Myringostapediopexy and myringolenticulopexy in mastoid surgery

2008 ◽  
Vol 122 (10) ◽  
pp. 1042-1046 ◽  
Author(s):  
P P Cheang ◽  
D Kim ◽  
T J Rockley
Keyword(s):  
Case Series ◽  
District General Hospital ◽  
Mastoid Cavity ◽  
Hearing Results ◽  
Canal Wall Down ◽  
Canal Wall Down Mastoidectomy ◽  
The Mean ◽  
One Year ◽  
Mastoid Surgery

AbstractObjective:To compare hearing results in patients undergoing myringostapediopexy or myringolenticulopexy in canal wall down mastoidectomy.Study design:Case series of one surgeon. A retrospective review of 83 consecutive mastoid cavity operations for primary cholesteatoma. Only those patients who had undergone either myringostapediopexy or myringolenticulopexy were included.Setting:District general hospital.Patients:Forty-two procedures were performed in 40 patients. The mean age was 42 years old. The average follow up was 5.9 years.Intervention:Seventeen patients underwent myringolenticulopexy (the incus head was excised, leaving the lenticular process attached to the stapes prior to graft placement) and 25 underwent myringostapediopexy (type III tympanoplasty).Main outcome measures:Audiometry three to six months after surgery, and status of mastoid cavity after a minimum follow up of one year.Results:Comparison of post-operative hearing results for the two groups showed a statistically significant hearing advantage for myringolenticulopexy (p = 0.029). In the myringolenticulopexy group, 92 per cent achieved a post-operative air–bone gap of less than 30 dB, compared with 62 per cent in the myringostapediopexy group. The mean post-operative air–bone gaps in the two groups were 17.5 and 24.7 dB, respectively.Conclusion:When surgically feasible, the technique of myringolenticulopexy is a useful method of preserving serviceable hearing in single-stage mastoid cavity surgery.

Incudostapedial Rebridging Ossiculoplasty with Bone Cement

2009 ◽  
Vol 141 (2) ◽  
pp. 243-246 ◽  
Author(s):  
Tekin Baglam ◽  
Erkan Karatas ◽  
Cengiz Durucu ◽  
Ali Kilic ◽  
Enver Ozer ◽  
...  
Keyword(s):  
Bone Cement ◽  
Chart Review ◽  
Case Series ◽  
Cost Effective ◽  
Hearing Results ◽  
Tertiary Referral Center ◽  
Different Types ◽  
The Mean ◽  
One Year

OBJECTIVE: The purpose of this study is to evaluate hearing results of our experience with ionomeric bone cement repair of ossicular discontinuity between incus and stapes. STUDY DESIGN: Case series with chart review. SETTING: Tertiary referral center. SUBJECTS AND METHODS: One hundred thirty-six patients who underwent incudostapedial rebridging ossiculoplasty with ionomeric bone cement were included in the study. Preoperative and postoperative audiologic results of incudostapedial rebridging ossiculoplasty with bone cement were evaluated. One year of follow-up is provided. RESULTS: The postoperative air-bone gap was less than 20 dB in 81.6 percent after one year. The mean preoperative and postoperative pure-tone avarages of the patients were 52.82 ± 5.59 and 32.81 ± 7.18 dB, respectively ( P < 0.01). The mean preoperative and postoperative air-bone gaps were 35.83 ± 4.73 and 16.54 ± 5.01, respectively ( P < 0.01). There were no statistically significant differences among the hearing results of different types of surgeries ( P >0.05). No complications in the middle ear related to bone cements were encountered. CONCLUSIONS: Incudostapedial rebridging ossiculoplasty with ionomeric bone cement is a reliable method for ossicular reconstruction that is cost effective and offers satisfactory hearing results in selected patients.

scholarly journals Manuka Honey versus Antibiotic Ear Drops in Healing of Post-Operative Mastoid Cavity: A Prospective Randomized Trial

2020 ◽  
Vol 63 (5) ◽  
pp. 199-205
Author(s):  
Niveditha Damodharan ◽  
Roshan Kumar Verma ◽  
Archana Angrup ◽  
Jaimanti Bakshi ◽  
Naresh K Panda
Keyword(s):  
Chronic Otitis Media ◽  
Mastoid Cavity ◽  
Control Group ◽  
Study Group ◽  
Manuka Honey ◽  
Sterile Culture ◽  
Canal Wall Down ◽  
Canal Wall Down Mastoidectomy ◽  
The Mean

Background and Objectives This study investigates the role of manuka honey in the healing of postoperative mastoid cavity.Subjects and Method This was a single centre prospective study on 40 consecutive patients of chronic otitis media undergoing canal wall down mastoidectomy. Manuka honey soaked in gel foam was kept in the mastoid cavity for the study group and antibiotic soaked gel foam was kept for the control group. Culture swabs from mastoid granulations were sent at various times from both groups. The healing of the mastoid cavity was assessed in the follow up period.Results Preoperatively 15 out of 20 patients (75%) had a positive aural swab culture in the study group while 11 out of 20 (55%) in the control group had a positive aural swab culture. The most common organism isolated was <i>Pseudomonas aeruginosa</i> and <i>Proteus mirabilis</i>. One month after mastoidectomy only 4 patients (20%) had sterile culture and 16 patients (80%) had grown organisms; in the control group, 7 patients (35%) had sterile culture and 13 patients (65%) had growth on culture. The mean merchant scores for the study group and the control were 2.61 (2-5) and 2.05 (1-4), respectively. At 3 months 13 patients (65%) with sterile culture and 7 patients (35%) had growth on culture; in the control group, 16 patients (80%) had sterile culture and 4 had shown persistent growth on culture (<i>p</i>=0.28). All positive cultures were aerobic in both groups. The mean merchant scores for the study group and the control were 1.03 (0-4) and 0.7 (0-3), respectively (<i>p</i>=0.09).Conclusion Healing of mastoid cavity was almost similar in both groups (<i>p</i>>0.05). Manuka honey exhibited antibacterial activity against <i>Pseudomonas</i>, <i>Proteus</i>, <i>Klebsiella</i>, <i>Escherichia coli</i>, <i>Staphylococcus</i>.

