scholarly journals Use of autogenic and allogenic malleus in tympanic membrane to footplate assembly — long-term results

2009 ◽  
Vol 61 (1) ◽  
pp. 9-13 ◽  
Author(s):  
A. Mahadevaiah ◽  
Bhavin Parikh
1973 ◽  
Vol 82 (4) ◽  
pp. 538-546 ◽  
Author(s):  
D. Thane R. Cody ◽  
William F. Taylor

Long-term results after 878 tympanoplasties using five different methods of repair were analyzed. The five groups were as follows: canal skin and fascia, single fascia, double fascia, canal skin, and canal skin and homograft tympanic membrane. Ten percent of the graft failures occurred 18 months or longer after operation. The highest percentage of graft takes (88%) and satisfactory hearing improvement (socially adequate level 87%, air-bone gap closure to within 15 dB 76%) and the lowest incidence of depression in cochlear reserve (0.7%) was in the double fascia group. Overall hearing results achieved in the 878 tympanoplasties were poorer than anticipated. Differences in results in the five groups, although occasionally large, were not statistically significant. Differences in the percentage of successful graft takes in ears that had no active disease as compared with ears that had active disease and in primary operations as compared with revision operations were not statistically significant. Complications encountered were common and varied.


1997 ◽  
Vol 111 (6) ◽  
pp. 517-520 ◽  
Author(s):  
Gilead Berger ◽  
Dov Ophir ◽  
Eliezer Berco ◽  
Jacob Sadé

AbstractThis retrospective study was undertaken to review the short- and long-term results of 70 revision and 16 re-revision myringoplasty operations. Of the former, 43 cases (61.4 per cent) had initial success, six weeks following surgery. The leading causes of immediate failure (27 cases) were associated with a complete no- take of thegraft, infection with graft necrosis and poor anterior adaptation of the graft in decreasing order. Six out of the 43 patients developed late re-perforations during the follow-up period, thus reducing the success rate of revision myringoplasty to 52.8 per cent. Late re-perforations were attributed to insidious atrophy of the tympanic membrane or episodes of acute otitis media. Sixteen patients underwent re-revision myringoplasty and their success rate was 62.5 per cent. The overall success rate of revision and re-revision myringoplasty was 54.7 per cent. It has been concluded that results of revision myringoplastywere independent of patients' age, location and size of perforation and the seniority of the surgeon.


1988 ◽  
Vol 98 (2) ◽  
pp. 162-169 ◽  
Author(s):  
Jerry J. Halik ◽  
G.D.L. Smyth

Long-term results of tympanic membrane repair were analyzed in 605 patients operated upon from 1970 to 1975. By survival life table analysis, 81% closure of perforations was found at 11 years, and only 74% of patients had normally healed tympanic membranes. Children less than 10 years of age and with anterior perforations healed more poorly. A second group of patients—all with anterior perforations operated upon from 1982 to 1984—showed autologous temporalis fascia to be superior to homograft dura as the graft material. Analysis of results also showed a 60% chance of perforation closure at revision operation. These results are believed to represent an accurate and realistic assessment of tympanic membrane repair by use of survival life table analysis.


