Ossicular chain reconstruction improves bone conduction threshold in chronic otitis media

2008 ◽  
Vol 122 (4) ◽  
pp. 351-356 ◽  
Author(s):  
H-S Lee ◽  
S-D Hong ◽  
S H Hong ◽  
Y-S Cho ◽  
W-H Chung
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Bone Conduction ◽  
Chronic Otitis Media ◽  
Ossicular Chain ◽  
Bone Conduction Threshold ◽  
Ossicular Chain Reconstruction ◽  
Duration Of Disease ◽  
The Mean ◽  
Conductive Mechanism

AbstractThis study aimed to assess the elevation of bone conduction threshold in patients with chronic otitis media and to investigate the mechanism of this phenomenon. One hundred and six patients with unilateral chronic otitis media who had undergone a tympanomastoidectomy were reviewed retrospectively. The differences in the bone conduction thresholds between the diseased and normal sides were assessed and compared according to the duration of the disease and the presence of cholesteatoma. Post-operative changes in the bone conduction threshold were also assessed. The mean bone conduction thresholds were significantly elevated on the diseased side, ranging from 3.4 to 11.6 dB across frequencies, with a maximal elevation at 2000 Hz. The duration of disease and the presence of cholesteatoma did not affect the degree of the bone conduction elevation. After ossicular reconstruction, bone conduction thresholds improved significantly at all frequencies, with the greatest improvement being observed at 2000 Hz. These results suggest that the elevation in the bone conduction threshold in chronic otitis media is mainly caused by a change in the conductive mechanism in the middle ear.

scholarly journals A comparative study of tragal cartilage and autologous incus for ossicular chain reconstruction in type IIB tympanoplasty at Dr. Hedgewar Hospital, Aurangabad

2019 ◽  
Vol 6 (1) ◽  
pp. 78
Author(s):  
Bharat G. Deshmukh ◽  
Deepak Bhisegaonkar ◽  
Akanksha Bakre
Keyword(s):  
Tympanic Membrane ◽  
Otitis Media ◽  
Middle Ear ◽  
Chronic Otitis Media ◽  
Ossicular Chain ◽  
Suppurative Otitis Media ◽  
High Incidence ◽  
Ossicular Chain Reconstruction ◽  
Small Bones ◽  
Set Up

<p class="abstract"><strong>Background:</strong> Tympanoplasty is the surgical operation performed for the reconstruction of the eardrum (tympanic membrane) and/or the small bones of the middle ear. Chronic otitis media is a very common condition of middle ear which not only has a high incidence in the world but also in our set up. So, in view of this, we decided to conduct a study on the surgical management of CSOM-tubotympanic type.</p><p class="abstract"><strong>Methods:</strong> We conducted this study at ENT department of Dr. Hedgewar Rugnalaya, Aurangabad to compare air bone gap closure by using tragal cartilage and autologous incus in type IIB tympanoplasty in patients with chronic suppurative otitis media, (tubotympanic). 66 patients with central perforation of tympanic membrane, necrosed incus and mobile stapes requiring type IIB tympanoplasty, were included as a part of the study.</p><p class="abstract"><strong>Results:</strong> We performed type IIB tympanoplasty with a routine post-aural incision in 66 patients. According to our observation, both incus and cartilage are good materials for ossiculoplasty, tragal cartilage being better.</p><p class="abstract"><strong>Conclusions:</strong> After conducting this study we concluded that incus and tragal cartilage both are excellent materials for ossiculoplasty.</p>

Mechanism of Hearing Loss in Irradiated Ears: A Long-Term Longitudinal Study

2001 ◽  
Vol 110 (10) ◽  
pp. 904-906 ◽  
Author(s):  
Yi-Ho Young ◽  
Ying-Chih Lu
Keyword(s):  
Hearing Loss ◽  
Otitis Media ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Bone Conduction ◽  
Chronic Otitis Media ◽  
Pure Tone Audiometry ◽  
Tube Function ◽  
The Mean ◽  
Air Conduction

