Titanium ossicular chain reconstruction in single stage canal wall down tympanoplasty for chronic otitis media with mucosa defect

2019 ◽  
Vol 40 (2) ◽  
pp. 205-208 ◽  
Author(s):  
Feng-Ming Gu ◽  
Fang-Lu Chi
Keyword(s):  
Otitis Media ◽  
Chronic Otitis Media ◽  
Ossicular Chain ◽  
Single Stage ◽  
Canal Wall ◽  
Ossicular Chain Reconstruction ◽  
Canal Wall Down

scholarly journals Comparison of Various Graft Materials in the Reconstruction of Ossicular Chain in Patients with Chronic Otitis Media: A Prospective Hospital Based Study

2017 ◽  
Vol 25 (3) ◽  
pp. 136-141
Author(s):  
Niaz Fakhruddin ◽  
Chethan Kumar Gangaiah ◽  
Gopakumar KP ◽  
Geogin George Thottan ◽  
Mon Noufal
Keyword(s):  
Otitis Media ◽  
Chronic Otitis Media ◽  
Ossicular Chain ◽  
Canal Wall ◽  
Exclusion Criteria ◽  
Hearing Results ◽  
The Status ◽  
Ossicular Chain Reconstruction ◽  
Study Population ◽  
Canal Wall Down

Introduction Ossicular chain reconstruction is the surgical procedure used to correct the hearing problems in patients with chronic otitis media (COM). In this era, where a large variety of innovative artificial prosthetic materials are being used to replace and reconstruct the ossicular chain, autografts still play a significant role. Materials and Methods The present study included 40 patients. Study population was selected based on inclusion and exclusion criteria. The ossicular reconstructive procedure was done under anesthesia and according to the status of the ossicular chain. Temporalis fascia was used to close the perforation. Mainly two procedures were performed: one is intact canal wall and the other is canal wall down.  Results Most of the study population was middle aged and males were more compared to females. Thirty five patients had air bone gap above 30dB. In 38 patients, the incus had undergone necrosis. Most of the patients underwent short columella reconstruction. A closure of air bone gap with in 20 dB was achieved in 72.2% in patients with malleus stapes assembly. In short columella 22.2% of patients had closure of air bone gap within 20 dB. Incus remnant grafts gave better hearing gain. Discussion The published literature on the result of use of sculptured ossicle and cartilage in tympanoplasty have been reviewed Conclusion In the present study, cases with COM showed good hearing results patients implanted with autogenous cartilage and bone.

Single Stage Management of Cholesteatoma

1995 ◽  
Vol 112 (5) ◽  
pp. P26-P26
Author(s):  
Donald B. Kamerer ◽  
Barry E. Hirsch
Keyword(s):  
Otitis Media ◽  
Chronic Otitis Media ◽  
Operative Management ◽  
Single Stage ◽  
Stage Management ◽  
Canal Wall ◽  
Educational Objectives ◽  
Posterior Canal ◽  
Canal Wall Down ◽  
Methods Of Reconstruction

Educational objectives: To understand the alternatives for operative management of chronic otitis media with cholesteatoma and to know the indications and advantages of canal wall-down procedures along with methods of reconstruction of the posterior canal wall.

scholarly journals Relation between Ossicular Erosion and Destruction of Facial and Lateral Semicircular Canals in Chronic Otitis Media

2016 ◽  
Vol 21 (03) ◽  
pp. 239-242 ◽  
Author(s):  
Suphi Bulğurcu ◽  
İlker Arslan ◽  
Bünyamin Dikilitaş ◽  
İbrahim Çukurova
Keyword(s):  
Facial Nerve ◽  
Otitis Media ◽  
Chronic Otitis Media ◽  
Semicircular Canals ◽  
Ossicular Chain ◽  
Facial Canal ◽  
Canal Wall ◽  
Radical Mastoidectomy ◽  
Canal Wall Down ◽  
Canal Wall Up

Introduction Chronic otitis media can cause multiple middle ear pathogeneses. The surgeon should be aware of relation between ossicular chain erosion and other destructions because of the possibility of complications. Objective This study aimed to investigate the rates of ossicular erosion in cases of patients with and without facial nerve canal destruction, who had undergone mastoidectomy due to chronic otitis media with or without cholesteatoma. Methods We retrospectively analyzed three hundred twenty-seven patients who had undergone tympanomastoidectomy between April 2008 and February 2014. We documented the types of mastoidectomy (canal wall up, canal wall down, and radical mastoidectomy), erosion of the malleus, incus and stapes, and the destruction of facial and lateral semi-circular canal. Results Out of the 327 patients, 147 were women (44.95%) and 180 were men (55.04%) with a mean age 50.8 ± 13 years (range 8–72 years). 245 of the 327 patients (75.22%) had been operated with the diagnosis of chronic otitis media with cholesteatoma. FNCD was present in 62 of the 327 patients (18.96%) and 49 of these 62 (79.03%) patients had chronic otitis media with cholesteatoma. The correlation between the presence of FNCD with LSCC destruction and stapes erosion in chronic otitis media with cholesteatoma is statistically significant (p < 0.05). Conclusion Although incus is the most common of destructed ossicles in chronic otitis media, facial canal destruction is more closely related to stapes erosion.

