Myringoplasty for the anterior perforation: experience with the Kerr flap

1992 ◽  
Vol 106 (1) ◽  
pp. 14-16 ◽  
Author(s):  
J. F. Sharp ◽  
T. F. Terzis ◽  
J. Robinson
Keyword(s):  
Tympanic Membrane ◽  
Graft Failure ◽  
Tympanic Membrane Perforation ◽  
Confidence Limits ◽  
Closure Rate ◽  
Surgical Closure ◽  
Membrane Perforation ◽  
Anterior Support ◽  
Threshold Gain ◽  
Anterior Perforation

AbstractSurgical closure of the anteriorly located tympanic membrane perforation can present a problem. The lack of anterior support for the graft frequently leads to graft failure if an underlay method is used whereas anterior blunting is a complication of onlay techniques in this situation. The experience with the Kerr flap, an underlay graft fashioned to include a tab of fascia which is placed laterally under the annulus and the anterior meatal skin, is presented. This method gave a 97.5 per cent closure rate with no cases of anterior marginal blunting and a mean auditory threshold gain of 8.5 dB (95 per cent confidence limits 5 to 11.9 dB, P<O.O1) was achieved at the frequencies tested. The use of the Kerr flap is recommended when repairing the anteriorly placed tympanic membrane perforation

scholarly journals Various techniques of grafting in anterior perforation of tympanic membrane: our experience

2017 ◽  
Vol 4 (1) ◽  
pp. 103
Author(s):  
Preeti S. Raga ◽  
Amrith Laal Waghre
Keyword(s):  
Tympanic Membrane ◽  
Age Groups ◽  
Tympanic Membrane Perforation ◽  
Medical Sciences ◽  
Surgical Experience ◽  
Closure Rate ◽  
Tympanic Membrane Perforations ◽  
Membrane Perforation ◽  
Anterior Support ◽  
Anterior Perforation

<p class="abstract"><strong>Background:</strong> <span lang="EN-GB">The lack of anterior support for the graft frequently leads to graft failure if an underlay method is used whereas anterior blunting is a complication of overlay techniques in the anteriorly located tympanic membrane perforations</span><span lang="EN-IN">. The objective of the study was </span><span lang="EN-GB">to evaluate the correct surgical technique for the reconstruction of anterior tympanic membrane perforation.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-GB">Our prospective study was conducted from January 2011 to December 2013. This study included 39 patients of either sex, 17-56 years of age groups, at Kamineni Institute of Medical Sciences Narketpally, Nalgonda district, Telangana state. Our surgical experience with a) Simplified underlay technique-in small perforations having healthy remnant in10 patients. b) Button hole and slitting the graft- in thin atrophic ring anteriorly in 25 patients. c) Gerlach’ quilting procedure- in inadequate anterior rim in 3 patients and d) Kerr flap-in only anterior rim annulus in 1 patient</span><span lang="EN-IN">.  </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-GB">All these methods gave 91.96% closure rate, a mean auditory threshold gain of 8.5 dB was achieved at the frequencies tested</span><span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-GB">Here we describe and promote the various techniques of placing grafts in anterior perforations of tympanic membrane, thereby attaining the aforementioned benefits and reducing the incidence of complications</span><span lang="EN-IN">.</span></p>

Fat graft myringoplasty in children – a safe and successful day-stay procedure

1997 ◽  
Vol 111 (2) ◽  
pp. 106-108 ◽  
Author(s):  
R. B. Mitchell ◽  
Kevin D. Pereira ◽  
Rande H. Lazar
Keyword(s):  
Tympanic Membrane ◽  
Otitis Media With Effusion ◽  
Tympanic Membrane Perforation ◽  
Successful Outcome ◽  
Fat Graft ◽  
Graft Material ◽  
Surgical Closure ◽  
Tympanic Membrane Perforations ◽  
Membrane Perforation ◽  
Ventilation Tubes

