Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “TYMPANOPLASTY”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 145 records · Page 8Linked to original sources
PubMed1990

Tympanoplasty: review of 400 staged cases.

Staging of tympanoplasty is important in the management of patients with chronic otitis media. It allows establishment of an air-containing middle ear space and adequate postoperative hearing levels in a large proportion of patients with severely diseased ears. The results of 400 staged procedures performed over a 3-year period at the House Ear Clinic, Los Angeles are reported. Staging was performed in 75% of tympanoplasty with mastoidectomy cases and in 15% of ears not requiring mastoid surgery. Closure of the air-bone gap to 20 dB or less occurred in 68% of patients with intact stapes. Mucous membrane problems were the most common reason for staging. Almost one third of cases with middle ear cholesteatoma at the first stage had residual disease on reexploration. Staging of tympanoplasty continues to be an important technique in management of severely diseased ears.

Adolescent↗
PubMed2006

Why do some children have good hearing results following type III and IV tympanoplasty? Current theories of middle ear mechanics.

INTRODUCTION: Middle ear reconstruction in children following tympanomastoidectomy for cholesteatoma is commonly limited to a Wullstein type III or IV reconstruction owing to ossicular erosion. The hearing outcomes of this procedure have been unpredictable. Nevertheless, there are children who have remarkably good hearing results despite having extensive and aggressive cholesteatoma surgery and limited reconstruction. METHODS: The current theories of middle ear mechanics following tympanoplasty and ossicular reconstruction are reviewed. In addition, a selective retrospective chart review of pediatric type III and IV tympanoplasty at The Hospital for Sick Children between 1998 and 2003 is presented. RESULTS: Nine patients were reconstructed with a type III (n = 3) or IV (n = 6) tympanoplasty. The mean pre- and postoperative air-bone gaps were 43.6 and 24.9 dB. Speech reception threshold improved from 37.5 to 22.8 dB. The changes were statistically significant (p < .05). CONCLUSIONS: This series of patients demonstrated a statistically significant hearing improvement at long-term follow-up. The improvements are consistent with optimal hearing outcomes predicted by current theories of middle ear mechanics.

Audiometry↗
PubMedDate not supplied

Late results in tympanoplasty. Staging the operation.

Based on the late results of tympanoplasty on 300 ears and of one-stage mastoidectomy and tympanoplasty on 269 discharging ears, the problems involved in staging tympanoplasty are discussed. The results of one-stage operations were found to be satisfactory 2-10 years after operation. The frequency of recurrent cholesteatoma was low, 3.4%. Instead of two-stage operations, re-operation is recommended in cases of functional failure and in cases in which further improvement of hearing can reasonably be expected.

Cholesteatoma↗
PubMed2001

[Evaluation of canal wall down tympanoplasty with canal reconstruction for draining ear with middle ear cholesteatoma].

OBJECTIVES: We studied the postoperative stability of canal wall down tympanoplasty with canal reconstruction for middle ear cholesteatoma with preoperative otorrhea. SUBJECTS AND METHODS: 155 ears with middle ear cholesteatoma treated with canal wall down tympanoplasty with canal reconstruction were evaluated retrospectively. A comparison was made between the group of 80 ears which showed otorrhea, preoperatively, and the group of 75 without preoperative otorrhea. Problems observed in the tympanic membrane or reconstructed external auditory canal were evaluated both at the postoperative initial stage and more than 1 year after surgery. Postoperative hearing prognosis was also studied. RESULTS: 1) In the postoperative initial stage, local infection and necrosis of materials for canal reconstruction were significantly more likely to be observed in ears with preoperative otorrhea. 2) In ears with postoperative local infection, necrosis of materials for canal reconstruction occurred more frequently, and the period until drying of the reconstructed external auditory canal was significantly extended. 3) No significant difference was seen in postoperative status of the tympanic membrane and reconstructed ear canal at least 1 year after surgery. 4) The presence of preoperative otorrhea had no influence on hearing prognosis. CONCLUSIONS: When canal wall down tympanoplasty with canal reconstruction is used for ears with preoperative otorrhea, careful attention should be paid to local treatment at the postoperative initial stage. However, no significant problem occurred in the outcome of preoperative ear draining at least 1 year after surgery.