Revision Surgery for Chronic Otitis Media: A Learning Experience

1998 ◽  
Vol 107 (6) ◽  
pp. 486-491 ◽  
Author(s):  
Jan E. Veldman ◽  
W. Weibel Braunius
Keyword(s):  
Otitis Media ◽  
Revision Surgery ◽  
Learning Experience ◽  
Chronic Otitis Media ◽  
Canal Wall ◽  
Long Term Follow Up ◽  
Surgical History ◽  
History Of ◽  
Canal Wall Down ◽  
Residual Air

The objective of this study was to evaluate, during a long-term follow-up period, the results of revision surgery for chronic otitis media with or without cholesteatoma. Intact canal wall and canal wall down procedures were performed. The surgical history of every patient was assessed before the operation. A dry, relatively safe, and disease-free ear was created in 90% of the reoperated ears (N = 389). The recurrence rate of cholesteatoma was 5% for the total group. Reperforations of the tympanic membrane occurred in 10%, and persistent or recurrent otorrhea was present in 10% of cases. The functional hearing results were quite satisfactory. A residual air-bone gap of ≤30 dB was reached in 70.3% of the cases after revision tympanoplasty only (N = 41). Revision mastoidectomy with revision tympanoplasty as a one-stage procedure led subsequently, in 76% of intact canal wall procedures (N = 113) and 55% of canal wall down procedures (N = 98), to a residual air-bone gap of ≤30 dB.

Long-term outcome of ossiculoplasty using autogenous mastoid cortical bone

2014 ◽  
Vol 128 (10) ◽  
pp. 866-870 ◽  
Author(s):  
Z Yu ◽  
L Zhang ◽  
D Han
Keyword(s):  
Cortical Bone ◽  
Otitis Media ◽  
Chronic Otitis Media ◽  
Prosthetic Material ◽  
Canal Wall ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Canal Wall Down ◽  
Canal Wall Up

AbstractObjective:To observe the long-term outcome of ossiculoplasty using autogenous mastoid cortical bone in chronic otitis media in-patients.Methods:Sixty-one ears of 57 in-patients with chronic otitis media, with or without cholesteatoma, underwent type III tympanoplasty using autogenous mastoid cortical bone as the prosthetic material. Twenty-one ears were treated by canal wall down mastoidectomy and 40 ears by canal wall up mastoidectomy. The follow-up period was 3 to 6 years (average 4.2 years). Pure tone averages for thresholds at 0.5, 1, 2 and 3 kHz were calculated using standard conventional audiometry.Results:The pre-operative mean air–bone gap of 31.6 dB, for all ears, was reduced to 20.3 dB post-operatively. For the 40 canal wall up ears, this value decreased from 30.8 dB to 19.9 dB, and for the 21 canal wall down ears it decreased from 33.0 dB to 21.0 dB. The differences between the pre- and post-operative mean air–bone gap values were significant.Conclusion:No cases of extrusion, necrosis or resorption were exhibited for the autogenous mastoid cortical bone prosthesis. A significant hearing improvement was obtained in the majority of cases and this remained stable over time.

scholarly journals Surgical Outcomes of Revision Operation for Non-Cholesteatomatous Chronic Otitis Media

2021 ◽  
Vol 64 (5) ◽  
pp. 304-309
Author(s):  
Juho Han ◽  
Jisoo Lee ◽  
Sung Kwang Hong ◽  
Hyo Jeong Lee ◽  
Hyung-Jong Kim
Keyword(s):  
Otitis Media ◽  
Surgical Outcomes ◽  
Chronic Otitis Media ◽  
Surgical Approaches ◽  
Middle Ear Surgery ◽  
Canal Wall ◽  
Revision Operation ◽  
Canal Wall Down ◽  
Canal Wall Down Mastoidectomy ◽  
Better Than

