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At least 595 records · Page 33Linked to original sources
PubMed1981

Posterior meatal wall reconstruction in tympanoplasty.

An operative method is described which has been employed in 41 cases of severe chronic otitis media. The posterior meatal wall was removed and reconstructed during the same operation, following cleansing of the middle-ear cavity and ossiculoplasty. Either autograft bone (previously removed from the meatal wall) or homograft cartilage was employed for the reconstruction. All the ears were found to be dry at the follow-up examination after an average of 28 months, but 18 per cent had recurrence of the cholesteatoma. A SRT improvement of 5-30 db, was observed in 78 per cent, and in 21 per cent a deterioration of between 0 and 10 db. The method provides a good field of vision of the middle-ear cavity and in no cases was rejection of the re-implanted material observed.

Adolescent↗
PubMed1985

Histochemical study of cartilage autografts in tympanoplasty.

Histochemical examination of lactic dehydrogenase enzyme activity was used to detect the effect of certain factors on the viability of cartilage autografts in the middle ear. The study shows that the presence of perichondrium on both sides of the strut and placing the lateral end of the strut increase the chance of survival of chondrocytes. On the other hand, middle ear infection has a very bad effect on the viability of chondrocytes. The length of the strut and the presence of silastic film in the middle ear have been found to be unimportant as far as the survival of the graft is concerned.

Animals↗
PubMed1986

Revision tympanoplasty.

The terms 'planned two-stage operations', 'planned second-look operations', 'previous surgery', and 'revision surgery' are discussed on the basis of our series of 2,303 ears operated upon from January 1965 to December 1980. We have not performed any planned two-stage operations. All operations prior to the first operation in our department are denoted 'previous surgery'. 'Revision surgery' denotes all reoperations performed either in this department or elsewhere during the observation period until the end of 1984, and the revision rate is analysed in patients with different pathological conditions. 'Revision surgery' was performed in 15.6 percent of 740 ears with cholesteatoma (in 13.9 per cent once, in 1.6 per cent twice, and in 0.1 per cent three times), and 'previous surgery' in 3 per cent. Among 229 ears with chronic granulating otitis, revision surgery had been performed in 12.2 per cent up to December 1982. By December 1984, this figure had risen to 16.1 per cent. 'Previous surgery' had been performed in 18.3 per cent. A total of 38.4 per cent had at least two operations. The revision rate in other conditions varied from 10 per cent (sequelae to chronic otitis) to 34 per cent (post-inflammatory acquired atresia). These rates are discussed and the functional results presented.

Cholesteatoma↗
PubMed1992

A five year follow up of incus transposition in relation to the first stage tympanoplasty technique.

This study was set up, prospectively, to determine factors affecting the long-term hearing results of patients undergoing incus transposition as a second stage in ossicular reconstruction, following a successful drumhead repair in non-cholesteatoma ears. Seventy-one patients were entered into the study over five years from 1980-1985, 66 were available to be studied throughout the five year follow-up period. Nine weeks post-operatively, 74 per cent of all patients has an air-bone gap of less than 15 dB (48/66). The type of first stage procedure had a significant effect on the hearing levels in the final five year assessment. The most successful sub-group were those patients who had a cortical mastoidectomy and silastic sheeting inserted in the first staging procedure. The air-bone gap, of less than 15 dB, was maintained in 71 per cent of this group (17/24). The sub-group who had a simple myringoplasty as the primary procedure had a good initial hearing level. By five years, however, only 30 per cent of the patients had maintained the air-bone gap of less than 30 dB (3/11).

Chronic Disease↗
PubMed1984

Permanent obliteration of old radical mastoid cavities combined with tympanoplasty.

An open radical mastoid cavity presents a handicap to the patient. If elimination of the cavity appears desirable, one should use an operative technique which does not incur the risk of a cholesteatoma redeveloping. In our experience obliteration of the cavity with non-resorbable methacrylate Sulfix-6 is the best way to achieve this. The arguments in favour of this view are presented and the operative technique is described.

Bone Cements↗
PubMed2003

Influence of total intravenous and inhalational anaesthesia on haemostasis during tympanoplasty.

