[Effects of repeated interventions in ear surgery].
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Permanent restoration of hearing is the goal of functional reconstruction in tympanoplasty. Nonbiologic prostheses have been abandoned for otic grafts. This is a long-term study of a group of 32 patients with type II tympanoplasties in which homografts of septal cartilage are used to reconstruct the sound conduction system. The good audiologic results obtained, with absence of immune reactions, allow recommendation of this technique in middle ear surgery.
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Sway was measured by static posturography in 25 patients undergoing stapedectomy, 16 first-side and nine second-side operations. Measurements were taken pre-operatively and at 1 week and 6 months after surgery, 25 age-matched controls were also tested. In both the first and second side groups, sway was greater at 1 week after surgery than pre-operatively when relying on vestibular function alone (P = 0.01 first-side, 0.05 second-side, 0.01 both sides taken together). By 6 months, sway measurements were no longer significantly different from pre-op or control values. Thus, it appears that there is a measurable increase in patients' sway following stapedectomy but this is well compensated by visual and proprioceptive information, and resolves fully with time. Patients undergoing a second side stapedectomy do not appear to fare worse than those undergoing first-side surgery.
Meningitis following stapedectomy occurring in the immediate postoperative period has not been previously described. This case report documents a case of diplococcus pneumoniae meningitis occurring within 36 hours following surgery with survival of the patient.
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