A 10-year longitudinal follow-up study of hearing was conducted in patients with nasopharyngeal carcinoma (NPC) in order to elucidate the mechanism of hearing loss in irradiated ears. Ten NPC patients were subjected to a battery of audiological tests before irradiation and 6 months, 5 years, and 10 years after irradiation. The tests included pure tone audiometry, tympanometry, eustachian tube function testing, and myringotomy to confirm middle ear effusion. The prevalences of otitis media with effusion (OME) were 25%, 25%, 40%, and 25% at the 4 testing periods described above, respectively. The prevalences of chronic otitis media were 0%, 0%, 15%, and 25%, respectively. In myringotomized ears (n = 17), the mean hearing levels for both air conduction and bone conduction were preserved from the preirradiation period to 10 years after irradiation. In contrast, in grommeted ears (n = 3), the mean hearing levels for both air conduction and bone conduction deteriorated progressively from the preirradiation period to 10 years after irradiation. We conclude that hearing can be preserved in NPC patients 10 years after irradiation if middle ear inflammation is well controlled. We do not recommend grommet insertion in irradiated NPC patients with OME, as it may result in persistent otorrhea and hearing deterioration.

scholarly journals Scanning Electron Microscopy in the Evaluation of Defects to the Ossicular Chain in the Course of Chronic Otitis Media

2019 ◽  
pp. 014556131987391
Author(s):  
Agnieszka Wiatr ◽  
Katarzyna Swiezy ◽  
Jacek Skladzien ◽  
Maciej Wiatr
Keyword(s):  
Electron Microscopy ◽  
Scanning Electron Microscopy ◽  
Chronic Inflammation ◽  
Otitis Media ◽  
Middle Ear ◽  
Chronic Otitis Media ◽  
Ossicular Chain ◽  
Suppurative Otitis Media ◽  
Ear Ossicles ◽  
Scanning Electron

Objective: Chronic otitis media is a heterogeneous disorder. Chronic suppurative otitis media with cholesteatoma and, to a lesser extent, chronic otitis media with granulation lead to the destruction of bone structures within the middle ear. Bone loss may appear in the prominence of the horizontal semicircular canals and the bony canal of the facial nerve. The inflammatory process may spread to the bony labyrinth of the sigmoidal sinuses and the cranial cavities. Materials and Methods: The analysis comprised the examination of fragments of auditory ossicles removed during surgery in 21 patients with various types of chronic inflammation of the middle ear. The purpose of this study was to evaluate the usefulness of scanning electron microscopy in evaluating the erosion of middle ear ossicles in different types of chronic otitis media. Images captured at various magnifications were used for the best possible illustration of the observed lesions in bone tissue. Results: The observed lesions and the degree of bone surface damage were dependent on the type of chronic inflammation of the middle ear. The largest destructive changes in the ossicular chain were observed in chronic otitis media with cholesteatoma; smaller changes were observed in chronic otitis media with granulation. Conclusion: In the case of damage to the ossicles inflicted by inflammation, the use of a modeled bone block made of a temporal bone taken from outside the tympanic cavity or a biomaterial prosthesis is a good choice in ossiculoplasty.

The styloid process in ossicular chain reconstruction

1988 ◽  
Vol 102 (2) ◽  
pp. 136-137 ◽  
Author(s):  
S. B. Ogale ◽  
C. Desouza ◽  
J. Sheode ◽  
K. L. Shah
Keyword(s):  
Bone Conduction ◽  
Chronic Otitis Media ◽  
Ossicular Chain ◽  
Styloid Process ◽  
Long Term Results ◽  
Graft Material ◽  
Ossicular Chain Reconstruction ◽  
One Year

AbstractOur pilot study reports twenty-six cases of resolved chronic otitis media in which the human, cadaveric styloid process was used as an ossicular graft material. A maximum follow-up of one year is presented in this paper. There was no extrusion or rejection of the styloid processes. Hearing improvement with a closure of the air-bone gap to within 10–15 dB. of the pre-operative bone conduction was found in most cases. So far the styloid process has proved to be an ideal ossicular graft though the long-term results are yet to be seen.

scholarly journals OSSICULAR STATUS IN CHOLESTEATOMA : A DEPARTMENTAL EXPERIENCE IN A STATE MEDICAL COLLEGE OF WESTBENGAL.

