scholarly journals “Sandwich technique” enables preservation of hearing and antivertiginous effect in cholesteatomatous labyrinthine fistula

2021 ◽  
Author(s):  
Anna Bartochowska ◽  
Marta Pietraszek ◽  
Małgorzata Wierzbicka ◽  
Wojciech Gawęcki
Keyword(s):  
Bone Conduction ◽  
Clinical Results ◽  
Type I ◽  
Membranous Labyrinth ◽  
Sandwich Technique ◽  
Temporal Fascia ◽  
Labyrinthine Fistula ◽  
Superficial Type ◽  
Materials Used ◽  
Hearing Outcomes

Abstract Purpose The aim of the study was to assess hearing, surgical and clinical results of the treatment in patients with cholesteatomatous labyrinthine fistula (LF) focusing on the different techniques and materials used in the management. Methods Study group included 465 patients. Cases with LFs discovered or confirmed during surgical procedure were thoroughly analyzed. Results LFs were noted in 11.4% of all cases. Thirty-eight patients, with all follow-up data available, were included into the further analysis. Most LFs were located in the lateral semicircular canal (87%). LFs were assessed as small in 2 cases, as medium in 24 patients while 12 were described as large. Based on Dornhoffer and Milewski classification, 50% of LFs were classified as IIa, 24% as IIb, 6 LFs were very deep (type III), while 4—superficial (type I). The size and type of LF did not influence postsurgical complaints (p = 0.1070, p = 0.3187, respectively). Vertigo was less frequent in LFs treated by “sandwich technique”, especially those with opened endosteum. In 30 (79%) patients, hearing improved or did not change after surgery. Hearing outcomes were significantly better in the ears operated by means of CWU technique (p = 0.0339), in LFs with intact membranous labyrinth (p = 0.0139) and when “sandwich technique” was performed (p = 0.0159). Postsurgical bone conduction thresholds levels were significantly better in LFs covered by “sandwich method” (p = 0.0440). Conclusion “Sandwich technique” (temporal fascia–bone pate–temporal fascia) enables preservation of hearing as well as antivertiginous effect in patients with cholesteatomatous labyrinthine fistula.

Factors Associated With Hearing Outcomes After Stapedotomy in Taiwanese Patients With Clinical Otosclerosis

2021 ◽  
pp. 014556132110376
Author(s):  
Pei-Hsin Chen ◽  
Kai-Nan Lin ◽  
Hsiu-Yin Lin ◽  
Rui-Bin Yu ◽  
Pi-Yun Liu ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Success Factors ◽  
Bone Conduction ◽  
Hearing Results ◽  
Hearing Sensitivity ◽  
Surgical Success ◽  
Factors Associated ◽  
Male Patients ◽  
Hearing Outcomes ◽  
Stratified Analysis

Objective: To examine the clinical factors associated with the effectiveness of stapedotomy in improving hearing sensitivity in Taiwanese patients with otosclerosis. Methods: In this retrospective study, we reviewed the medical records of 31 patients (36 ears) with otosclerosis undergoing stapedotomy performed by a single surgeon. Preoperative and postoperative hearing results were analyzed to identify factors associated with hearing outcomes after stapedotomy in the Taiwanese population with clinical otosclerosis. Results: Compared with preoperative pure tone averages (PTAs), stapedotomy significantly improved postoperative air conduction (AC) thresholds ( P < .0001), bone conduction (BC) thresholds ( P = .025), and air-bone gaps (ABGs; P < .0001). Postoperative closure of ABGs less than 10 or 20 dB was achieved in 16 (44.4%) and 33 (91.7%) of 36 surgical ears. Improvement in postoperative AC thresholds and ABGs and the size of preoperative ABGs were significantly correlated (r = .650, P < .001 and r = .745, P < .001, respectively). Gender-stratified analysis indicated a stronger correlation between improvement in postoperative AC thresholds and preoperative ABGs in male patients than in female patients (r = .893, P < .001 and r = .476, P = .014, respectively), and in postoperative and preoperative ABGs (r = .933, P < .001 and r = .626, P < .001, respectively). With the more stringent criteria for surgical success, factors including age (≤50 years), type (conductive, BC ≤25 dB), and degree (PTA ≤55 dB) of preoperative hearing loss led to more favorable outcomes. Conclusions: We reported evidence supporting a potential gender difference on hearing outcomes after stapedotomy in Taiwanese patients with otosclerosis. Age, type, and degree of preoperative hearing loss may affect the surgical success rate.

