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At least 667 records · Page 37Linked to original sources
PubMedDate not supplied

Sensorineural hearing loss following chronic ear surgery.

The incidence and characteristics of postoperative sensorineural hearing loss were analyzed in 2,303 cases of chronic otitis and its sequelae, representing our total series from 1965 to 1980. Sensorineural hearing loss occurred in a total of 1.2% of cases: 0.5% became totally deaf, and 0.7% acquired a high tone loss, most often at 4 kHz only. The incidence was highest in congenital malformations, granulating otitis and cholesteatoma, mastoidectomy (especially canal-down), and during the period from 1965 to 1974. The most common causes of anacusis were removal of cholesteatoma from the semicircular canal and removal of the fistula membrane. Different types of severe high tone loss are described and, in addition, 19 patients with mild high tone loss are discussed.

Audiometry↗
PubMed1996

Healing of tympanic membrane after myringotomy during Streptococcus pneumoniae otitis media. An otomicroscopic and histologic study in the rat.

The purpose of our study was to elucidate the course of healing of the tympanic membrane (TM) when myringotomy was performed during acute otitis media. The early and long-lasting structural changes of the TM were studied in an animal model. Rats were inoculated with Streptococcus pneumoniae (PnC) type 3 in the bulla. When the infection was manifest, myringotomy was performed. On days 4 and 12, and 3 and 6 months after myringotomy, the TM status was checked by otomicroscopy and TMs were prepared for light and electron microscopy. Comparison was made with PnC-infected TMs that were not perforated, as well as myringotomized noninfected TMs. The infection resolved more slowly in myringotomized ears compared to PnC-infected ears that were left untouched. After 6 months, the pars tensa of the myringotomized infected ears was thickened and showed a disorganized collagen structure, compared with myringotomized noninfected ears, in which TMs were normalized. The PnC-infected TMs without myringotomy were completely normalized after 2 months. We conclude that a combination of bacterial infection and myringotomy causes long-lasting changes in TM structure. This impaired structure of the connective tissue could be of importance in chronic middle ear disease as a presumptive site for retraction and perforation of the TM.

Acute Disease↗
PubMedDate not supplied

Semipermeable membrane tubes: a prospective study.

Four years ago, we introduced the use of Castelli membrane tubes into our practice. Although initial reports in the literature and restrictions on indications from the manufacturer on use were extremely cautionary, we were able, by careful intraoperative technique and the use of postoperative antibiotics, to expand the use of the membrane tube and offer it to our entire patient population. To document this, we used a prospective study of 124 consecutive ears receiving a membrane tube. Follow-up study included clinical, audiometric, and tympanometric evaluation. We found the membrane tube to function extremely well in an extremely high percentage of ears, regardless of whether the ear contains serous or mucoid fluid. The advantages of membrane tubes include the lack of special care required, resultant high patient and parental acceptance, and the low incidence of draining ears with tubes in place.

Acoustic Impedance Tests↗
PubMed1991

A universal ossicular replacement prosthesis: clinical trials of 152 cases.

An ossicular replacement prosthesis is described that advances implant design in several respects. The head is a flattened egg shape, which eliminates pressure points against the pars tensa and provided balance on the stapes. Dense hydroxylapatite ceramic provides maximal biocompatibility. The shaft, of either Teflon or Plastipore, is easily cut to size and is replaceable to minimize wastage. Interchangeable partial or total shaft variants are provided. Trials in more than 200 patients have produced optimal results. Among 152 mature patients in 85% of the good-risk cases, the air-bone gap closed to within 20 dB and in 65% to within 10 dB; in 69% of all cases the gap closed to within 20 dB. Extrusion rates were 5% in good-risk cases and 7% overall. Long-term extrusions have not occurred. Inasmuch as cartilage interpositioning is unnecessary, the prosthesis is rapidly prepared and implanted by an easily mastered technique.

Bone Conduction↗
PubMed1992

Repair of chronic tympanic membrane perforations using epidermal growth factor.

Perforation of the tympanic membrane (TM) is a frequent cause of conductive hearing loss. Persistent TM perforations often require surgical repair with an autologous tissue graft to restore hearing and prevent recurrent infection. While highly efficacious, this method of closure requires a relatively complex and expensive microsurgical procedure. We have recently developed a chronic TM perforation model in the chinchilla for use in the exploration of novel methods of TM repair.