AbstractThe surgical closure of dry tympanic membrane perforations in children remains a controversial issue due to conflicting opinions on the appropriate technique, graft material and success rate. We present a review of 342 children who underwent fat graft myringoplasty as a day-stay procedure over a six-year period. Successful closure of the tympanic membrane perforation was achieved in 92 per cent of ears. Subsequent recurrent otitis media with effusion required insertion of ventilation tubes in 12 per cent. No relationship was observed between the age of the child and a successful outcome. We conclude that day-stay fat graft myringoplasty is a safe and successful procedure which results in a dry and safe ear in the majority of children.

scholarly journals Inferior Flap Tympanoplasty: A Novel Technique for Anterior Perforation Closure

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Haim Gavriel ◽  
Ephraim Eviatar
Keyword(s):  
Tympanic Membrane ◽  
Anterior Part ◽  
Tympanic Membrane Perforation ◽  
The Novel ◽  
Posterior Flap ◽  
Membrane Perforation ◽  
The Mean ◽  
Contralateral Ear ◽  
A Prospective Study ◽  
Anterior Perforation

Objective. To report a novel tympanoplasty modification for anterior tympanic membrane perforation closure.Materials and Methods. A prospective study on 13 patients who underwent inferior tympanoplasty between December 2008 and May 2011 was carried out. In our technique, an inferior rather than a posterior flap is raised and the graft is laid from the inferior direction to obtain better access to the anterior part of the tympanic membrane perforation and provide better support.Results. A total of 13 patients underwent the novel inferior tympanoplasty technique with a mean age of 33 years. Six patients had undergone tympanoplasties and/or mastoidectomies in the past, 3 in the contralateral ear. A marginal perforation was observed in 3 cases, total perforation in 2 and subtotal in 1 case. The mean preoperative pure-tone average was 40.4 dB (10 to 90 dB), compared to 26.5 dB (10 to 55 dB) postoperatively. All perforations were found to be closed but one (92.3% success rate).Conclusions. The inferior tympanoplasty technique provides a favorable outcome in terms of tympanic membrane closure and hearing improvement for anterior perforations, even in difficult and complex cases. It is based on a well-known technique and is easy to implement.

scholarly journals Randomized Clinical Trial Comparing Bucket Handle and Cartilage Tympanoplasty Techniques for the Reconstruction of Subtotal or Anterior Tympanic Membrane Perforation

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Alimohamad Asghari ◽  
Mohammad Mohseni ◽  
Ahmad Daneshi ◽  
Yasser Nasoori ◽  
Sara Rostami ◽  
...  
Keyword(s):  
Tympanic Membrane ◽  
Chronic Otitis Media ◽  
Tympanic Membrane Perforation ◽  
Case Group ◽  
Cartilage Tympanoplasty ◽  
Membrane Perforation ◽  
Registration Number ◽  
Bucket Handle ◽  
And Cartilage ◽  
Anterior Perforation

Objective. The purpose of the study is to compare the clinical outcome of the two techniques of Bucket Handle Tympanoplasty and Cartilage Tympanoplasty in achieving success in graft survival as well as acceptable auditory results. 60 patients who suffered chronic otitis media with anterior perforation of the tympanic membrane were chosen. The patients were randomly assigned using Block Randomization Method of two groups including patients who underwent Bucket Handle Tympanoplasty (n=30) or those that underwent Cartilage Tympanoplasty (n=30). The patients were followed up for 1, 3, 6, and 12 months postoperatively. Results. The mean PTA was lower in Bucket Handle Tympanoplasty group as case group compared to Cartilage Tympanoplasty group as the control (P=0.023). No significant statistical differences had identified passing through the time, in terms of PTA outcome (P Value = 0.547) and SRT outcome (P Value = 0.352), between Bucket Handle Tympanoplasty group and the Cartilage Tympanoplasty group. In total, postoperative tympanic membrane perforation was found in 10.0% of patients in Cartilage Tympanoplasty group and 13.3% in Bucket Handle Tympanoplasty group with no difference (P=0.500). Conclusions. Hearing improvements in both methods were similar. Registration Number. The trial is registered with IRCT2016022626773N1.

