A randomized prospective trial to compare four different ear packs following permeatal middle ear surgery

1998 ◽  
Vol 112 (2) ◽  
pp. 140-144 ◽  
Author(s):  
H. Zeitoun ◽  
G. S. Sandhu ◽  
M. Kuo ◽  
M. Macnamara
Keyword(s):  
Prospective Study ◽  
Middle Ear ◽  
Prospective Trial ◽  
Middle Ear Surgery ◽  
Ear Surgery ◽  
Post Operative Pain ◽  
Significant Difference ◽  
Different Types ◽  
Randomized Prospective Trial ◽  
Previous Training

AbstractSurgeons choice of an ear pack is dictated by availability, previous training and personal preference. There has been no recent prospective study evaluating the use of different types of ear packs. This randomized prospective study compares the use of BIPP impregnated ribbon gauze (Aurum), Pope wicks (Xomed-Teace), silastic sheeting (Dow Corning) and tri-adcortyl ointment (Squibb) as an ear dressing following ‘clear’ middle ear procedures via a permeatal approach. The results showed that there was no statistically significant difference in post-operative pain and discomfort experienced, neither was there any significant difference regarding the otolaryngologist's assessment of the degree of canal granulation, stenosis or discharge with the above named packs. This study concludes that non-traditional dressings such as tri-adcortyl ointment or simply a thin silastic sheet placed on the drum are no worse than time honoured BIPP. They have, as well, the advantage of being well-tolerated by the patients.

A study of chorda tympani nerve injury and related symptoms following middle-ear surgery

2005 ◽  
Vol 119 (3) ◽  
pp. 189-192 ◽  
Author(s):  
P Gopalan ◽  
M Kumar ◽  
D Gupta ◽  
J J Phillipps
Keyword(s):  
Prospective Study ◽  
Middle Ear ◽  
Recovery Time ◽  
Middle Ear Surgery ◽  
Chorda Tympani ◽  
Chorda Tympani Nerve ◽  
Ear Surgery ◽  
Number Of Patients ◽  
Prolonged Recovery ◽  
A Prospective Study

This is a prospective study that looks into the prevalence of chorda tympani nerve (CTN) injury and related symptoms following varying degrees of trauma to the nerve during three common types of middle-ear operation: myringoplasty, tympanotomy and mastoidectomy. The number of patients with CTN-related symptoms varied widely between the three groups. Increased occurrence of the nerve related symptoms and a prolonged recovery time were observed in the tympanotomy group. Stretching of the nerve produced more symptomatic cases than cutting it in the myringoplasty and mastoidectomy groups. Recovery was complete in 92 per cent of the symptomatic patients by 12 months. It is important to inform patients about the possibility of CTN injury during middle-ear operations, and it should also be emphasized that symptoms related to CTN injury can occur irrespective of the type of damage to the nerve.

The value of head dressings for middle ear surgery

1993 ◽  
Vol 107 (1) ◽  
pp. 17-19 ◽  
Author(s):  
Julian M. Rowe-Jones ◽  
Susanna E. J. Leighton
Keyword(s):  
Middle Ear ◽  
Wound Closure ◽  
Prospective Trial ◽  
Wound Complication ◽  
Operative Management ◽  
Middle Ear Surgery ◽  
Ear Surgery ◽  
Mastoid Surgery ◽  
Pressure Dressing

AbstractA prospective trial was performed to ascertain the value of head dressings in the post-operative management of patients undergoing middle ear and mastoid surgery. One hundred consecutive patients were randomly allocated to a head dressing or no head dressing group after wound closure.Nine patients in the head dressing group developed a wound complication as opposed to four patients in the no head dressing group.The application of a pressure dressing following middle ear and mastoid surgery is unnecessary and may contribute to increased wound morbidity.

scholarly journals Effect of Dexmeditomidine on Isofluorane Consumption in Middle Ear Surgery

2020 ◽  
Vol 5 (2) ◽  
pp. 14-19
Author(s):  
Smriti Bandhu ◽  
Arunabh Mukharjee
Keyword(s):  
Heart Rate ◽  
Middle Ear ◽  
Normal Saline ◽  
Middle Ear Surgery ◽  
Ear Surgery ◽  
Mean Values ◽  
Isoflurane Concentration ◽  
Significant Difference ◽  
Surgical Field ◽  
End Tidal