scholarly journals Assessment of Bone Conduction Thresholds After Surgical Treatment in Patients with Labyrinthine Fistula

2018 ◽  
Vol 56 (2) ◽  
pp. 89-94 ◽  
Author(s):  
Muzeyyen Yildirim Baylan ◽  
◽  
Umit Yilmaz ◽  
Zeki Akkus ◽  
Ismail Topcu ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Bone Conduction ◽  
Labyrinthine Fistula

Initial Clinical Experience Using the Low-Profile Altura Endograft System With Double D-Shaped Proximal Stents for Endovascular Aneurysm Repair

2018 ◽  
Vol 25 (3) ◽  
pp. 379-386 ◽  
Author(s):  
Dainis Krievins ◽  
Albrecht Krämer ◽  
Janis Savlovskis ◽  
Georgij Oszkinis ◽  
E. Sebastian Debus ◽  
...  
Keyword(s):  
Clinical Investigation ◽  
Clinical Success ◽  
Endovascular Aneurysm Repair ◽  
Clinical Results ◽  
Type I ◽  
Midterm Outcome ◽  
Early Results ◽  
Low Profile ◽  
Type I Endoleak ◽  
Aneurysm Repair

Purpose: To report the initial clinical results of endovascular aneurysm repair (EVAR) using the low-profile (14-F) Altura Endograft System, which features a double “D-shaped” stent design with suprarenal fixation and modular iliac components that are deployed from distal to proximal. Methods: From 2011 to 2015, 90 patients (mean age 72.8±8.3 years; 79 men) with abdominal aortic aneurysm (AAA; mean diameter 53.8±5.7 mm) were treated at 10 clinical sites in 2 prospective, controlled clinical studies using the Altura endograft. Outcomes evaluated included mortality, major adverse events (MAEs: all-cause death, stroke, paraplegia, myocardial infarction, respiratory failure, bowel ischemia, and blood loss ≥1000 mL), and clinical success (freedom from procedure-related death, type I/III endoleak, migration, thrombosis, and reintervention). Results: Endografts were successfully implanted in 89 (99%) patients; the single failure was due to delivery system malfunction before insertion in the early-generation device. One (1%) patient died and 4 patients underwent reinterventions (1 type I endoleak, 2 iliac limb stenoses, and 1 endograft occlusion) within the first 30 days. During a median follow-up of 12.5 months (range 11.5–50.9), there were no aneurysm ruptures, surgical conversions, or AAA-related deaths. The cumulative MAE rates were 3% (3/89) at 6 months and 7% (6/89) at 1 year. Two patients underwent coil embolization of type II endoleaks at 6.5 months and 2.2 years, respectively. Clinical success was 94% (84/89) at 30 days, 98% (85/87) at 6 months, and 99% (82/83) at 1 year. Conclusion: Early results suggest that properly selected AAA patients can be safely treated using the Altura Endograft System with favorable midterm outcome. Thus, further clinical investigation is warranted to evaluate the role of this device in the treatment of AAA.

Clinical efficacy of the ‘sandwich technique’ in repairing cholesteatoma with labyrinthine fistula

2022 ◽  
pp. 1-6
Author(s):  
Huanhuan Sun ◽  
Taiqin Wang ◽  
Liangwen Shi ◽  
Suling Zhuang ◽  
Jianzhi Liu
Keyword(s):  
Clinical Efficacy ◽  
Sandwich Technique ◽  
Labyrinthine Fistula

scholarly journals Comparison of Temporalis Fascia and Transcanal Composite Chondroperichondrial Tympanoplasty Techniques

2019 ◽  
pp. 014556131987566 ◽  
Author(s):  
Mustafa Sitki Gozeler ◽  
Abdulkadir Sahin
Keyword(s):  
Medical Records ◽  
Operation Time ◽  
Graft Material ◽  
Cartilage Graft ◽  
Success Rates ◽  
Temporal Muscle ◽  
Temporal Fascia ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Hearing Outcomes