scholarly journals Comparison of Tympanic Membrane Perforation With and Without Calcification of Anterior Mallear Ligament Under Transcanal Endoscopic Type I Tympanoplasty

2021 ◽  
pp. 014556132110100
Author(s):  
Cong Wu ◽  
Xiaoyun Chen ◽  
Yideng Huang ◽  
Min Zhang ◽  
Fan Ye ◽  
...  
Keyword(s):  
Tympanic Membrane ◽  
Operation Time ◽  
Tympanic Membrane Perforation ◽  
Type I ◽  
Closure Rate ◽  
Suppurative Otitis Media ◽  
Low Frequencies ◽  
Membrane Perforation ◽  
Type I Tympanoplasty ◽  
Hearing Outcomes

Objectives: Chronic suppurative otitis media (CSOM) induced tympanic membrane perforation (TMP) can be accompanied by anterior mallear ligament (AML) calcification. So far, comparative evaluations of TMP with and without AML calcification have rarely been reported. The aim of the current study is to compare the hearing outcomes of TMP with and without calcification of AML under transcanal endoscopic type I tympanoplasty. Methods: Records of 67 patients diagnosed with CSOM and receiving transcanal endoscopic type I tympanoplasty were divided into the AML calcification group (Cal group, n = 31) and the non-AML calcification group (non-Cal group, n = 36). The 31 patients in the Cal group were divided into subgroup A and B according to the severity of calcification. The operation time, closure rate, and pre- and postoperative audiometric results were retrospectively collected and analyzed. Results: Preoperatively, the Cal group had higher mean air–bone gap (ABG; P = .022), and ABGs at 250 Hz ( P = .017) and 500 Hz ( P = .008) compared with the non-Cal groups. The Cal group showed higher improvements of ABGs at 250 Hz ( P = .039) and 500 Hz ( P = .021) compared with the non-Cal groups postoperatively. Conclusions: The TMP with AML calcification leads to higher ABGs at low frequencies. The hearing outcomes are similar for TMP both with and without AML calcification after surgery. Our results suggest that transcanal endoscopic type I tympanoplasty is an appropriate surgical method for TMP with AML calcification, if the lesion can be detected and completely eliminated.

scholarly journals A study to compare the outcomes of CO2 laser assisted myringoplasty versus conventional type1 tympanoplasty in small central tympanic perforations

2021 ◽  
Vol 7 (5) ◽  
pp. 809
Author(s):  
Inderdeep Singh ◽  
Basavaraj S. Patil ◽  
Mohammad Z. Akhtar
Keyword(s):  
Success Rate ◽  
Tympanic Membrane ◽  
Acute Otitis Media ◽  
Tympanic Membrane Perforation ◽  
Surgical Closure ◽  
Type 1 Tympanoplasty ◽  
Microscopic Surgery ◽  
Membrane Perforation ◽  
Conventional Type

<p class="abstract"><strong>Background:</strong> The standard treatment of tympanic membrane perforation is conventional surgical closure using myringoplasty or a tympanoplasty type 1. In this study the role of cabon dioxide (CO<sub>2</sub>)-laser-assisted de-epitheliazation of perforation margins and application of bioinert silastic sheet. Success rate was compared with conventional microscopic surgery.</p><p class="abstract"><strong>Methods:</strong> This was a comparative study containing 60 patients with small dry tympanic membrane perforation (diameter 1-3 mm). The causes of tympanic membrane perforations were mainly traumatic or the eardrum did not heal after spontaneous perforation caused by an acute otitis media or after surgery. The procedure was performed under local anaesthesia. CO<sub>2</sub> (acupulse) applied along the edge of the perforation until complete de-epitheliazation and application of bioinert silastic sheet in small dry perforation. Closure of eardrum perforation was monitored using an otoendoscope. Success rate of the CO<sub>2</sub> laser myringoplasty was compared with conventional type 1 tympanoplasty.  </p><p class="abstract"><strong>Results:</strong> Complete eardrum closure occurred in 24 cases (80%), 06 patients (20%) had a residual perforation. The success rate of this procedure is lower than conventional type 1 tympanoplasty, which is 90-94%. There were no complications during and after the treatment.</p><p class="abstract"><strong>Conclusions:</strong> A closure rate of 80% (24/30) was achieved with a CO<sub>2</sub>-laser-assisted de-epitheliazation. This procedure can be offered carefully to selected cases with perforation size &lt;3 mm, where the CO<sub>2</sub> facility is available before they undergo formal conventional microscopic surgery.</p><p class="abstract"> </p>