Background and Objectives The aim of this study was to investigate the surgical outcomes of revision operation due to recurrence of non-cholesteatomatous chronic otitis media (COM) surgery cases.Subjects and Method From 1989 to 2018, 5197 cases of COM surgery were performed at Kangdong and Hallym University Sacred Heart Hospital. Among them, clinical data of 297 subjects who had undergone revision tympanoplasty and/or mastoidectomy for recurrent noncholesteatomatous COM were retrospectively collected from computerized database of middle ear surgery (Korean Otological Society program 2005). Each case was categorized by surgical approaches into canal wall down mastoidectomy (CWDM), canal wall up mastoidectomy (CWUM), or tympanoplasty only groups.Results Tympanoplasty only was performed in 170 cases, CWDM in 74 cases, and CMUM in 53 cases. Postoperative perforation occurred in 9.4% of total cases, and less frequently in CMDM compared with tympanoplasty only (<i>p</i>=0.023), and CMUM (<i>p</i>=0.049), respectively, whereas no differences between tympanoplasty only and CMUM (<i>p</i>=0.930) were found. Postoperative infection rate was 1.0% and did not show any differences among the groups. Postoperative successful hearing was obtained in 66.7% of total cases, and the success rate of tympanoplasty only was better than that of CMDM (<i>p</i>=0.001), and CMUM (<i>p</i>=0.011). And, that of CMUM was better than that of CMDM (<i>p</i>=0.011).Conclusion The results showed that postoperative perforation occurred less frequently in CMDM than in tympanoplasty only and in CWUM; successful hearing was achieved more frequently in tympanoplasty alone than in the other surgical approaches in recurrent non-cholesteatomatous COM.

Development and Validation of a Prognostic Model to Predict Hearing Recovery for Patients With Chronic Otitis Media

2021 ◽  
pp. 014556132110655
Author(s):  
Fengyang Xie ◽  
Xiaoyue Zhen ◽  
Haiyuan Zhu ◽  
Yan Kou ◽  
Changle Li ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Otitis Media ◽  
Validation Cohort ◽  
Area Under The Curve ◽  
Chronic Otitis Media ◽  
Ossicular Chain ◽  
Multivariable Logistic Regression Analysis ◽  
Canal Wall ◽  
Multivariable Logistic Regression ◽  
Hearing Recovery

Objective To explore the factors affecting postoperative hearing recovery in chronic otitis media (COM) patients, establish a clinical prediction model for hearing recovery, and verify the accuracy of the model. Methods Data of patients with COM who were admitted to our hospital between January 1, 2012 and September 30, 2020 were retrospectively analyzed. We collected data on relevant clinicopathological characteristics of patients. The patients were randomly divided into the development cohort and validation cohorts. A postoperative air-bone gap (ABG) ≤20 dB was defined as successful hearing recovery. Univariate and multivariable logistic regression analyses were used to investigate the association of several prognostic factors with hearing recovery. These factors were then used to establish a nomogram. The model was subjected to bootstrap internal validation and performance evaluation in terms of discrimination, calibration, and clinical validity. Results This study included 2146 patients with COM: the development cohort comprised 1610 patients (mean [standard deviation; SD] age, 44.1 [14.7] years; 733 men [45.5%]) and the validation cohort included 536 patients (mean [SD] age, 42.9 [14.4] years; 234 men [43.7%]). Multivariable logistic regression analysis showed that age, duration of onset, styles of surgery (tympanoplasty, canal wall up-CWU, or canal wall down-CWD), ossicular prosthesis, granulation or calcified blocks around the ossicular chain, ossicular chain integrity, duration of drilling, eustachian tube dysfunction, mixed hearing loss, semicircular canal fistula, and second surgery were associated with hearing recovery. A nomogram based on these variables was constructed. The area under the curve was 0.797 (95% confidence interval [CI], 0.778–0.812) in the development cohort and 0.798 (95% CI, 0.7605–0.8355) in the validation cohort. Conclusions This study demonstrated the various clinical factors correlated with hearing recovery in patients with COM. The nomogram developed with these data could provide personalized risk estimates of hearing recovery to enhance preoperative counseling and help to set realistic expectations in patients.

Revision surgery for chronic otitis media: recurrent-residual disease and hearing

2002 ◽  
Vol 116 (12) ◽  
pp. 996-1000 ◽  
Author(s):  
Stephen O’Leary ◽  
Jan E. Veldman
Keyword(s):  
Retrospective Analysis ◽  
Otitis Media ◽  
Surgical Approach ◽  
Revision Surgery ◽  
Residual Disease ◽  
Chronic Otitis Media ◽  
Canal Wall ◽  
Persistent Disease ◽  
Canal Wall Down

