartilage. In the ventral branch, it is also possible to describe at 16 weeks three posterior, medial and anterior parts which are composed of cartilage. The initiating role played by the ventral part of Meckel's cartilage on the ossification of the mandible leads during the embryonal period to the formation of the mandibular primary growth center, which is therefore clearly defined in our first stage at 12 weeks. The partial fibrous evolution and the regression of the major part of the ventral branch of Meckel's cartilage only start after 16 weeks of intrauterine life.

Branchial Region↗
PubMed2001

Short- and long-term results of stapedectomy in children.

Otosclerosis in children and teenagers is very uncommon. Typical otosclerosis presents as a slowly progressive conductive hearing loss and tinnitus in the third to fourth decade of life. Stapedectomy is a well-established procedure for correction of conductive hearing loss in adult patients with otosclerosis. The aim of this work is to assess short- (6 months) and long-term (7 years) results after stapedectomy performed in 10 patients under 20 years of age. In 1 patient cochlear otosclerosis was diagnosed and in 1 patient incus anomaly was found during the operation. Pure tone audiograms obtained 6 months after stapedectomy showed air-bone gap closure to 10 dB in 6 patients, to 15 dB in 8 patients and in all patients to 20 dB. Average air conduction threshold improved by 26.5 dB and average bone conduction threshold by 5.9 dB. 7 years after stapedectomy air-bone gap was similar to the one measured 6 months postoperatively. Stapedectomy in children provides good and stable hearing results.

Adolescent↗
PubMed1999

[An anatomical investigation relating to the stapes elevation surgery].

OBJECTIVE: For the purpose of improving patient's hearing in stapes elevation surgery. METHOD: The anatomical features relating to this operation were observed and measured in 30 ears of fresh cadavers, which included the length of lenticular process, the highness of stapes head and neck, the thickness of lower border of footplate, the angle of incudostapecial joint and the gradients of upper and lower wall of vestibular niche. The relation between two types of the present operation and the investigation were discussed. RESULT: The two types of present operations were in accord with the physiologicoanatomical features of the stapes and incus. CONCLUSION: In order to improve the patient's hearing, making use of biobinder for strengthening the incudostapedial connexion as a routine is suggested.

Anatomy, Regional↗
PubMed2000

[Clinical observe of the middle ear malformation].

OBJECTIVE: To analyze the diagnosis and therapeutic effect of the middle ear abnormalities. METHOD: 65 ears from 1967 to 1996 were reviewed. The degrees of the ossicular abnormalities were analyzed, operative effect were valued. RESULT: In the 65 ears, incus abnormalities was 57 ears (87.7%), stapes was 55 ears (84.6%), mixed malformation was dominant. 47 ears were operated with ossicular chain reconstruction. 44 ears (93.6%) had hearing improvement, 32 ears (68.1%) had obviously improvement (> 20 dB). They were followed up over one year, 44 ears had steadily hearing and had not any complications. CONCLUSION: If diagnosis and interference were all proper, operation would obtain good result.

Adolescent↗
PubMed1977

[Implantation of ossicles (A histological study in animals) (author's transl)].

Autogenetic and allogenetic incuses as well as xenogenetic malleus were implanted into the middle-ear of rabbits after different procedures of conservation. The process of healing was studied by histological examination. The different conservation methods are leading to different antigenic qualities of the donor material. A different reorganization along the wurse of the donor vessels is resulting. Accordingly a different extent of osteoneogenesis of the intercellular substance is induced. The vascular tissue showed a revascularization in the case of autogenetic transplantation and in the case of implantation after cialit conservation of 1:5000. Whereas deep-freezing led to swelling, cialit conservation 1:500 to temporary fibrosis of the sides of vessels. Hyalinosis of the vessels was observed after lyophilization and gamma-sterilization of the xenogenetic malleus. The different effects on the healing process are discussed.

Animals↗
PubMed2005

Ossicular chain dislocation with normal hearing.

We report a unique case of an ossicular chain injury in a young man. Despite the fact that the patient's incus was dislocated into the external auditory canal while remaining attached to the stapes, his hearing was not affected and remained nearly normal. We discuss the patient's presenting features and our diagnostic and management strategy in this case.

Accidents, Traffic↗
PubMed1990

Biocompatibility of clinically applied hydroxylapatite ceramic.

The biocompatibility of 11 porous canal wall prostheses and 4 dense incus prostheses, both types made of hydroxylapatite, was studied by light microscopy, scanning electron microscopy, transmission electron microscopy, and x-ray microanalysis. The duration of implantation varied between 4 and 40 months, and the 15 retrieved implants constitute 4% of the 375 clinically applied hydroxylapatite prostheses involved in this study. With respect to integration characteristics, coverage by epithelium and fibrous tissue, and biodegradation, the performance of clinically applied hydroxylapatite generally resembled that seen in animal experiments. However, the reactions during chronic infection in the human ear were more severe than those in experimentally induced acute infections in the rat middle ear. One of the canal wall prostheses showed trace element accumulation in the cytoplasm of phagocytes.

