Middle Ear Packing: Comparison Between Merogel and Gelfoam

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P102-P102
Author(s):  
Michael Julian Lipan ◽  
Alava Ibraham ◽  
Simon I Angeli ◽  
Thomas R Van De Water
Keyword(s):  
Tympanic Membrane ◽  
Middle Ear ◽  
Inflammatory Reaction ◽  
Tympanic Membrane Perforation ◽  
Mucosal Inflammation ◽  
Controlled Study ◽  
Control Group ◽  
Otologic Surgery ◽  
Membrane Perforation ◽  
Brainstem Response

Problem Gelfoam has been used for decades in otologic surgery to support grafts and prostheses despite causing fibrosis and adhesions. More biocompatible packing materials could avoid these complications. This study compares Gelfoam with an injectable esterified hyaluronic acid, Merogel, as middle ear packing material after mucosal trauma. Methods A randomized, blinded, controlled study was performed in 17 juvenile guinea pigs. Middle ear surgery with mucosal trauma was performed and middle ears were packed with Merogel or Gelfoam; unpacked contralateral ears were used as controls. Auditory brainstem response (ABR) thresholds were measured in 4 frequencies pre-operatively, and repeated at 1, 2, and 6 weeks postoperatively. Gross analysis measured inflammatory reaction in each group. Statistical analysis was performed using ANOVA followed by post-hoc analysis for ABR thresholds and packing remaining at 6 weeks. Non-prametric tests were used for presence of mucosal inflammation, effusion and tympanic membrane perforation. Results ABR threshold changes from baseline were minor and comparable between the Merogel group and the control group. Threshold change was higher in the Gelfoam group. This difference was seen in each frequency tested at each time interval (all p<0.05). Gross analysis showed 1) Mucosal inflammation higher in the Gelfoam group (p<0.05), 2) Effusions were higher in the Gelfoam group but the difference was not significant (p=0.07), 3) Tympanic membrane perforation was equally rare between groups (p>0.05), 4) Unabsorbed packing was higher in the Gelfoam group (p<0.05); little Merogel was detectable at time of sacrifice. Conclusion Middle ear healing after surgery occurred similarly in the control group and the Merogel group. In contrast, the Gelfoam group demonstrated greater perturbation of hearing and a greater inflammatory reaction. Significance These results support Merogel as an alternative to Gelfoam in middle ear packing after otologic surgery. Support Research grant from Medtronic ENT.

scholarly journals Recovery from tympanic membrane perforation: Effects on membrane thickness, auditory thresholds, and middle ear transmission

2019 ◽  
Vol 384 ◽  
pp. 107813 ◽  
Author(s):  
Lingling Cai ◽  
Glenna Stomackin ◽  
Nicholas M. Perez ◽  
Xiaohui Lin ◽  
Timothy T. Jung ◽  
...  
Keyword(s):  
Tympanic Membrane ◽  
Middle Ear ◽  
Tympanic Membrane Perforation ◽  
Membrane Thickness ◽  
Auditory Thresholds ◽  
Membrane Perforation

Common drugs used in ENT

2009 ◽  
pp. 347-350
Author(s):  
Rogan Corbridge ◽  
Nicholas Steventon
Keyword(s):  
Inner Ear ◽  
Tympanic Membrane ◽  
Middle Ear ◽  
Otitis Externa ◽  
Round Window ◽  
Acid Reflux ◽  
Tympanic Membrane Perforation ◽  
Active Infection ◽  
Middle Ear Mucosa ◽  
Membrane Perforation

Drugs used in the ear 348 Drugs used in the nose 349 Drugs used in the treatment of acid reflux 350 This group of drugs is widely used for the treatment of otitis externa. Otitis externa 2 drops tds for 10 days Presence of grommet or tympanic membrane perforation due to aminoglycoside ototoxicity in the inner ear. Risk thought to be low in the presence of active infection where the middle-ear mucosa is swollen and the antibiotic is unlikely to reach the inner ear via the round window...

scholarly journals Correlation of Site and Size of Tympanic Membrane Perforation and Middle Ear Air Space Volume with Magnitude of Hearing Loss

2019 ◽  
Vol 02 (01) ◽  
pp. 10-15
Author(s):  
Ramandeep Singh Virk ◽  
Krishan Kudawla ◽  
Sandeep Bansal ◽  
Ramya Rathod ◽  
Samarendra Behera
Keyword(s):  
Hearing Loss ◽  
Tympanic Membrane ◽  
Middle Ear ◽  
Tympanic Membrane Perforation ◽  
Tympanic Membrane Perforations ◽  
Air Space ◽  
Membrane Perforation ◽  
Volume Group ◽  
Space Volume ◽  
Lower Frequencies