Animals↗
PubMed1992

Effects of sodium hyaluronate on tympanic membrane perforations.

The effects of topically applied 1% sodium hyaluronate as an alternative treatment to surgery for tympanic membrane perforations was studied. In an open study, the inclusion criteria were increased by accepting patients previously treated by surgery or with placebo and, compared with a previous study, the frequency at which sodium hyaluronate was applied was reduced. Reduction in the size of the perforation was detected in 12/16 (75.0%) patients, six (37.5%) of whom showed complete tympanic healing, and in the remaining four (25.0%) there was no healing. The average percentage reduction in the perforation area was 80.5%. The two factors altered in this trial, i.e. inclusion criteria and frequency of administration of treatment, had little influence on the degree of membrane healing.

Administration, Topical↗
PubMed2002

Diclofenac or paracetamol for analgesia in paediatric myringotomy outpatients.

This prospective, randomized, double-blind study compared the analgesic efficacy of oral diclofenac resinate 0.5 mg.kg(-1) with paracetamol 15 mg/kg(-1) for control of postoperative pain in paediatric patients for outpatient bilateral myringotomy and tube insertion. Paracetamol, the most commonly used oral analgesic for paediatric patients, was compared with a new palatable syrup formulation of diclofenac. Sixty-three ASA 1 orA SA 2 children aged one year and above were randomly assigned to receive diclofenac (Group A) or paracetamol (Group B). The study drug was given 30 to 60 minutes before induction of anaesthesia. Anaesthesia was induced with either inhalational sevoflurane or intravenous thiopentone. All subjects received intravenous fentanyl 1 microg/kg(-1) intraoperatively. Postoperative pain was assessed by a blinded observer using the CHEOPS score on eye-opening, and then at 10, 30 and 60 minutes. Children with a CHEOPS score > 7 received further fentanyl 1 microg x kg(-1). The number of cases requiring this "rescue" analgesia was recorded. Both groups were comparable in demographics, induction technique, duration of anaesthesia and time between premedication and induction of anaesthesia. Overall, CHEOPS scores were low for both groups at all times and did not differ between the groups at any time. Twenty per cent of the diclofenac group and 27% of the paracetamol group required rescue analgesia (not statistically significant). The efficacy of diclofenac 0.5 mg x kg(-1) and paracetamol 15 mg x kg(-1) as oral analgesic premedication for BMT was comparable in children receiving an anaesthetic which included intraoperative administration of fentanyl 1 microg x kg(-1).

Acetaminophen↗
PubMed2000

Middle-ear disease in remote Aboriginal Australia: a field assessment of surgical outcomes.

Chronic middle-ear disease is highly prevalent among Australian Aboriginal people, and many undergo surgical treatment. However, the outcomes of surgery in this group have not been fully evaluated. This is a descriptive study of operations for middle-ear disease (excluding grommets) on Aboriginal patients in Kimberley hospitals between 1 October 1986 and 31 December 1995. Logistic regression was used to model predictors of surgical outcome. Success was defined by an intact tympanic membrane and air-bone gap of < or = 25 dB at review at, or later than, six months post-operation. A success rate of 53 per cent was observed; increasing age was the only variable predictive of success. Successful outcomes were more likely in adults and children aged > 10 years, however, this does not take into account the necessity of hearing for language acquisition and learning. Dedicated resources must be allocated for post-operative follow-up of Aboriginal patients so that much-needed, rigorous evaluations of ENT surgery can be conducted.

Adolescent↗
PubMed2003

Myringostapediopexy: surgical expectation.

Myringostapediopexy may occur as a result of incus erosion with medialization of the tympanic membrane and is recognized as often producing serviceable hearing. The technique may be used as part of tympanoplasty following either canal wall up or canal wall down surgery for chronic otitis media. The use of this type of reconstruction is influenced by the anatomy of the ear after disease excision. This review of the hearing levels associated with myringostapediopexy shows that there is a similar range of hearing level both for naturally formed as well as surgically fashioned myringostapediopexy. For both 'naturally formed' and following canal wall up surgery about 80 per cent of patients will have an air-bone gap of 20 dB or less compared to 60 per cent of those who undergo canal wall down surgery.

Adolescent↗