Adolescent↗
PubMed2002

[Channel fixation of a fascial graft to the manubrium mallei in tympanoplasty].

Long-term results of tympanoplasty with channel fixation of the fascial graft to the manubrium mallei (MM) is described. For better contact of the fascia with the malleus, a blind channel in the graft is created and the graft is put on the MM. The above operation was performed in 86 patients. The results were compared to those of 51 tympanoplasties when the MM was passed through the hole created in the graft. Better late results were obtained in tympanoplasty with channel fixation. The tympanic membrane healing rate was 92%, no lateralization occurred. The average pure air conduction threshold at frequencies 0.5-2 kHz has become 22.1 +/- 1.64 dB (before operation 37.7 +/- 1.60 dB; p < 0.001), average bone conduction threshold 11.8 +/- 1.21 dB (before operation 13.7 +/- 1.25 dB; p > 0.05) and air-bone gap was 10.4 +/- 0.9 dB.

Fascia↗
PubMed2000

[The semiconductor diode laser application in tympanoplasty].

OBJECTIVE: To investigate the method, indications and initial results of semiconductor diode laser application in tympanoplasty. METHOD: The diode laser was used in 14 tympanoplasty procedures. The laser manipulation was mainly used in cases of malleus and incus bony fixation with the tympanum, the fibrous scar tissue around the ossicular chain and the malleus head resection. RESULT: There was no postoperative vertigo and facial paralysis. The average hearing improvement was 24 dB. Seven cases (50%) reached an air-bone gap within 20 dB. CONCLUSION: The application of diode laser in tympanoplasty could effectively reduce the manipulation trauma of ossicular chain and control the bleeding of operative field, especially in managing the bony adhesion of the ossicular chain.

Adolescent↗
PubMed2003

Outcome of type-1 tympanoplasty.

OBJECTIVE: The outcome of 97 patients who underwent tympanoplasty type-1 surgery by different ear, nose and throat surgeons was evaluated. METHODS: This retrospective study was carried out from the records pertaining to all patients who had tympanoplasty type-1 at King Fahd Specialist Hospital, Buraidah, Al-Qassim, Kingdom of Saudi Arabia, during the years April 1995 through to April 2000. Specific criterias were setup for selecting all the patients involved and excluding others. Thus 97 ears were selected in this study. The factors presumed to influence the outcome included age, sex, nationality, affected ear, middle ear status at surgery, perforation size and surgical approach and techniques chosen by different surgeons. These data was collected in a set out proformae and tables and analyzed and discussed. RESULTS: The patients age ranged from 11-45 years with a mean of 26.3, standard deviation 7.6 in all selected patients and also in the successful group. Very few children from age of 11-16 were involved. The male female ratio was 1:1.4 in the total selected group and 1:1.6 in the successful group. The success rate was 80% in males and 87.7% in females (p value 0.301). The results obtained showed no significant difference due to these factors except the permeatal approach (p<0.045) as compared to endaural approach. In this series the overall graft success rate was 84.5% in the total of 97 patients selected for the study. CONCLUSION: The overall success rate coincided with published literature from elsewhere. The factors presumed to influence the outcome of tympanoplasty type-1 surgery showed no significant difference, except the permeatal approach as compared to endaural approaches.

Adolescent↗
PubMed2003

Chondrotympanoplasty: a modified technique of cartilage graft tympanoplasty.

BACKGROUND: Although the temporalis fascia has been widely used since 1957as a graft in tympanoplasty, it can eventually become thin and atrophic. In addition, due to the lack of elasticity and resistance to pressure changes in the external ear canal, secondary perforations may also develop. Therefore, several authors have suggested that temporalis fascia should be strengthened by periosteum or replaced by cartilage. MATERIAL/METHODS: In the present paper the term chondrotympanoplasty is introduced to describe modified techniques of cartilage graft tympanoplasty and intratympanal chondroplasties. These techniques were used in 76 patients who were prospectively followed up for two years post-operatively. RESULTS: In type I chondrotympanoplasty, the mean pre-operative air-bone gap was reduced from 20 dB to 8 dB at 2000 Hz. In 93% of these cases the cartilage graft was taken without problems and there was no perforation in the new eardrum. In two cases of type I chondrotympanoplasty who experienced acute post-operative otitis media, the cartilage graft was found to be relatively resistant to infection, as only a pinhole perforation was noted. Type III chondrotympanoplasty with endotympanic chondroplasty (intratympanal tubal chondroplasty and intratympanal stapes chondroplasty) was found to give good aeration in the cavity, an intact new eardrum, and remarkable hearing results, reducing the mean pre-operative air-bone gap from 25 dB to 10 dB at 2000 Hz. CONCLUSIONS: Cartilage was found to be an excellent graft material and the described chondrotympanoplasties gave very promising results. Cartilage should be used more widely in tympanoplasty (chondrotympanoplasty).

