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At least 793 records · Page 44Linked to original sources
PubMed1985

[Cholesteatoma of the ear. Experience with an eclectic therapeutic attitude].

In the light of 702 cases of cholesteatoma seen over a 20 year period, the authors report the experience of a hospital team based upon analysis of the last 517 cases. 322 patients were treated by a conservative attitude to the bony meatus, including 120 undergoing routine revision between 14 and 24 months. 195 cases were treated by an open technique, either primarily or following massive recurrences despite the use of closed techniques. In 33% of cases, patients had already undergone at least a tympanoplasty. The authors discuss the indications of the treatment of cholesteatoma. Each patient must be considered as an individual case and whilst our preference would be for conservation of the bony meatus, certain anatomical and functional conditions make a so-called open technique necessary in 1/3 of cases.

Adolescent↗
PubMed1985

[Use of fibrin glue in microsurgery of the ear. An analysis of operations at the Pisa ENT Clinic].

The authors report the indications for and methods of application of fibrin glue in reconstructive microsurgery of the middle ear. On the basis of 180 interventions, they describe in detail the use of fibrin glue in myringo- and tympanoplasty for correct fixing of grafts. Furthermore, they illustrate the particular use of fibrin glue in reconstruction of the incudostapedial joint, in covering eroded areas of the lateral semicircular canal and in one case of perilymph gusher.

Drug Combinations↗
PubMed1985

Recent advances in otitis media with effusion.

OME is similar to other chronic inflammatory diseases with the additional fact that ventilation of the middle ear is an extremely important and necessary part of therapy. Antimicrobial therapy alone may not cure middle ear inflammatory disease as long as Eustachian tube dysfunction persists. If Eustachian tube dysfunction and middle ear fluid persists, all forms of immunologic reactivity may occur in the middle ear which may result in persistent effusion and damage to the mucosal system, to the middle ear ossicles, and to the mastoid mucosal system. These changes may require more aggressive surgical management. It is obvious that we must learn more about the physiology and pathophysiology of the Eustachian tube; about understanding of the systemic, and particularly the local humoral and cell-mediated immune response in the middle ear. Finally, we must determine the potential role of inflammatory mediators, both in the protection against disease and also in the potential role that they play in tissue injury. Encouraging progress is being made in all of these areas and it seems likely that the increased research interest and productivity from laboratories throughout the world will eventually lead to the goal of enhanced prevention and improved treatment of OME.

Child, Preschool↗
PubMed1979

[Replacement of the tympanic membrane by corneal transplantation (keratomyringoplasty)].

The authors present a new method of the substitution of the ear-drum with cornea transplantation, applied with success in 28 cases. They have established that the various tissues (skin, veins fascia, etc.) applied up to now for myringoplastic are not so suitable as the cornea, because the latter is similar to the ear-drum, according to its histological construction and physical properties. The execution of the operation, the technique of the removal of the cornea from a corpse, as well as the preparation of the auditory meatus and the inserting of the cornea are discussed in detail. The removal of the cornea can be carried out in its whole or lamellated. In contrast to ceratoplastic, the cornea need not remain transparent in ceratomyringoplastic, because, in the latter case, only its tectorial and sound-conduction effect is needed.

Cornea↗
PubMed1985

Otitis media and the Australian aboriginal.

Australia's aboriginal population, which numbers 150,000 persons, suffers much more from otitis media than does the nonaboriginal population, which numbers 15,000,000. Moreover, the clinical presentation, course, and pathology of otitis media in aboriginals have features that differ from what are considered usual. Problems of isolation, communication, and socioeconomic circumstances require that specially designed treatment projects be set up. Debate continues as to why aboriginal otitis media behaves so differently, and theories cover the full range: genetic factors, environment, protein-calorie malnutrition and immunity mechanisms, allergies, different microbiology, and so on. Current research may point up a link to ocular trachoma. The process of spontaneous healing of drum perforations is being studied in an attempt to identify those factors that may delay or prevent such healing.

Australia↗
PubMed1985

[Role of tubal insufflation in the postoperative follow-up of évidement cavities].

The authors report their experience of tubal insufflation in the post-operative care of cavity évidement. Their indications consist of évidement cavities with persistent residual muco-purulent otorrhoea or "glue ear" from the atrial area which remains thickened, while the rest of the cavity is healed (about 15% in their statistics). The technique is simple, consisting essentially of insufflations of air by means of an Itard catheter, which are repeated at regular intervals for a variable period of time. In some cases, drugs, in particular corticosteroids, are injected into the cavity via the catheter. In a series of 17 operated patients, the authors report: 9 excellent results in which drying of the cavity was obtained in record time; 4 good results in which drying of the cavity required numerous insufflations associated with systemic treatment (vaccine therapy, crenotherapy); 1 moderate result with transient persistent otorrhoea; 3 failures.

Air↗
PubMed1985

[Tragal perichondrium and cartilage in tympanoplasty. A report on 2500 operations by an established ENT physician].

The operations were almost always performed under local anaesthesia. The procedure, which is bloodless and painless, is described in detail. The material is taken via an endaural incision and causes little trauma. Tragal perichondrium, which can be reinforced by adherent cartilage, is suitable for apposition to manubrium and to the anterior tympanic sulcus due to inherent properties such as bradytrophia, natural concavity and the absence of contraction or swelling. Autologous cartilage was usually used for interpositions. The results were satisfactory with respect to healing and function. There were 3.25% perforations, and 6.7% (n = 283) in subtotal tympanic membrane defects. In cholesteatoma operations the recurrence was only 5%; this may be due to the prevalence of small cholesteatomas and the almost constant use of an open technique. A socially acceptable hearing level (less than or equal to 35 dB) was obtained in 62.7% in the short term.

Adolescent↗
PubMed1985

[Comparison of 2 molded autograft technics on intact ossicular chains].

Two techniques using molded autografts on intact ossicular chains were compared in 159 patients: some patients received molded autografts alone while in the others it was reinforced by a second fragment of temporal aponeurosis inserted behind the manubrium of the malleus. Fixation of these two grafts prevented ascension of the graft into the canal. Results obtained showed slight superiority for the double graft over the single one.

Adolescent↗