2015 ◽  
Vol 23 (3) ◽  
pp. 116-119
Author(s):  
Somesh Mozumder ◽  
Arunabha Sengupta ◽  
Alok Ranjan Mondal ◽  
Soumik Basu
Keyword(s):  
Otitis Media ◽  
Clinical Examination ◽  
Middle Ear ◽  
Chronic Otitis Media ◽  
Ossicular Chain ◽  
Radiological Evaluation ◽  
Super Structure ◽  
Medical College ◽  
Middle Ear Cleft ◽  
Age And Sex

Introduction: Chronic otitis media is a long standing infection of part or whole of middle ear cleft. Its active squamosal variant (cholesteatoma) is most dangerous due to its bone eroding property. Aims & Objective: Background knowledge of ossicular status in cholesteatoma  will help us in determining the type  of reconstruction needed during the surgery. Material & methods: 60 cases of cholesteama, irrespective of age and sex [diagnosed on the basis of clinical examination , audiological and radiological evaluation] were selected during the study period of two years and their ossicular status were recorded intra-operatively. Results &  analysis: Ossicles and their parts getting involved in cholesteatoma cases , in decreasing order are : Lenticular process (in total 50 cases)>Long process of incus (in total 49 cases) > stapes super-structure(in total 29 cases) > body of incus(in total 26 cases)> head of malleus(in total 23 cases)> handle of malleus(in total 10 cases). Ossicular chain  defeact in decreasing order are : M-I-S- > M+I-S- > M-I-S+ > M+I-S+. Conclusion: In our study it was found that incus is the most vulnerable ossicle to get involved in cases of active squamosal variety of chronic otitis media where as malleus appeared to be the least susceptible one.

Chronic Secretory Otitis Media: Effects of Surgical Management

1989 ◽  
Vol 98 (1_suppl2) ◽  
pp. 2-32 ◽  
Author(s):  
George A. Gates ◽  
J. C. Cooper ◽  
Christine A. Avery ◽  
Thomas J. Prihoda
Keyword(s):  
Hearing Loss ◽  
Otitis Media ◽  
Surgical Management ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Chronic Otitis Media ◽  
Secretory Otitis Media ◽  
Tympanostomy Tubes ◽  
The Mean ◽  
First Recurrence

To study the effectiveness of adenoidectomy and tympanostomy tubes in the treatment of chronic otitis media with effusion, we randomly assigned 578 4- to 8-year-old children to receive one of the following: Bilateral myringotomy and no additional treatment (group 1), tympanostomy tubes (group 2), adenoidectomy and myringotomy (group 3), or adenoidectomy and tympanostomy tubes (group 4). The 491 who accepted surgical treatment were evaluated at 6-week intervals for up to 2 years. Treatment effect was assessed by four main outcomes: Time with effusion, time with hearing loss, time to first recurrence of effusion, and number of surgical re-treatments. For the groups (in order), the mean percent of time with any effusion in either ear was 49, 35, 30, 26 (p < .0001); the mean percent of time with hearing thresholds 20 dB or greater was 19, 10, 8, and 7 (p < .0001) in the better ear; and 38, 30, 22 and 22 in the worse ear (p < .0001); the median number of days to first recurrence was 54, 222, 92, and 240 (p < .0001); and the number of surgical re-treatments was 66, 36, 17, and 17 (p < .0001). The most notable adverse sequela, purulent otorrhea, occurred in 22%, 29%, 11%, and 24% of the patients assigned to groups 1 through 4, respectively (p < .001). In severely affected children who have chronic otitis media with effusion resistant to medical therapy, adenoidectomy is an effective treatment. Adenoidectomy plus bilateral myringotomy lowered posttreatment morbidity more than tympanostomy tubes alone and to the same degree as did adenoidectomy and tympanostomy tubes. Adenoidectomy appears to modify the underlying pathophysiology of chronic otitis media with effusion. This effect is independent of the preoperative size of the adenoid. Tympanostomy tube drainage and ventilation of the middle ear provide adequate palliation so long as the tubes remain in place and functioning. We recommend that adenoidectomy be considered in the initial surgical management of 4- to 8-year-old children with hearing loss due to chronic secretory otitis media that is refractory to medical management and, further, that the size of the adenoid not be used as a criterion for adenoidectomy. Concomitant bilateral myringotomy with suction aspiration of the middle ear contents also should be done, with or without placement of tympanostomy tubes at the discretion of the surgeon.