The purpose of this study was to compare the success rates and hearing outcomes of transcanal composite chondroperichondrial cartilage graft with that of underlay temporal muscle fascia (TMF) graft for myringoplasty. In this retrospective study, the medical records of patients who underwent type 1 myringoplasty between September 2015 and February 2018 at Otorhinolaryngology Department of Erzurum Ataturk University were reviewed. Demographic properties, preoperative otological findings, preoperative pure ton audiogram findings, postoperative pure ton audiogram findings, and duration of surgeries were reviewed from medical records. The patients with lack of one or more of these information at medical records or lost to at least 3 months of follow-up were excluded from the study. According to the graft material used in the operation, the patients were divided into 2 groups. The patients operated with cartilage graft by transcanal composite chondropericondrial cartilage graft myringoplasty (TCM) technique was regarded as first group, while patients operated with temporal fascia was regarded as the second group (TMF). Both groups were compared according to preoperative and postoperative air–bone gap (ABG), graft acceptance rate, and duration of operation using SPSS version 20.0 software. A total of 113 patients whose medical records met the inclusion criteria were included in the study. Of these, 59 underwent TCM and 54 underwent TMF myringoplasty. Tympanic membrane perforation closure success rate was higher in the cartilage group (94.9%) than in the fascia group (83.3%; P = .046). In the former, preoperative and postoperative ABG was 19.5 ± 5 and 10.8 ± 4.8 dB, respectively. In the latter, the corresponding values were 20.7 ± 5.4 and 11.5 ± 5.4 dB, respectively ( P < .05). Duration of surgery was 29.5 ± 3.4 minutes in the TCM group and 61.5 ± 6.0 minutes in the TMF group ( P < .05). Transcanal cartilage myringoplasty could be considered as an appropriate surgical option because of its simplicity, shorter operation time, and rapid patient recovery, with no significant difference in terms of hearing outcomes compared to temporal fascia.

scholarly journals Boston type I Keratoprosthesis assisted with intraprosthetic amniotic membrane ( Amnioti KP ro sandwich technique)

2014 ◽  
Vol 93 (1) ◽  
Author(s):  
Alejandro Navas ◽  
Julio C. Hernandez‐Camarena ◽  
Juan Carlos Serna‐Ojeda ◽  
Arturo Ramirez‐Miranda ◽  
Enrique O. Graue‐Hernández
Keyword(s):  
Amniotic Membrane ◽  
Type I ◽  
Sandwich Technique ◽  
Boston Type I Keratoprosthesis

scholarly journals Evaluation of Functional Outcomes after Stapes Surgery in Patients with Clinical Otosclerosis in a Teaching Institution

2015 ◽  
Vol 20 (01) ◽  
pp. 039-042 ◽  
Author(s):  
José Souza ◽  
Ricardo Bento ◽  
Larissa Pereira ◽  
Liliane Ikari ◽  
Stephanie Souza ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Functional Outcomes ◽  
Bone Conduction ◽  
Stapes Surgery ◽  
Educational Institutions ◽  
Teaching Institution ◽  
Bilateral Surgery ◽  
Sound Amplification ◽  
Hearing Outcomes ◽  
Residual Air

Introduction Otosclerosis is a primary disease of the temporal bone that leads to stapes ankylosis. Hearing loss is the main symptom. Treatment includes surgery, medical treatment, and sound amplification therapy alone or in combination. Objective To evaluate the functional outcomes of patients with clinical diagnosis of otosclerosis undergoing primary stapes surgery in a teaching institution. Method Retrospective descriptive study. Results A total of 210 ears of 163 patients underwent stapes surgery. Of the 163 patients, 116 (71.2%) underwent unilateral surgery and 47 (28.8%) underwent bilateral surgery. Six of the 210 operated ears had obliterative otosclerosis. The average preoperative and postoperative air–bone gap was 32.06 and 4.39 dB, respectively. The mean preoperative and postoperative bone conduction threshold was 23.17 and 19.82 dB, respectively. A total of 184 (87.6%) ears had a residual air–bone gap <10 dB, and 196 (93.3%) had a residual air–bone gap ≤15 dB. Two patients (0.95%) had severe sensorineural hearing loss. Conclusion Stapes surgery showed excellent functional hearing outcomes in this study. This surgery may be performed in educational institutions with the supervision of experienced surgeons.

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