Adult↗
PubMed2002

[Tympanoplasty in the only hearing ear].

OBJECTIVE: To evaluate result of tympanoplasty in only hearing ear. METHOD: 15 cases were analyzed retrospectively. All cases were operated by tympanoplasty for middle ear diseases with conductive deafness. The contralateral ears of all cases had sensorineural deafness. RESULT: All ears obtained dry ear and 80% ears obtained hearing improvement. CONCLUSION: Tympanoplasty is availability in only hearing ear with middle ear diseases, but operation must be manipulated by senior expert.

Adult↗
PubMed2003

Overlay versus underlay tympanoplasty. Comparative study of 122 cases.

INTRODUCTION: In tympanoplasty, the most common two techniques for positioning the graft relative to the remnant of both the tympanic membrane and of the annulus, are the "overlay" and the "underlay" techniques. Each technique has advantages and disadvantages. METHODS: One hundred and twenty-two cases over the age of 8 years who had undergone a tympanoplasty for tympanic membrane perforation secondary to chronic otitis media were included. All patients had a minimum 3-month postoperative otoscopic and audiometric follow-up. RESULTS: of 122 cases, 115 tympanoplasties (94%) were anatomically successful. At frequencies of 0.5, 1, 2, and 4 kHz, the mean air-bone gap improved significantly from 21.7 dB preoperatively to 8.4 dB postoperatively giving a mean gain of 13.3 dB. CONCLUSION: In our series the underlay or overlay positioning of the graft does not significantly influence the rate of postoperative perforations or complications with the exception of epithelial pearls, which occur significantly more frequently following the overlay technique for perforations that require fibro-epidermal cleaving across a large area.

Adolescent↗
PubMed2003

Tympanoplasty without skin incision of the external auditory canal: preliminary results.

INTRODUCTION: Most tympanoplasty techniques require skin incision of the external auditory canal. This step is not without morbidity and postoperative complications such as delayed healing, granulation tissue, lateralization, blunting and iatrogenic cholesteatoma. For small or midsize non-marginalized tympanic membrane perforations of the posterior or inferior quadrants, a transmeatal approach without incision of the cutaneous epidermis of the external auditory canal can theoretically offer advantages such as rapid healing and reduced postoperative complications. In this paper we present the preliminary results of a tympanoplasty technique with a retroauricular approach without skin incision of the canal and an overlay graft. MATERIALS AND METHODS: We performed 10 tympanoplasties without skin incisions for small or midsize non-marginalized perforations, which do not exceed one third of the tympanic membrane surface, located in the inferior or posterior quadrants. RESULTS: With a minimum follow up of 3 months all patients showed excellent anatomical results without complications. Nine of them closed their average air bone gap at less than 10 dB. CONCLUSION: When anatomically feasible, our technique combines a post auricular approach and the absence of skin incision. It ensures rapid healing, preserves the anatomy of the eardrum and external auditory canal and reduces the risk of blunting and lateralization phenomena. The main difficulty concerns the cleavage of the epidermal and fibrous layer.

Adolescent↗
PubMed2003

[The application of mastoid obliteration with homograft tooth in open method tympanoplasty].

