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At least 541 records · Page 30Linked to original sources
PubMed1977

Tympanoplasty: medial grafting using Williams' microclips.

A technique for medial grafting that evolved in Alaska over a period of about five years has been used by the author at the Dartmouth-Hitchcock Medical Center for over two years. The technique is one whereby fresh temporalis fascia is placed medial to the tympanic membrane remnant and fastened to that remnant with stainless steel wire microclips. This technique has resulted in a success rate in excess of 94% in the Alaskan "bush." In a private practice setting, the success rate has been slightly better than 97%.

Adolescent↗
PubMed1984

Tympanoplasty with calcium phosphate.

In 35 patients, with an average follow-up period of 2 1/2 years, the middle ear was reconstructed with prostheses of hydroxyapatite, which is the main substance of living bone tissue. In case of a missing incus, an interposition prosthesis of dense hydroxyapatite was used. Defects in the bony posterior canal wall were reconstructed with a canal wall prosthesis of porous hydroxyapatite and cavities with a barefoot plate were reconstructed with a total alloplastic middle-ear implant, consisting of a canal wall of porous hydroxyapatite and a chain of wire and dense hydroxyapatite. With these prostheses, radical surgery of the middle ear can be combined with a physiological reconstruction.

Audiometry↗
PubMed1978

Postinflammatory ossicular fixation in tympanoplasty.

Postinflammatory ossicular fixation in chronic ear surgery is a common problem faced by the otologic surgeon. This thesis presents a review of the evolution of the three forms of postinflammatory ossicular fixation. The surgical techniques used to correct ossicular fixation are discussed. A detailed evaluation of 311 patients diagnosed as having clinical tympanosclerosis is presented.

Acute Disease↗
PubMed1979

Tympanoplasty using formaldehyde formed fascia grafts.

The closure of total perforations of the tympanic membrane has always been more difficult than lesser eardrum defects. Postoperative anterior sulcus blunting and graft lateralization occur with greater frequency in this situation and thus compromise results. In 1975, Rodney Perkins developed and described a technique for the closure of such total perforations which involved the use of formaldehyde treated temporalis muscle fascia, shaped by means of a metal mold into the configuration of a normal tympanic membrane and medial end of the bony external ear canal. This formaldehyde formed fascia (FFF) graft impressed us with its adaptability and logic. This article is a review of 139 cases involving the use of formaldehyde treated grafts not only for closure of total performations, but also for closure of total performations with concomitant middle ear ossicular reconstruction. The postoperative nonperforation rate in this series is 96.4%; blunting and/or graft lateralization was absent in 94.2% of cases. Closures of the air-bone gap to within 20 db occurred in 74% of cases with an overall gain in hearing for all cases of 84%. We believe that formaldehyde formed fascia grafts are an effective tool for the closure of total tympanic membrane perforations with or without concomitant ossicular chain reconstruction.

Adolescent↗
PubMed1977

[Behavior of the middle ear mucosa in cholesteatoma and following tympanoplasty. An experimental histological study in rabbits].

After operation three consecutive phases can be observed: 1. thickening of epithelial cell layer with development of edema in the submucosa, 2. metaplasia of epithelium with formation of ciliated and goblet cells, concomitantly round cells are found in the submucous tissue, 3. regression of inflammation and epithelial metaplasia. After 6 months goblet and ciliated cells disappear and eventually a slightly irregular monolayer epithelium is seen. If cholesteatoma is present the second phase persists. Remarkably epithelial and subepithelial changes are not concentrated in the vicinity of cholesteatoma but are seen in the whole middle ear. By autoradiography it was demonstrated, that the subepithelial tissue of cholesteatoma has a normal metabolic rate. It can be concluded that high metabolic activity postulated by other authors cannot be responsible for inflammation.

Animals↗
PubMed1977

Tympanoplasty in Korea (ossiculoplasty).

Three hundred and ninety three cases of ossicular reconstruction are presented. In the most favourable cases with both malleus handle and stapes present, this presents a closure of the air-bone gap to within 20 dB better than 80%. With connective tissue, underlay and fixation technique and staging are all important aspects of ossicular chain repair. Preservation of the function of the sound conduction mechanism in most favourable cases (malleus handle and stapes arch present) were improved by the employment of a sculptured, fitted incus prosthesis between the handle of the malleus and the head of the stapes.

Ear Ossicles↗
PubMed1979

The applicability of porous polyethylene for tympanoplasty; an animal experimental study.

The problem of a replacement material for the reconstruction of the posterior wall of the auditory canal, as well as for the obliteration of the radical cavity has not been solved satisfactor;ly so far. In order to examine the possible applicability of porous plastics, the posterior wall of the auditory canal of guinea pigs was first removed and then reconstructed using porous polyethylene and filling the bulla tympanica with fine polyethylene chips. One third of the animals had an infected middle ear at the time of implantation. Histologic assessments were made until 24 weeks after implantation. In 80% of the animals the implant settled well, even in cases where the middle ears had been originally infected. By proliferation of vessels and connective tissue, the polyethylene had almost been completely integrated into the surrounding tissue after one week. Extent and frequency of metaplastic osseous growth was greater inthe chip-filled bulla than in the reconstructedposterior wall(Fig. 9). After four weeks, the new osteoid substance was firmly connected with the regional bone (Fig. 4). According to these results, it would seem possible to use porous polyethylene even for the nonaseptic implant bed as it is found in the chronically infected middle ear.

Animals↗
PubMed1997

[Autologous tissue in initial type I and type III tympanoplasty operations in chronic suppurative otitis media].

We reviewed 192 patients who had been treated for chronic otitis media. All operations were carried out at the Department of Otolaryngology, University of Tübingen. No patient had a previous ear operation and revision operations were excluded. The observation period varied from a minimum of 1 year to a maximum of 4 1/2 years. The ossicular chain was partially destroyed in 43 ears (22.4%). Ossiculoplasty was performed using autologous ossicles. An inens was used in 31 ears and a malleus in 12 cases. The overall failure rate was 20.8%. Most recurrent perforations were found in middle-aged patients. Children had only a 14% incidence of recurrent perforations. Fascia was the material associated with the highest failure rate (28.6%). After using perichondrium 6.8% of the cases had recurrent perforations, whereas the perichondrium-cartilage transplant was not successful in 4.8%. Overall, 62.7% of the patients were found to have an air-bone gap of 10 dB or less at 1.5 kHz 3-6 months after surgery. An air-bone gap of 20 dB or less was found in 91.2% of the patients. The main problem seen in the patients with chronic otitis media was not reconstruction of the ossicular chain but a lasting closure of the tympanic membrane. The perichondrium-cartilage transplant permitted the best results and is now recommended especially for patients with unfavorable middle ear conditions. A long-lasting closure of the tympanic membrane was also found in children (< or = 15 years of age). For this reason we also recommend an early operation in order to allow children to lead a normal life.

Adolescent↗