The aim of this study was to determine the effect of surgical approach, intact canal wall (ICW) or canal wall down (CWD), upon the success of revision surgery for chronicotitis media (COM). A retrospective analysis of 367 patients (including 65 children aged <15years) who underwent revision tympanoplasty because of persistent disease was performed. Single-staged tympanoplasty was performed, preserving the canal wall when present. Hearing was reconstructed with allograft incus. Follow-up ranged from one to 15 years. Hearing was determined by pre- and post-operative air-bone gaps.Post-operative re-perforation, aural discharge and/or cholesteatoma rates were similar for CWD and ICW. Cholesteatoma could present following the revision, even though it was not apparentat surgery. Following tympanoplasty, the final hearing was not significantly affected by the surgical approach or presence of cholesteatoma. Improvement in hearing was adversely affected by cholesteatoma or an absent stapes suprastructure.Revision ICW and CWD operations were both successful in controlling signs of COM. Cholesteatoma is a peripheral risk in COM and may become apparent after revision surgery.

scholarly journals Management of labyrinthine fistula using Surdille flap

2017 ◽  
Vol 4 (1) ◽  
pp. 32
Author(s):  
Rashmi P. Rajashekhar ◽  
Vinod V. Shinde
Keyword(s):  
Otitis Media ◽  
Chronic Otitis Media ◽  
Semicircular Canals ◽  
Canal Wall ◽  
Endochondral Bone ◽  
Labyrinthine Fistula ◽  
Modified Radical Mastoidectomy ◽  
Canal Wall Down ◽  
Vestibular Symptoms ◽  
Postoperative Vertigo

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Labyrinthine fistula (LF) is the most common intra-temporal complication of squamosal chronic otitis media represents an erosive loss of endochondral bone overlying the semicircular canals without loss of perilymph. Main treatment of LF is surgical. The aim of our study is to discuss its incidence and sex ratio. The main objective is to describe the audio-vestibular results after closure of labyrinthine fistula by our technique using surdille flap. </span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">234 patients with squamosal chronic otitis media presented to our institution in a period of 24 months. Out of 234 patients, 22 patients were having labyrinthine fistula. Eleven patients had fistula test positive. Rest eleven patients were found to have LF intra-operatively. All patients underwent canal wall down modified radical mastoidectomy (MRM). Treatment of LF was done surgically by using surdille flap in all the cases. Post operatively Audio-vestibular results of labyrinthine fistula surgery by our technique were studied.  </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">The results show that the cholesteatoma matrix can be removed from the fistula. Removal of the fistula generally improves the vestibular symptoms. In all patients canal wall down procedure was done with surdille flap seal over LF. In our study, incidence of LF was 9.40% and none of the patients ended up with postoperative deafness. Hearing improved in 36.40% patients whereas it remained unchanged in rest of the cases. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Labyrinthine fistula, very commonly seen in the lateral semicircular canal has incidence of 5-10% reported in many studies. We demonstrated that open technique with removal of matrix and sealing with three layers may be a valuable choice for the surgical treatment of LF with little risk for cochlea-vestibular functions. Advantage of using surdille flap (sealing the fistula with three layers) is that it decreases the possibility of postoperative vertigo.</span></p>

scholarly journals TO EVALUATE THE HEARING RESULTS FOLLOWING OSSICULAR RECONSTRUCTION IN PATIENT WITH CHRONIC SUPPURATIVE OTTITIS MEDIA.

2019 ◽  
Vol 3 (4) ◽  
Author(s):  
Arjun Nath Yogee ◽  
Navneet Mathur
Keyword(s):  
Otitis Media ◽  
Chronic Infection ◽  
Chronic Otitis Media ◽  
Canal Wall ◽  
Hearing Results ◽  
Ossicular Reconstruction ◽  
Ear Ossicles ◽  
Life Threatening ◽  
Canal Wall Down ◽  
A Prospective Study

Background: Chronic otitis media erodes the bone, destroys the ossicles and has the potential to cause life threatening complications. Methods: This is a prospective study involving patients with chronic otitis media. 120 patients were included and all of them are subjected to ossicular reconstruction either by canal wall down or intact canal wall surgery. Results: As per Wehr's classification 80% of patients in Group 1A have got improvement and 20% have failed to gat improved in A-B gap, in Group 1B 20% -have failed to get improved in A-B gap and in Group 1C, 30% have failed to get improved in A-B gap. 70% of patients in Group 2A have got improvement and 30% have failed to gat improved in A-B gap, in Group 2B 80% of patients have got improvement and 20% -have failed to get improved in A-B gap and in Group 2C 70% of patients have got improvement and 30% have failed to get improved in A-B gap. Conclusion: All the three modalities gave statistically significant improvement (p < 0.001) in A-B gap leading to improvement in hearing but among the three groups there was no statistically significant (p > 0.05) difference found in improvement of A-B gap. Keywords: Chronic Infection, Middle Ear, Ossicles.

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