Background: With the introduction of intentional hypotensive anesthesia in the surgical field to achieve a relatively bloodless surgical field along with the use of the operative microscope, it has revolutionized the middle ear surgery practice. Dexmedetomidine is a relatively new and potent α2 agonist prototype found efficient in rendering bloodless intra-surgical field and inducing controlled hypotension during the surgeries of the middle ear. The objective is to present prospective study was aimed at evaluating with and without dexmedetomidine infusion effect on end-tidal isoflurane concentration for lowering blood pressure by 30%, awakening time and quality of bloodless surgical field during middle ear surgical procedure. Subjects and Methods:54 patients who were to undergo middle ear surgery and had ASA I and II were randomly divided into the two groups. In Group I Dexmedetomidine was used and in Group II Normal saline. Effect of Dexmedetomidine infusion on end-tidal isoflurane concentration for lowering blood pressure by 30%, awakening time, quality of bloodless surgical field during middle ear surgical procedure, heart rate was evaluated. The data collected were statistically analyzed. Results: The mean values of the heart rate were statistically non-significant between the groups when recorded at the baseline, whereas, a statistically significant difference was seen in the values for heart rate intra-operatively. The mean values for heart rates were significantly higher for the placebo group. A significant difference in Isoflurane concentration was found with dexmedetomidine requiring a percentage of 0.6 0.4 and normal saline 1.8 0.5. Less bleeding was seen with dexmedetomidine. Conclusion:  Dexmedetomidine is a potent hypotensive agent which also reduces the requirement of Isoflurane compared  to the normal saline placebo. The use of dexmedetomidine is relatively safe and provide a relatively bloodless surgical field, hence, increasing efficacy, and improving visibility at the surgical site.

scholarly journals Effects of nitrous oxide on middle ear pressure

2007 ◽  
Vol 60 (9-10) ◽  
pp. 473-478
Author(s):  
Branislava Majstorovic ◽  
Radomir Radulovic ◽  
Vojko Djukic ◽  
Dragana Kastratovic ◽  
Nada Popovic ◽  
...  
Keyword(s):  
Nitrous Oxide ◽  
Hearing Loss ◽  
General Anesthesia ◽  
Middle Ear ◽  
Wilcoxon Test ◽  
Middle Ear Surgery ◽  
Study Group ◽  
Ear Surgery ◽  
Significant Difference ◽  
Balanced Anesthesia

Introduction. Recent literature data suggest that permanent or reversible hearing loss may occur after general anesthesia. The etiology varies, while hearing loss following middle ear surgery is attributed to exposure to nitrous oxide (N2O). The objective of our study was to measure, using tympanometry, the middle air pressure change caused by nitrous oxide during general anesthesia and to establish its emetogenic effects during the postoperative period. Material and Methods. This academic (non-commercial) prospective study included two groups of patients (a total of 58), with ASA status I, II and III. The study group (n 30) consisted of patients undergoing unilateral ear surgery. In this group, the intratympanic pressure was measured in the unoperated (healthy) ear before and during the surgery. The control group (n 28) patients underwent nose, throat or neck surgical interventions. This group underwent measurement of bilateral intratympanic pressure in healthy ears, before and during the surgery. Both groups were operated under general balanced anesthesia. Pain, nausea and antiemetics were monitored during the first 24 postoperative hours. Statistical analysis was performed using the Mann-Whitney-Wilcoxon test. Results. This perioperative study confirmed the following: highly significant (p<0.001) increase in intratympanic pressure in non-operated ears in the study group and significant (p<0.05) in controls. However, there was no statistical significance (p>0.05) between groups. Pain was more frequent in controls, and nausea in the study group, but without significant difference (p>0.05). Conclusions. Postoperative audiometry findings showed no conductive or sensorineural hearing loss after interventions. Nitrous oxide can be used in general balanced anesthesia with discontinuation 15 to 45 minutes before insertion of the tympanic membrane and completion of middle ear surgery. .

scholarly journals The experience of the tympanoplasty in Volyn region

2020 ◽  
pp. 44-52
Author(s):  
Olexander Z. Shchuruk ◽  
Georgy Z. Shchuruk
Keyword(s):  
Middle Ear ◽  
Postoperative Period ◽  
High Rate ◽  
Middle Ear Surgery ◽  
Canal Wall ◽  
Ear Surgery ◽  
Clinical Hospital ◽  
Different Types ◽  
Intracranial Complications ◽  
Canal Wall Down