Abstract Introduction The effects of tympanic membrane perforations on middle ear sound transmission are not well characterized, largely because ears with perforations typically have additional pathological changes. It has been established that the larger the perforation, the greater is the hearing loss (HL). Aim This study aimed to correlate the location and size of tympanic membrane perforation and middle ear air space volume with the magnitude of HL in patients with tubotympanic or inactive mucosal type of chronic otitis media (COM). Materials and Methods A prospective clinical study of patients with tympanic membrane perforations due to COM and without any other ear disease and who attended the Otolaryngology services at our institute between July 2010 and December 2011 was conducted. A total of 300 ears were evaluated by performing otoendoscopy, followed by photo documentation and audiological investigations (pure-tone audiometry and tympanometry). Tympanic membrane perforations were categorized based on their size and location, and the mean air-bone (AB) gap between the various types of perforations was compared and statistically analyzed with significance level of p < 0.05. Results Out of 300 ears, maximum number of ears (n = 124, 41.3%) had large-sized perforations (> 30 mm2) that had a maximum mean AB gap of 26.43 dB, and minimum number of ears (n = 60, 20%) had small-sized perforations (0–9 mm2) that had minimum mean AB gap of 9.12 dB. The remaining were medium-sized perforations that had mean AB gap of 16.13 dB. Depending on the location, maximum were central perforations (n = 198, 66%) and minimum were anterosuperior (AS) perforations (n = 9, 3%). Based on the middle ear volume on tympanometry, maximum ears were of low-volume group (n = 246, 92%) that had larger mean AB gap of 19.96 dB HL when compared with the high-volume group (n = 24, 8%) with 11.80 dB HL. AB gap was maximum at lower frequencies and decreased with increase in frequencies except at 4,000 Hz, that is, 56.9 dB HL at 250 Hz, 42.6 at 500 Hz, 41.5 at 1,000 Hz, 32.4 at 2,000 Hz, and 49.5 at 4,000 Hz. Conclusion HL increases as the area of tympanic membrane perforation increases. There is an inverse relationship between HL and middle ear air space volume. Comparing the small-sized perforations at different sites with the middle ear volume being low, it was found that posterosuperior (PS) perforations had 4 to 7 dB greater HL than AS and anteroinferior (AI). However, the relationship was statistically insignificant. The phase cancellation effect of round window causing greater HL in posteroinferior (PI) perforations does not exist in small- and medium-sized perforations. HL is greater at lower frequencies and less at higher frequencies.

Ototoxicity after use of neomycin eardrops is unrelated to A1555G point mutation in mitochondrial DNA

2004 ◽  
Vol 118 (7) ◽  
pp. 546-550 ◽  
Author(s):  
Tatsuya Yamasoba ◽  
Katsunori Tsukuda
Keyword(s):  
Mitochondrial Dna ◽  
Tympanic Membrane ◽  
Point Mutation ◽  
Middle Ear ◽  
Dna Analysis ◽  
Tympanic Membrane Perforation ◽  
Mitochondrial Dna Analysis ◽  
Membrane Perforation ◽  
Inner Ear Damage ◽  
Ear Drops

Ear drops containing neomycin only rarely cause ototoxicity. The authors report on three patients with a tympanic membrane perforation who developed severe ototoxicity after use of eardrops containing 0.35 per cent neomycin. Mitochondrial DNA analysis revealed that there was no A1555G point mutation in these patients. This finding indicates that application of low concentration neomycin to the middle ear can cause severe inner ear damage even in humans who are not hyper-susceptible to aminoglycosides.

scholarly journals A Correlative Study Between Size of Tympanic Membrane Perforation, Pure Tone Audiometry and Intraoperative Findings in Tympanoplasty

2018 ◽  
Vol 26 (1) ◽  
pp. 43-47
Author(s):  
Santosh U P ◽  
Sridurga J ◽  
Aravind D R
Keyword(s):  
Hearing Loss ◽  
Tympanic Membrane ◽  
Otitis Media ◽  
Middle Ear ◽  
Pure Tone ◽  
Chronic Otitis Media ◽  
Pure Tone Audiometry ◽  
Tympanic Membrane Perforation ◽  
Membrane Perforation ◽  
Operative Findings