Biocompatible Materials↗
PubMed1988

Congenital ossicular abnormalities: a review of 68 cases.

Sixty-eight cases of congenital conductive hearing loss due to ossicular abnormalities were reviewed. The clinical and surgical details of each case were documented, and a classification was drawn up on the basis of the abnormalities encountered. Sixty-six percent of the cases were documented as middle ear anomalies in the absence of any other evidence of congenital disease. Improved hearing was obtained in 47% of those cases where corrective surgery was undertaken. Treatment and results are reviewed. The pattern of ossicular abnormality encountered in this series suggests a variable origin of the incus, either from first branchial arch alone or from both first and second branchial arches.

Abnormalities, Multiple↗
PubMedDate not supplied

Ossicular and otic capsular lesions in LP/J mice.

Otosclerosis is an inherited disease in which abnormal bone growth results in ossicular fixation and hearing loss. Although the disease affects up to 10% of humans, it has not been observed in other animals. The LP/J inbred mouse has been found to develop abnormal bony lesions of the middle ear which resemble human otosclerosis. In this study of 113 temporal bones from LP/J mice, we found that the lesions develop after puberty and involve only the ossicles and the otic capsule. The most frequent site of involvement was the incus (46.9%), followed by the anterior crus of the stapes (31.3%), the malleus (14.2%), the otic capsule (14.2%), and the stapes footplate (8%). Cochlear hair cell loss was progressive throughout the lifespan of these animals. Although this disease is not identical in histologic appearance to human otosclerosis, understanding its disease process may shed light upon the pathophysiology of the human disease.

Animals↗
PubMed1994

Ossicular chain reconstruction. Capitulum to malleus.

Ossicular chain reconstruction is most commonly performed for an absent or diseased incus. Reestablishing continuity by placing a strut prosthesis between the stapes capitulum and malleus handle minimizes the possibility of extrusion and displacement. Strut prostheses are made of hydroxyapetite, which is a highly biocompatible material that bonds to living bone.

Biocompatible Materials↗
PubMed1977

Hearing and anatomical results with homograft tympanoplasty.

Homograft tympanic membranes and ossicles have been found to be a valuable asset in tympanoplasty surgery. The homograft tympanic membrane has been used in conjunction with a canal skin graft with a graft take rate of 94 per cent. Anatomical results have been gratifying in that most patients are totally rehabilitated and may swim or shower without restrictions. The homograft incus has been sculptured into prostheses to reconstruct the sound conduction mechanism, both at the initial procedure and in revision cases to improve the hearing.

Ear Diseases↗
PubMed1998

[The evolution of the lower jaw and the jaw joint, from reptiles to man].

The evolution of the mandible shows two characteristic features: transformation of the angular, articular and square bones in reptiles into the tympanic bone, malleus and incus of the middle ear respectively; and specific volume expansion of the tooth-bearing bone which in mammals comprises the entire mandible. Posture, locomotion and mastication are the basic evolutionary factors which simultaneously provoked 1) a displacement of the temporal regions, 2) a transformation of the face lowering and widening the lower jaw and 3) an elongation of the sutures uniting the different bones in the reptile jaw bone, progressively leading to their separation and transversal orientation. These transformations were accentuated in the biped. Thus in man the temporomandibular joint is in a very lateral and elevated position near the mastoids. The mandibular condyls are elongated transversally with a medial cantilever. The medial part of the meniscus is drawn medially by the lateral pterygoid while the lateral part is drawn laterally by the temporal and masseter fibers. The ramus is oriented vertically and lies close to the cervical spine. The dental arches are displaced posteriorly on the bone and have lost their anterior abutment. The strongest occlusal forces are displaced to the posterior part of the arches and are transmitted vertically to the intra-articular meniscus. All these phenomena are termed extreme adaptations and the temporomandibular joint would (apparently) suffer if the evolution continued. The architectural features of temporomandibular joint overload can be deducted by comparison with the "ideal" architectural conditions for the craniofacial equilibrium.

Adaptation, Physiological↗
PubMed1998

[Fixed mallear head syndrome].

Fixed head malleus syndrome is a rare anatomoclinical entity first described by Goodhill in 1966. We present a series of 9 patients who underwent surgery between 1991 and 1997 and discuss the technical procedures used and functional outcome. Ossicular mobility can be re-established with two surgical methods. The more simple method consists in a classical incus transposition with malleus neck section. The more physiological method consists in drilling the synostosis fixing the malleus without disrupting the ossicular chain; stapedotomy is associated in certain cases (Type III).

Adult↗