Factors affecting myringoplasty success

2015 ◽  
Vol 129 (1) ◽  
pp. 23-26 ◽  
Author(s):  
S D Carr ◽  
D R Strachan ◽  
C H Raine
Keyword(s):  
Tympanic Membrane ◽  
Tympanic Membrane Perforation ◽  
Graft Material ◽  
Adult Group ◽  
Closure Rate ◽  
Factors Affecting ◽  
Perforation Site ◽  
Cortical Mastoidectomy ◽  
Membrane Perforation ◽  
Adults And Children

AbstractObjective:To identify factors that significantly influence myringoplasty success.Methods:A retrospective study was performed of all adults and children who underwent myringoplasty from January 2005 to January 2010 in a teaching hospital. Outcome measures were tympanic membrane perforation closure and air–bone gap closure to within 20 dB HL. The factors assessed were the surgeon grade, pre-operative condition of the ipsilateral and contralateral middle ears, perforation site, perforation size, graft material, and whether simultaneous cortical mastoidectomy was performed. Factors with statistically significant effects were determined by logistic regression analysis.Results:In the adult group, the perforation site significantly influenced tympanic membrane closure (p = 0.016): anterior (p = 0.008) and subtotal (p = 0.017) sites had the greatest influence. None of the factors proved to have a significant influence on tympanic membrane closure in the paediatric group.Conclusion:There was a significant association between perforation site and tympanic membrane perforation closure in adults. Anterior and subtotal perforations had a significantly reduced closure rate.

scholarly journals Outcome of Graft Uptake and Hearing Results between ‘U’ Flap Technique and Conventional Tympanomeatal Flap Technique for Anterior and Subtotal Tympanic Membrane Perforation

2018 ◽  
Vol 16 (3) ◽  
pp. 297-301
Author(s):  
Sundar Dhungana ◽  
Pabina Rayamajhi ◽  
Rakesh Prakash Shrivastav
Keyword(s):  
Tympanic Membrane ◽  
Uptake Rate ◽  
Chronic Otitis Media ◽  
Tympanic Membrane Perforation ◽  
Hearing Results ◽  
Flap Technique ◽  
Significant Difference ◽  
Membrane Perforation ◽  
Subtotal Perforation ◽  
Anterior Perforation

Background: Myringoplasty done for anterior and subtotal perforation needs expertise and practice than conventional underlay myringoplasty. The objective of this study was to compare the graft uptake and postoperative hearing results between ‘U’ flap and conventional tympanomeatal flap technique in anterior and subtotal tympanic membrane perforation.Methods: Sixty three patients of age fifteen years and above with chronic otitis media mucosal type with any sized anterior and subtotal perforation of tympanic membrane were randomly allocated for myringoplasty by lottery method. There were thirty one cases in ‘U’ flap group and thirty two cases in conventional tympanomeatal flap group. Graft uptake and hearing results were assessed after six weeks and results were compared within and between the groups.Results: Graft uptake rate was 90.3%(28/31) in‘U’ flap group and it was 87.5%(28/32) in conventional tympanomeatal flap group with no statistically significant difference (p= 0.772) between the two groups. The mean pre and post-operative air bone gap in ‘U’ flap group were 23.63dB±7.77dB; 13.26dB±5.50dB and that in the conventional tympanomeatal flap group were 20.88±9.88dB, 9.42dB±6.70dB respectively. There was no statistically significant difference in hearing results between the two groups (p= 0.504).Conclusions: The graft uptake rate and hearing results of ‘U’ flap group were comparable and showed no statistically significant difference to those of conventional tympanomeatal flap group. Keywords: Anterior perforation; myringoplasty; subtotal perforation; ‘U’ flap.