Introduction             Chronic otitis media (COM) is a most common and prevalent disease of the middle ear. COM has been defined as a longstanding inflammatory condition of middle ear and mastoid, associated with perforation of the tympanic membrane. Tympanoplasties are common surgeries performed for chronic otitis media in inactive mucosal type. Any otological surgery may involve a menace/ hazard of hearing loss post operatively.             In this study, an attempt was made to correlate, size of tympanic membrane perforation, pure tone audiometry and intra-operative findings in tympanoplasties, results were analysed and conclusion drawn. Materials and Methods Forty patients attending ENT OPD with chronic otitis media (COM), inactive mucosal type, with conductive hearing loss undergoing tympanoplasties who were willing to participate in the study were selected.  Ear was examined pre-operatively to assess the size of perforation and then, pure tone audiometry (PTA) was done to assess the type of hearing loss and its severity. During tympanoplasty, middle ear was inspected for ossicular status and any other pathology was noted. Later, the size of tympanic membrane perforation, pure tone audiometry and intra operative findings were correlated with each other and analysed. Result  In small and medium sized perforation, PTA and intraoperative findings correlated with each other. Whereas, in large and subtotal perforation, there was no correlation. Conclusion             In small and medium sized perforation, middle ear inspection may not be necessary. Whereas, in large and subtotal perforation it is necessary. 

Otologic Manifestations of Wegener's Granulomatosis

1980 ◽  
Vol 88 (5) ◽  
pp. 586-593 ◽  
Author(s):  
Thomas V. McCaffrey ◽  
Thomas J. McDonald ◽  
George W. Facer ◽  
Richard A. DeRemee
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Tympanic Membrane ◽  
Middle Ear ◽  
Wegener’S Granulomatosis ◽  
Wegener's Granulomatosis ◽  
Tympanic Membrane Perforation ◽  
Sensorineural Hearing ◽  
Suppurative Otitis Media ◽  
Membrane Perforation

Review of 112 patients with Wegener's granulomatosis showed that 21 (19%) had ear involvement. Conductive deafness, which was present in all 21 patients, was due to serous middle ear fluid, suppurative otitis media with thickening of the tympanic membrane, perforation of the tympanic membrane, or granulation tissue in the middle ear space. Nine patients also had sensorineural hearing loss. Sensorineural hearing loss was improved in five of the nine patients after control of the disease with prednisone and cyclophosphamide.

Platelet-rich plasma improves healing of tympanic membrane perforations: experimental study

2008 ◽  
Vol 123 (5) ◽  
pp. 482-487 ◽  
Author(s):  
E Erkilet ◽  
M Koyuncu ◽  
S Atmaca ◽  
M Yarim
Keyword(s):  
Tympanic Membrane ◽  
Histopathological Examination ◽  
Platelet Rich Plasma ◽  
Healing Time ◽  
Tympanic Membrane Perforation ◽  
Control Group ◽  
Tympanic Membrane Perforations ◽  
Significant Difference ◽  
Membrane Perforation ◽  
Tympanic Membranes

AbstractObjective:The aim of this study was to investigate the effect of local application of platelet-rich plasma to perforated rat tympanic membranes, in terms of healing time and histopathological outcome.Methods:Eighty-eight tympanic membranes of 44 rats were given a standard 3 mm perforation, and platelet-rich plasma was applied to the right tympanic membrane perforations. The left tympanic membranes were left to heal spontaneously, as controls. The 44 rats were divided into two groups. In group one, comprising 20 rats, daily otomicroscopic examination of the tympanic membrane perforations was performed. The 24 rats in group two were subdivided into four subgroups of six rats each; these subgroups were sacrificed sequentially on days three, seven, 14 and 28 for histopathological examination, regardless of tympanic membrane healing stage.Results:In group one, the mean tympanic membrane healing times for tympanic membrane perforations receiving platelet-rich plasma and controls were respectively 10.2 ± 2.1 and 13.0 ± 2.9 days (mean ± standard deviation). This difference was statistically significant (p < 0.001). In group two, histopathological evaluation of tympanic membrane perforation healing at days three, seven, 14 and 28 did not reveal any statistically significant difference, individually or within the four groups as a whole.Conclusion:These findings suggest that earlier healing of tympanic membrane perforations occurred in the platelet-rich plasma group compared with the control group. These findings suggest that platelet-rich plasma is effective in accelerating tympanic membrane perforation healing, and that it may be effective in human subjects, particularly as it is an autologous material.

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