OBJECTIVE: To investigate the effect of open method tympanoplasty with mastoid obliteration with homograft tooth and reconstruction of the attic wall. METHOD: Fifty-two cases with cholesteatoma or skeletal ulcer otitis media were performed the open method tympanoplasty with mastoid obliteration with homograft tooth and reconstruction of the attic wall after radical mastoidectomy. RESULT: External auditory canals of 48 patients were normal in appearance. The transplanted membrane in 46 ears was survived. The dry-ears rate was 92.31% and the average time waited till dry-ears was 17.56 +/- 4.16 days. The air-conducting hearing levels of average language frequency have been enhanced over 15 dB HL in 41 ears. An air-bone gap of less than 20 dB HL was achieved in 31 ears. CONCLUSION: The open method tympanoplasty with mastoid obliteration with homograft tooth and reconstruction of the attic wall can recovery the anatomic structure and physiological function of external auditory canal and middle ear better. The long-term effect on improving hearing was significant.

Adolescent↗
PubMed2004

[Partial remove of mastoid tip in open-ended tympanoplasty or mastoidetomy].

OBJECTIVE: To summarize the effect of partial remove of mastoid tip in open-ended tympanoplasty or simple redical mastoidectomy. METHOD: Ten cases of cholesteatoma otitis media were treated with simple redical mastoidectomy. Thirty-four cases were treated with open-ended tympanoplasty. The mastoid tip were partial removed in all cases. RESULT: The volume of mastoid cavity became small after operation. The follow up time was 3 months. The dry ear rate was 97.6% (43 cases). After 1 years follow up there wasn't recurrence of cholesteatoma. CONCLUSION: The technique of partial remove of mastoid tip effective in open-ended tympanoplasty or simple redical mastoidectomy. We believe that in order to destry death cavity, shorten dry ear time and decrease recurrence it is very necessary.

Adolescent↗
PubMed2004

Canal wall down tympanoplasty surgery with or without ossiculoplasty in cholesteatoma: hearing results.

Aim of the study was to evaluate the functional results, in two homogeneous groups, for severity of the disease, submitted to canal-wall-down tympanoplasty (TPL CWD), with and without ossiculoplasty. A total of 60 patients who underwent canal-wall-down tympanoplasty for cholesteatoma were evaluated: 31 underwent ossiculoplasty (group A) and 29 classic Wullstein type III and IV operation (group B). Hearing results were evaluated 2 years after surgery according to the AAO-HHS guidelines. Pre-operative audiometrics revealed an air conduction PTA (AC-PTA) of 45.12 dB in group A, and 56.25 dB in group B. Bone conduction PTA (BC-PTA) was 16.86 dB in group A and 26.06 in group B. Two years after surgery, AC-PTA was 42.98 dB in group A and 58.65 dB in group B; BCPTA was 18.79 dB in group A and 25.13 dB in group B. The mean pre-operative ABG was 28.44 dB in group A and 30.14 dB in group B. Two years after surgery, group A showed a mean ABG of 24.06 and group B of 35.54 dB, the difference between the two groups was significant (p = 0.03). In conclusion, the functional results observed in the present study support the need to reconstruct the ossicular chain in canal-wall-down tympanoplasty, in fact, ossiculoplasty is associated with a better hearing gain than the classic Wullstein operations.

Adult↗
PubMed2005

[Application of the tragus cartilage ring with perichondrium in open-ended tympanoplasty].

OBJECTIVE: To investigate the effect of the application of tragus cartilage ring with perichondrium in open-ended tympanoplasty and it's long-term results. METHOD: The tympanic membrane perforations were treated by the surgery of open-ended tympanoplasty. The tragus cartilage ring with perichondrium autograft in 38 patients with otitis media were adopted in the operation from 1995 to 2000. After operation,the patients were followed up in 2 weeks, 1 month, 3 months, 6 months, 1 year and 3 years. RESULT: Of 38 cases, 4 failed but the othershealed in one stage. The successful rate was 89.47%. After 2 weeks, among the 4 cases,2 had grafts crannies and 2 cases were infected. But when they accepted the second operation and after a following up of three years, the successful rate was 100%. Grafts were atrophy in 2 cases after 6 months to 3 years. Before the operation the average air conduction hearing was (45.66+/-8.40)dB HL and the difference between bone and air was less to (26.05+/-8.15)dB HL. From 1 months to 3 years after the operation, the air conduction and bone conduction ware respectively (31.58+/-7.45)dB HL and (19.61+/-6.41)dB HL in 1 month, (26.18+/-7.02)dB HL and (12.63+/-7.59)dB HL in 3 months,(23.55+/-7.70)dB HL and (10.79+/-5.52)dB HL in 6 months,and (23.42+/-6.99)dB HL and (11.05+/-5.95)dB HL in 1 years, keeping at limits of (23.95+/-6.69)dB HL and 10.53+/-5.43 dB HL in 3 years. There were significant differences between pre-operation and post-operation in 1 month,and 3 months. But there were no significant differences after operation in 6 months, 1 year, 3 years and 3 months. CONCLUSION: The tragus cartilage ring with perichondrium is of great importance to increase the guality of tympanoplasty and effective rate owing to its reliable technique and material collection.