Chronic Otitis Media With Cholesteatoma With Canal Fistula and Bone Conduction Threshold After Tympanoplasty With Mastoidectomy

2014 ◽  
Vol 35 (6) ◽  
pp. 981-988 ◽  
Author(s):  
Tadashi Kitahara ◽  
Takefumi Kamakura ◽  
Yumi Ohta ◽  
Tetsuo Morihana ◽  
Arata Horii ◽  
...  
Keyword(s):  
Otitis Media ◽  
Bone Conduction ◽  
Chronic Otitis Media ◽  
Bone Conduction Threshold

Early complications of surgery for chronic otitis media

1999 ◽  
Vol 113 (9) ◽  
pp. 803-810 ◽  
Author(s):  
P. J. D. Dawes
Keyword(s):  
Otitis Media ◽  
Bone Conduction ◽  
Chronic Otitis Media ◽  
Chorda Tympani ◽  
Threshold Elevation ◽  
Early Complications ◽  
Ear Surgery ◽  
Bone Conduction Threshold ◽  
Operative Complications ◽  
Complications Of Surgery

AbstractThis audit report details early post-operative complications following surgery for chronic otitis media. One hundred and forty-five cases were assessed. There were no facial nerve palsies, a bone conduction threshold elevation occurred in 4.6 per cent of cases. A wound infection occurred in six per cent of cases as did BIPP allergy. Twenty-six per cent of patients reported symptoms consistent with chorda tympani trauma. Short-lived symptoms of jaw discomfort were reported by 46 per cent of patients and imbalance or vertigo by 10 per cent of patients. The findings are compared with other published reports of complications following ear surgery.

scholarly journals Pre-operative predictors of ossicular necrosis in chronic otitis media-mucosal type

2019 ◽  
Vol 5 (2) ◽  
pp. 396
Author(s):  
Razim Abdul Rasheed ◽  
Mubeena . ◽  
K. S. Gangadhara Somayaji
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Granulation Tissue ◽  
Chronic Otitis Media ◽  
Ossicular Chain ◽  
Bivariate Analysis ◽  
Middle Ear Mucosa ◽  
Cross Sectional ◽  
Suppurative Otitis Media ◽  
Wide Range

<p class="abstract"><strong>Background:</strong> Chronic suppurative otitis media can cause a wide range of pathologies in the middle ear that include irreversible mucosal changes, granulation tissue formation, cholesteatoma, tympanosclerosis, and destruction of ossicles. Knowledge regarding ossicular discontinuity before surgery enables the surgeon to be prepared for ossiculoplasty. Objective was to study the pre-operative clinical, audiological and microscopic findings in chronic otitis media mucosal type and correlate preoperative findings with intra-operative ossicular necrosis. </p><p class="abstract"><strong>Methods:</strong> Study design was observational, descriptive and cross sectional study. All patients were subjected to detailed clinical, otoscopic and microscopic examination to assess the size and site of perforation, presence or absence of ear discharge, granulation tissue, tympanosclerosis in the middle ear, exposure of incudostapedeal joint and condition of middle ear mucosa. Pure tone audiogram was also done. All patients underwent tympanoplasty±cortical mastoidectomy and the intraoperative findings of ossicular necrosis were noted.  </p><p class="abstract"><strong>Results:</strong> Of the 105 patients, 18(17.1%) had ossicular necrosis. Bivariate analysis showed positive correlation for long standing disease (p=0.004), presence of discharging ear (p=0.014), polypoidal middle ear mucosa (p=0.000) granulations in middle ear (p=0.000) and also when incudostapedeal joint was exposed (p=0.005). Mean Air bone gap was higher with 35 dB in ossicular necrosis and 22.7 dB in intact ossicular chain was also statistically significant (p=0.0001).</p><p class="abstract"><strong>Conclusions:</strong> Ossicular necrosis was best indicated by the presence of polypoidal mucosa, granulation in the middle ear and higher air-bone gap on audiometry. However longer duration of disease, persistent active stage of disease and exposure of incudostapedeal joint were also found to be significant.</p>

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