2020 ◽  
Vol VOLUME 8 (ONE) ◽  
pp. 17-23
Author(s):  
M Kashoob

Abstract Objectives: Tympanic membrane retraction pathology is a frequently encountered middle ear problem that can be a self cleansing pocket, a deep sac with hidden cholesteatoma or a potential reservoir for its future formation. In selected cases, a defect in attic and posterior superior canal wall can result after surgical removal of the diseased epithelium and/or cholesteatoma. If this occurs, reconstruction is usually attempted. Avoiding an open cavity in such conditions is currently the preferred approach. We sought to study the cartilage reconstruction outcomes of the attic and/or posterior superior canal wall defects for selected cases of retraction pathology without a need for an open mastoid cavity. We investigated the short and long term results with regards to the resorption with time, displacement or recurrence of cholesteatoma. Methods: This is a retrospective study conducted at Al Nahda Hospital in Oman between 2008 and 2014. A total 301 patients who underwent inside-out atticotomy with attic defect repair or cortical mastoidectomy with atticotomy and attic defect repair were included in the study. Staging and classication criteria for middle ear cholesteatoma proposed by the Japan Otological Society (JOS) were applied based on surgical and follow-up notes in cases with recurrent cholesteatoma. The status of the reconstructed part of the outer attic wall with respect to survival and stability of cartilage was assessed carefully at less than six months (short term) and at more than two year periods (long term) after surgery. Results: Out of 301 patients who underwent mastoid surgeries between 2008 and 2014, 72 patients met the inclusion criteria. Results of both surgical methods were then assessed. It was noted that the longer the duration after postoperative period (> 2 years), the more chance to have a recurrence of disease, displacement/ resorption of the reconstructed part or retraction/perforation of tympanic membrane (p < 0.026). Moreover, the reconstruction part of the attic and posterior superior canal wall may be resorbed with time in some cases as shown in this study (9.4%). However, the rate is low and worth considering in all the cases of attic or selected atticoantral cholesteatomas. Conclusion: Resorption and displacement of the reconstructed part of the attic and/or posterior superior canal wall was observed during the follow–up period of this study. This may have contributed to the retraction pocket reformation followed by the recurrence of cholesteatoma. It was noted to be more obvious during long duration of follow-up. Hence, we recommend a longer follow-up of at least 2 years post operatively even if the ndings are showing good results during initial visits. Although the recurrence rate of disease with the used surgical methods in this study was 16.9%, in order to compare the results of this surgical method with either canal wall up or canal wall down, future surgical methods will require a randomized trial. Key words: Cholesteatoma, mastoidectomy, reconstruction, cartilage, canal wall, atticotomy


2005 ◽  
Vol 173 (4S) ◽  
pp. 116-117
Author(s):  
Hannes Steiner ◽  
Reinhard Peschel ◽  
Tilko Müller ◽  
Christian Gozzi ◽  
Georg C. Bartsch ◽  
...  

VASA ◽  
2011 ◽  
Vol 40 (6) ◽  
pp. 474-481 ◽  
Author(s):  
Radak ◽  
Babic ◽  
Ilijevski ◽  
Jocic ◽  
Aleksic ◽  
...  

Background: To evaluate safety, short and long-term graft patency, clinical success rates, and factors associated with patency, limb salvage and mortality after surgical reconstruction in patients younger than 50 years of age who had undergone unilateral iliac artery bypass surgery. Patients and methods: From January 2000 to January 2010, 65 consecutive reconstructive vascular operations were performed in 22 women and 43 men of age < 50 years with unilateral iliac atherosclerotic lesions and claudication or chronic limb ischemia. All patients were followed at 1, 3, 6, and 12 months after surgery and every 6 months thereafter. Results: There was in-hospital vascular graft thrombosis in four (6.1 %) patients. No in-hospital deaths occurred. Median follow-up was 49.6 ± 33 months. Primary patency rates at 1-, 3-, 5-, and 10-year were 92.2 %, 85.6 %, 73.6 %, and 56.5 %, respectively. Seven patients passed away during follow-up of which four patients due to coronary artery disease, two patients due to cerebrovascular disease and one patient due to malignancy. Limb salvage rate after 1-, 3-, 5-, and 10-year follow-up was 100 %, 100 %, 96.3 %, and 91.2 %, respectively. Cox regression analysis including age, sex, risk factors for vascular disease, indication for treatment, preoperative ABI, lesion length, graft diameter and type of pre-procedural lesion (stenosis/occlusion), showed that only age (beta - 0.281, expected beta 0.755, p = 0.007) and presence of diabetes mellitus during index surgery (beta - 1.292, expected beta 0.275, p = 0.026) were found to be significant predictors of diminishing graft patency during the follow-up. Presence of diabetes mellitus during index surgery (beta - 1.246, expected beta 0.291, p = 0.034) was the only variable predicting mortality. Conclusions: Surgical treatment for unilateral iliac lesions in patients with premature atherosclerosis is a safe procedure with a low operative risk and acceptable long-term results. Diabetes mellitus and age at index surgery are predictive for low graft patency. Presence of diabetes is associated with decreased long-term survival.


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