Introduction: In Volyn middle ear microsurgical interventions were first performed in the early 60s in the previous century. Stapedioplasty, different types of myringoplasty and cholesteatoma middle ear surgery were introduced in the mid 70s. In 1983 a drill as a replacement to a chisel and a mallet, which were traditionally used to perform the bone stage of the ear surgery in the USSR, was introduced by Shchuruk Z.S. Aim: to share the experience of the development of otosurgery in Volyn and the results of the middle ear microsurgery operations in the Department of Otolaryngology in Volyn regional clinical hospital. Materials and methods: For the last twenty years (from 1999 to 2019) 1008 middle ear surgeries which can be divided into three main types: canal-wall-down tympanoplasty – 608 operations, canal-wall-up tympanoplasty – 94 ones and 306 myringoplasty were performed in the Department of Otolaryngology in Volyn regional clinical hospital. In addition, 35 mastoidectomies for acute and latent mastoiditis, 33 extended mastoidectomies with otogenic intracranial complications, 27 extended radical surgeries with otogenic intracranial complications and 560 tympanostomy tube insertion procedure were performed. Results: Complete elimination of air-bone gap after myringoplasty was observed in 20% of patients, the airbone gap in about 80% of patients was about 8dB. After a canal-wall-down tympanoplasty in the late postoperative period the average air conduction thresholds in 35,4% of the patients was less than 30dB. 92% of our patients had a complete wound healing and a positive morphological result in the early postoperative period after different types of tympanoplasty. Conclusions 1. Having evaluated the results of microsurgery operations for the last 20 years (1008 operations), we noted the high rate of positive clinical and functional outcomes. 2. The experience of Volyn otolaryngologists who began to perform middle ear surgeries in the 60-70s of the previous century was transferred to younger generation of otolaryngologists. 3. The performance of tympanoplasty demands in-depth knowledge of the anatomy of temporal bone and a burning desire to perform these complicated surgery interventions.

scholarly journals A comparative study of endoscopic assisted versus conventional middle ear and mastoid surgery at a tertiary care teaching hospital

2021 ◽  
Author(s):  
Jitendra Kumar Sharma ◽  
Sushma Mahich ◽  
Navneet Mathur
Keyword(s):  
Comparative Study ◽  
Middle Ear ◽  
Operative Time ◽  
Middle Ear Surgery ◽  
Wide Field ◽  
Time Duration ◽  
Ear Surgery ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Mastoid Surgery

<p><strong>Background:</strong> Objectives were to compare outcomes, intra operative visualization and operative time duration in endoscopic assisted vs conventional middle ear and mastoid surgery.</p><p><strong>Methods: </strong>This prospective comparative study was conducted in 50 patients; among them 25 cases were of endoscope assisted middle ear surgery and 25 cases with conventional microscopic middle ear surgery. A 4 mm diameter, 18 cm long rigid, zero-degree endoscope and operating microscope was used. Primary outcomes include mean average pre and post operative air-bone (A-B) gap, hearing thresholds, intra operative visualization and duration of surgery.<strong></strong></p><p><strong>Results: </strong>Mean A-B gap closure for endoscopic assisted tympanoplasty was 12.76±6.00 dB, while it was 8.38±5.78 dB for non-endoscopic assisted tympanoplasty. The results were comparative. Mean intra-operative time duration for endoscopic assisted tympanoplasty was 70.23±4.17 min, while it was 77±9.80 min for non-endoscopic assisted tympanoplasty with statically significant difference between both groups (p=0.03). Graft uptake rate for endoscopic assisted tympanoplasty was 92.31% while it was 84.62% for non-endoscopic assisted tympanoplasty. Residual cholesteatoma remnant on endoscopy was found in 43.66% cases out of 12 mastoidectomy cases performed via endoscopic assistance.<strong></strong></p><p><strong>Conclusions: </strong>The endoscope can be successfully applied to ear surgery for most of the ear procedures with a reasonable success rate both in terms of perforation closure and hearing improvement and with minimal exposure. Wide-field zero, 30 or 70° endoscope sallow visualization of hidden anatomic spaces and working around corners i.e., epitympanum, hypotympanum and retro tympanum for safe removal of cholesteatoma.</p>

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