Surgical management of retraction pockets of the pars tensa with cartilage and perichondrial grafts

2006 ◽  
Vol 120 (9) ◽  
pp. 725-729 ◽  
Author(s):  
P Spielmann ◽  
R Mills
Keyword(s):  
Tympanic Membrane ◽  
Incidental Findings ◽  
Conductive Hearing Loss ◽  
Pars Tensa ◽  
Early Results ◽  
Retraction Pockets ◽  
Successful Technique ◽  
One Year ◽  
Conductive Hearing ◽  
Results Of Surgery

Stable, self-cleansing retraction pockets of the pars tensa are common incidental findings and require no treatment. In other cases, recurrent discharge occurs and there may also be associated conductive hearing loss. In a minority of cases, cholesteatoma may develop.This paper presents the results of surgery using a graft composed of cartilage and perichondrium for retraction pockets involving the posterior half of the tympanic membrane, as well as early results using a larger graft designed to manage retraction of the entire tympanic membrane. Data on 51 patients with posterior retraction pockets are presented. Forty-two (82 per cent) patients had no aural discharge one year following surgery and the tympanic membrane was not retracted in 43 (84 per cent). The larger ‘Mercedes-Benz’ graft was used in four patients and the results obtained suggested that it may prove a successful technique for extensive retraction pockets.

Management of retraction pockets of the pars tensa

1991 ◽  
Vol 105 (7) ◽  
pp. 525-528 ◽  
Author(s):  
Robert P. Mills
Keyword(s):  
Surgical Treatment ◽  
Tympanic Membrane ◽  
Composite Graft ◽  
Study Group ◽  
Pars Tensa ◽  
Retraction Pockets

AbstractA study of 73 patients with retraction pockets of the pars tensa (93 affected ears) has been carried out. Of these 32 per cent had otalgia and 31 per cent reported episodes of aural discharge. Adequate audiometric data was available on 75 ears. Mean air-bone gaps were calculated using 500 Hz, 1000 Hz, 2000 Hz and 4000 Hz. Thirty per cent of ears had air-bone gaps of less than 10 dB and in 93 per cent the air-bone gap was less than 30 dB. Air-bone gaps of more than 40 dB were found in seven per cent. Of this group, seven patients were selected for surgical treatment. In all cases the retraction pockets were elevated and everted. In six cases, the thinned tympanic membrane was reinforced with a composite graft of cartilage and perichondrium. This technique has also been used in three patients not included in this study group. An ossiculoplasty was performed in four cases. In the early months, the retraction pockets remained completely everted. However, by 12 months some degree of retraction had recurred in four of the six patients who have been followed for more than 12 months.

scholarly journals Otosclerosis. 2. rész. Diagnózis

2019 ◽  
Vol 160 (51) ◽  
pp. 2007-2011
Author(s):  
Balázs Liktor ◽  
Andor Hirschberg ◽  
Bálint ifj Liktor ◽  
Tamás Karosi
Keyword(s):  
Hearing Loss ◽  
Tympanic Membrane ◽  
Preoperative Diagnosis ◽  
Conductive Hearing Loss ◽  
Clinical Suspicion ◽  
Otic Capsule ◽  
Human Temporal Bone ◽  
Stapes Footplate ◽  
Bony Lesions ◽  
Conductive Hearing

Abstract: Otosclerosis is a bone remodeling disorder affecting exclusively the human temporal bone which causes small bony lesions in the otic capsule. The symptoms depend on the location and the extent of the otosclerotic foci. Hence, clinically the most relevant sign is the conductive hearing loss due to the stapedial otosclerosis with fixation of the stapes footplate. In many cases, the specific anamnestic features, the age of presentation and usually the absence of tympanic membrane pathology can provide a strong clinical suspicion for otosclerosis. Although audiometric and imaging examinations and VEMP testing can confirm our preoperative diagnosis, the histolopathologic examination of the removed stapes footplate is the most accurate way to determine the diagnosis. Orv Hetil. 2019; 160(51): 2007–2011.

Modified sleeve tympanotomy approach for removal of congenital cholesteatoma

2008 ◽  
Vol 122 (12) ◽  
pp. 1365-1367 ◽  
Author(s):  
H J Park ◽  
G H Park ◽  
J E Shin ◽  
S O Chang
Keyword(s):  
Hearing Loss ◽  
Case Report ◽  
Tympanic Membrane ◽  
Middle Ear ◽  
Conductive Hearing Loss ◽  
Tympanic Cavity ◽  
Operative Techniques ◽  
Congenital Cholesteatoma ◽  
The Right ◽  
Conductive Hearing

AbstractObjective:We present a technique which we have found useful for the management of congenital cholesteatoma extensively involving the middle ear.Case report:A five-year-old boy was presented to our department for management of a white mass on the right tympanic membrane. This congenital cholesteatoma extensively occupied the tympanic cavity. It was removed through an extended tympanotomy approach using our modified sleeve technique. The conventional tympanotomy approach was extended by gently separating the tympanic annulus from its sulcus in a circular manner. The firm attachment of the tympanic membrane at the umbo was not severed, in order to avoid lateralisation of the tympanic membrane.Conclusion:Although various operative techniques can be used, our modified sleeve tympanotomy approach provides a similarly sufficient and direct visualisation of the entire middle ear, with, theoretically, no possibility of lateralisation of the tympanic membrane and subsequent conductive hearing loss.