BACKGROUND: Surgical trauma leads to systemic changes in haemostasis. Haematological changes activated by surgery may become so prominent that changes caused by anaesthesia might be hidden or underestimated. Therefore, we have undertaken a prospective study to compare the behaviour of selected factors involved in the coagulation and fibrinolytic systems. METHODS: Forty healthy adult patients scheduled for otological surgery were enrolled in the study. Upon receiving informed consent, they were randomly assigned to receive either inhalational (IA) or total intravenous anaesthesia (TIVA). Platelet function (PFA100TM), disseminated intravascular coagulopathy (DIC) panel, and generalized d-dimer (GFC) were studied during certain periods of anaesthesia to identify the changes in haemostasis. RESULTS: Statistically, no significant change in DIC parameters were encountered between the two groups. No statistical difference was found between the two groups in the measured coagulation parameters, but statistically GFC showed slight activation in the 1st hour of surgical intervention. CONCLUSION: Presuming a minimal traumatic effect of surgical procedure on the determined variables, we conclude that different anaesthetic techniques have a negligible effect on platelet activation and fibrinolysis. The clinical relevance of coagulation activation and fibrinolysis during different anaesthetic techniques remains to be investigated.

Adult↗
PubMed2002

[Results after rebuilding the ossicular chain using the autogenous incus, ionomer-cement-and titanium implants (tympanoplasty type III)].

BACKGROUND: A defective ossicular chain can reliably be reconstructed with standardized techniques using e. g. modern alloplastic materials. The comparison of clinical and functional results have proved its worth. Prospective clinical trial as well as collecting and evaluating relevant intraoperative and postoperative findings may be helpful to find the appropriate bone substitute in each case when rebuilding middle ear structures. METHOD: In 354 middle ears (332 patients) the defective or destroyed ossicular chain was rebuilt with the carefully trimmed autogenous incus (n = 83), with ionomer-cement implants (n = 100) and with titanium prostheses (n = 171). The follow-up of the earmicroscopic findings and middle ear function extended over a period of 1.5 years postoperatively on an average (min. 3 months, max. 6 years). The modified otologic record form named "Würzburger Ohrbogen" was used for preoperative and operative data, the "Ohrnachsorgebuch" for the postoperative follow-up. RESULTS: Using incus the air bone gap was improved up to 15 dB in the main speech area. Thus the average remaining conduction deficit was less than 10 dB. The "taking" of ionomer based cement prostheses and titanium prostheses was equally good. The cement implants showed a tendency to protrusion (n = 3), 2 titanium implants were extruded. The air bone gap decreased about 10 to 35 dB using titanium total prosthesis and about 15 to 20 dB using ionomer-cement total prosthesis. The remaining air bone gap with titanium implants was slightly less than with the ionomer-cement PORP (10-15 dB). The air bone gap using the titanium TORP was diminished in a reach of 10 to 35 dB, with the ionomer cement prosthesis between 15 to 20 dB. The remaining gap in the main speech area was slightly favorable to titanium (less than 15 dB) compared with the ionomer-cement TORP. Comparing higher frequencies the air bone gap of titanium was recognizable due to its light weight, but less impressive than expected. Revision surgery (n = 50) has to be performed by reason of cholesteatoma (n = 9), adhesive process (n = 8), dislocation of alloplastic prostheses (n = 8) and because of proposed "second look" (n = 14). CONCLUSIONS: Compared with other materials autogenous implants used for reconstruction of the incus have proved their value, however a deterioration of the sound transmission may develop in the long run. The middle ear compatibility of ionomer-cement implants is similar to titanium implants. The functional results of the titanium implants seem to be slightly superior.

Adolescent↗
PubMed2007

[A new model for training in tympanoplasty].

BACKGROUND: Functional simulation of middle ear reconstruction is a valuable tools for training in otosurgery. We introduce a new experimental model which provides a direct acoustic feedback of the functional quality of ossicular chain reconstruction. METHOD: In this model the tympanic membrane and the ossicular chain have to be reconstructed for proper sound transmission to an artificial inner ear receptor. The received signal is converted into acoustic information and consecutively provided via headphone. RESULTS: Any changes in the reconstruction (e. g. tilting the prosthesis) can be experienced online and immediately optimized by the surgeon or a trainee. CONCLUSION: The experimental model can be used for demonstration and training in otosurgery. This model is also suitable for comparing measurements of transfer functions in a calibrated version and can be applied to development and critical evaluation of middle ear prostheses.

Acoustic Stimulation↗
PubMed1995

[Modern aspects of tympanoplasty. An overview].

The cholesteatoma should be removed with a canal wall down-technique in small mastoids. In patients with well or highly pneumatized temporal bones the reconstruction of the posterior canal wall is recommended after complete removal of the matrix. Myringoplasty is mainly performed using perichondrium. In highly damaged middle ears the cartilage palisade technique is indicated. The reconstruction of the ossicular chain performed using modern artificial materials.

Cholesteatoma, Middle Ear↗