Adolescent↗
PubMed2005

[Tympanoplasty and mastoidectomy in patients with large perforation of tympanic membrane in pars tensa].

OBJECTIVE: To present the experiences of tympanoplasty in patients with large perforation of tympanic membrane in pars tensa. METHOD: Of 147 patients who underwent surgery for chronic otitis media with large perforation of tympanic membrane in pars tensa,101 patients without mastoid problem underwent tympanoplasty, 46 patients who had evidence of middle ear, antral/epitympanic, or mastoid disease underwent tympanoplasty with mastoidectomy. RESULT: The tympanic membrane graft take rate for the entire group of 147 patients was 96.6% (142 grafts succeed). The average postoperative pure tone air-bone gap was (16.6 +/- 10.9) dBHL after 3 months of the operation. CONCLUSION: To patients with chronic supperative otitis media and large perforation of tympanic membrane, the CT scan before operation and detailed exploration of tympanum are necessary. The drainage of Eustachian tube, attic and antrum must be enough. The cartilage-perichondrium composite is an ideal material for reconstruction of the drum, the attic and the posterior tympanum.

Adolescent↗
PubMed2005

[Tympanoplasty for cholesteatoma in pediatric patients].

OBJECTIVE: To discuss the best strategy in tympanoplasty for cholesteatoma in pediatric patient. Both intact canal wall mastoidectomy with tympanoplasty (ICW) and canal wall down mastoidectomy with tympanoplasty (CWD) were the basic technique for cholesteatoma in pediatric patient. The outcomes of ICW and CWD as comparisons of different surgical technique were assessed. METHODS: A retrospective analysis of all cases of pediatric primary acquired cholesteatoma aged 4-14 years old between April, 1997 and October, 2003 was conducted. The follow-up information was completed. Forty-two patients (45 ears) were treated and followed from 1 to 7 years [ the average is (3.6 +/- 2. 6) years]. RESULTS: ICW was the primary surgical treatment in 20 patients (20 ears) initially, the recidivism rate was 30% ( 6/20), the achieved rate of pure-tone threshold average (PTA) was 77% (13/17); Twenty-five (two) patients (45 ears) underwent CWD, the recidivism rate was 4% (1/25), the achieved rate of PTA was 72% (18/25). CONCLUSIONS: ICW had the advantage which could preserve the physical structure of the external acoustic meatus and had more profits for the treatment of cholesteatoma in pediatric patients, but it should be done for planned second stage surgery as a routine method that could get over the defect of recrudescence . If the function of eustachian tube was still not normal when planned second stage surgery operation was done, the CWD was suggested instead.

Adolescent↗
PubMed2006

[Transcanal butterfly cartilage tympanoplasty].

OBJECTIVES: This study evaluated the long-term results of transcanal butterfly cartilage tympanoplasty technique in adult patients. PATIENTS AND METHODS: Transcanal butterfly cartilage tympanoplasty was performed in 11 adult patients (7 males, 4 females; mean age 30 years; range 21 to 45 years) with chronic otitis media. The operations were performed under general or local anesthesia. Perforation diameters ranged from 2 to 6 mm. The mean follow-up period was 9.5 months. RESULTS: At the end of the follow-up period, perforations closed in 10 patients (90.9%). In one patient, reperforation occurred in the second month. The mean preoperative and postoperative air-bone gaps obtained in 10 patients were 18 dB and 6.5 dB, respectively. CONCLUSION: Butterfly cartilage tympanoplasty technique was very effective to close central, small tympanic membrane perforations associated with minimal hearing loss.

Adult↗