Repair of Chronic Tympanic Membrane Perforations Using Epidermal Growth Factor

1992 ◽  
Vol 107 (5) ◽  
pp. 669-683 ◽  
Author(s):  
C. Philip Amoils ◽  
Robert K. Jackler ◽  
Lawrence R. Lustig
Keyword(s):  
Hearing Loss ◽  
Tympanic Membrane ◽  
Surgical Repair ◽  
Conductive Hearing Loss ◽  
Recurrent Infection ◽  
Autologous Tissue ◽  
Tympanic Membrane Perforations ◽  
Epidermal Growth ◽  
Conductive Hearing ◽  
Microsurgical Procedure

Perforation of the tympanic membrane (TM) is a frequent cause of conductive hearing loss. Persistent TM perforations often require surgical repair with an autologous tissue graft to restore hearing and prevent recurrent infection. While highly efficacious, this method of closure requires a relatively complex and expensive microsurgical procedure. We have recently developed a chronic TM perforation model in the chinchilla for use in the exploration of novel methods of TM repair.

Endoscopic Transtympanic Tympanoplasty in the Treatment of Conductive Hearing Loss: Early Results

2006 ◽  
Vol 27 (1) ◽  
pp. 14-19 ◽  
Author(s):  
Seiji Kakehata ◽  
Kazunori Futai ◽  
Akira Sasaki ◽  
Hideichi Shinkawa
Keyword(s):  
Hearing Loss ◽  
Conductive Hearing Loss ◽  
Early Results ◽  
Conductive Hearing

scholarly journals EARLY INTERVENTION OF PARS TENSA RETRACTION POCKETS IN CHILDREN BY CARTILAGE REINFORCED TYMPANOPLASTY

1970 ◽  
Vol 43 (156) ◽  
Author(s):  
Toran KC ◽  
S Shrestha ◽  
P K Kafle
Keyword(s):  
Hearing Loss ◽  
Early Intervention ◽  
Medical Treatment ◽  
Tympanic Membrane ◽  
Pediatric Population ◽  
Chronic Otitis Media ◽  
Management Options ◽  
Pars Tensa ◽  
Retraction Pockets ◽  
Grade Iii

Posterosuperior retraction pockets involving pars tensa of a tympanic membrane is not an uncommonproblem particularly in pediatric population. This occurs as a sequelae of chronic otitis media with effusion.The management options include “wait and watch,” medical treatment and surgery. But in patients inwhom retraction is severe and seems to be irreversible the treatment should be surgery at the earliest. Weperformed cartilage reinforced tympanoplasty in 29 ears of 28 children who had grade III and IVposterosuperior retraction pockets of the pars tensa. Their average pre-operative hearing loss was 16.6 and19.4dB for grade III and IV retraction pockets respectively with 10 and 12.4dB post operative gain. Norecurrences were noted except few minor complications. We suggest that such procedures are safe andshould be performed at the earliest rather than to keep under surveillance and medical treatment only.Key Words: Pars tensa retraction pockets, Tympanic membrane atelectasis, atelectatic ear, Tympanoplasty. 

scholarly journals Non-surgical approach for repairing perforations of pars tensa in tympanic membrane using TCA cauterization

2019 ◽  
Vol 5 (2) ◽  
pp. 299
Author(s):  
Sushil Gaur ◽  
Monika Patel ◽  
Prince Hirdesh ◽  
Vandana Singh
Keyword(s):  
Acetic Acid ◽  
Success Rate ◽  
Tympanic Membrane ◽  
Ossicular Chain ◽  
Surgical Approaches ◽  
Cost Burden ◽  
Surgical Interventions ◽  
Pars Tensa ◽  
Tympanic Membrane Perforations ◽  
One Year

<p class="abstract"><strong>Background:</strong> Tympanic membrane perforations occurring due to mucosal COM usually require surgical interventions for repair (myringoplasty or tympanoplasty) depending on the size and site of the perforation and the ossicular chain continuity. Various studies have shown TCA cautery as an efficacious non surgical method for repairing small and medium sized TM perforations. This technique was successfully used and popularized for repairing small and medium sized perforations by Derlacki in 1953.</p><p class="abstract"><strong>Methods:</strong> In this study we included dry pars tensa perforations in 100 patients occurring due to trauma or unresolved cases after inflammation/infection of middle ear. 50% w/v trichloro acetic acid was used for a maximum number of 5 applications at the margins of the perforations which were followed up for the next one year.  </p><p class="abstract"><strong>Results:</strong> In this study, involving a total of 125 perforations (75 unilateral and 50 bilateral), success rate was high among the patients with traumatic perforations and small sized perforations while a few number of perforations only reduced in size, which were later corrected with surgical approaches (myringoplasty/tympanoplasty). The overall success rate achieved in this study was 72.16%.</p><p class="abstract"><strong>Conclusions:</strong> Though there are various materials and methods available for this procedure, the principle remains the same. This technique should be attempted for patients that fit the criteria for undergoing this procedure before being undertaken for surgical approaches to minimize the risks and cost burden associated with surgery and anesthesia.</p>

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