scholarly journals Outcome of mobile ear surgery units in Thailand

2009 ◽  
Vol 124 (4) ◽  
pp. 382-386 ◽  
Author(s):  
K Snidvongs ◽  
P Vatanasapt ◽  
S Thanaviratananich ◽  
M Pothaporn ◽  
P Sannikorn ◽  
...  
Keyword(s):  
Tympanic Membrane ◽  
Middle Ear ◽  
Hearing Threshold ◽  
Descriptive Study ◽  
Tympanic Membrane Perforation ◽  
Impaired Hearing ◽  
Hearing Improvement ◽  
Ear Surgery ◽  
Closure Rate ◽  
Membrane Perforation

AbstractObjectives:To evaluate the outcome of mobile ear surgery, in terms of tympanic membrane perforation closure, absence of otorrhoea and hearing threshold improvement.Study design:Descriptive study.Methods:The study enrolled patients with chronic ear disorders requiring surgery who presented to the mobile ear surgery unit at Sakaeo Hospital, Thailand, from 1 to 4 July 2008. The following data were recorded: pre-operative audiogram, post-operative middle-ear and mastoid infection, wound infection, graft condition, any complications, and post-operative audiogram. Patients were followed up at one week, two weeks, four weeks and 24 weeks post-operatively.Results:For the 31 cases of tympanic membrane perforation, the closure rate was 90.3 per cent. For the 32 patients with otorrhoea, the rate of ear dryness was 87.5 per cent. All 35 patients had impaired hearing initially; the rate of hearing improvement was 74.3 per cent (95 per cent confidence intervals = 56.7–87.5 per cent). Patients' mean hearing improvement was 22.9 dB.Conclusion:The assessed ear surgery procedures had good results.

scholarly journals Blood clots affect the response of tympanic membrane perforations to gelfoam grafting after ventilation tube insertion

2021 ◽  
Vol 50 (1) ◽  
Author(s):  
Zhengcai Lou
Keyword(s):  
Tympanic Membrane ◽  
Otitis Media With Effusion ◽  
Chronic Otitis Media ◽  
Tympanic Membrane Perforation ◽  
Ventilation Tube ◽  
Tube Insertion ◽  
Closure Rate ◽  
Surgical Closure ◽  
Tympanic Membrane Perforations ◽  
Temporal Fascia

AbstractChronic tympanic membrane (TM) perforation associated with ventilation tube (VT) insertion was commonly encountered in pediatric patients with chronic otitis media with effusion (COME) treatment and eustachian tube dysfunction. The persistent perforation require surgical closure by myringoplasty. Song JS et al. recently a paper entitled: “Evaluating short and long term outcomes following pediatric myringoplasty with gelfoam graft for tympanic membrane perforation following ventilation tube insertion.” In their study, the authors performed gelfoam myringoplasty to repair the perforations following VT insertion in children and compare the successful TM closure rate among different graft materials. The authors believed that gelfoam alone was superior to hyaluronic acid (HA), tragal cartilage (TC), and gelfoam-plus-temporal fascia (TF). The sample size is unbalanced and incommensurable between gelfoam and other graft materials. In addition, a confounding factor was added in the gelfoam group, thereby affected the assessment of TM closure. Thus, the conclusion is not rigorous and scientific.

Sign in / Sign up

Export Citation Format

Share Document