scholarly journals Prognosis for Recovery of Foot Drop after Transforaminal Endoscopic Decompression of Far Lateral Lumbar 5-Sacral 1 Herniated Disc: Case Series

2019 ◽  
Vol 2 (22.2) ◽  
pp. E97-E103
Author(s):  
Albert Telfeian
Keyword(s):  
Endoscopic Treatment ◽  
Case Series ◽  
Foot Drop ◽  
Consecutive Series ◽  
Motor Score ◽  
Endoscopic Decompression ◽  
Far Lateral ◽  
The Mean ◽  
One Year

Background: Foot drop that results from compression of the exiting L5 nerve as a result of far lateral disc herniation (FLDH) at L5-S1 poses a significant surgical challenge to the minimallyinvasive spine surgeon given the narrow corridor for an extraforaminal approach because of the high iliac crest. Objectives: Here we describe our experience with transforaminal endoscopic decompression for the treatment of foot drop secondary to FLDH at L5-S1. Study Design: Retrospective case review. Setting: This study took place in a single-center, academic hospital. Methods: A technique for the transforaminal endoscopic treatment of foot drop secondary to L5-S1 FLDH is presented in a series of 5 consecutive patients treated over a period of 3 years. Preoperative and postoperative clinical data with 1-year follow-up are presented. Results: A consecutive series of 211 patients who underwent transforaminal endoscopic treatment for lumbar radiculopathy between 2011 and 2014 are presented. Seventy-seven patients had L5- S1 discectomies and 5 of those patients presented with foot drop and FLDH. The mean visual analog scale score for radicular pain improved from an average pain score before surgery of 7.2 to 0.8 one year after surgery, and the mean motor score for anterior tibialis strength improved from an average motor score before surgery of 2.6 to 4.8 one year after surgery. Limitations: Small case series evaluated retrospectively with one year follow-up. Conclusions: Transforaminal endoscopic surgical access to FLDH pathology may be a unique approach to the treatment of foot drop because it allows for neural decompression of disc and foraminal pathology without requiring significant destabilizing bone removal. Key words: E

scholarly journals LUMBAR SPINAL STENOSIS: EVALUATION OF PAIN AND LIFE QUALITY AFTER SURGICAL TREATMENT

2019 ◽  
Vol 18 (1) ◽  
pp. 37-42
Author(s):  
Gustavo Alvarenga ◽  
João Otávio Araújo Rotini ◽  
Leonardo Yukio Jorge Asano ◽  
Vinícius Alves de Andrade ◽  
André Evaristo Marcondes Cesar ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Life Quality ◽  
Case Series ◽  
Level Of Evidence ◽  
The Mean ◽  
One Year ◽  
Lumbar Spinal

ABSTRACT Objective: The objective of this study was to present an analysis of progression of the quality of life and pain in patients undergoing surgical treatment of LSS and the potential correlations between individual factors and the clinical outcome observed. Methods: We studied 111 patients undergoing surgical treatment of LSS from January 2009 to December 2011 using the functional capacity (ODI) and pain (VAS) questionnaires. The preoperative data were compared statistically with the results obtained during the postoperative follow-up at one month, six months, one year, and two years. Results: The population consisted of 60 men and 51 women. The mean age was 61.16 years at the time of surgery, 33.33% were 60 years or older. When the questionnaires were applied, we found improvement in the progressive disability assessment with a mean drop of 23.65 ODI points after 6 months of the surgical treatment and 27.47 at the end of one year of surgery compared to preoperative for this scale. There was a decline of 3.84 points (mean) in the VAS at first postoperative month. Conclusion: Surgical treatment of LSS presented favorable postoperative evolution in a 2-year follow-up regarding pain and quality of life through VAS and ODI. Level of Evidence IV; Case series.

scholarly journals Mastoid Reconstruction With Platelet-Rich Plasma and Bone Pate After Canal Wall Down Mastoidectomy: A Preliminary Report

2019 ◽  
pp. 014556131987978 ◽  
Author(s):  
Sherif M. Askar ◽  
Ibrahim M. Saber ◽  
Mohammad Omar
Keyword(s):  
Tympanic Membrane ◽  
Cortical Bone ◽  
Platelet Rich Plasma ◽  
Case Series ◽  
Stressful Events ◽  
Mastoid Cavity ◽  
Canal Wall ◽  
Tympanic Membrane Perforations ◽  
Canal Wall Down ◽  
Canal Wall Down Mastoidectomy

Objectives: Mastoid reconstruction principle had been described to overcome problems of chronic discharging cavity. Different materials were used; nonbiologic materials seem to be less preferred. Platelet-rich plasma (PRP) could promote the regeneration of mineralized tissues. In this work, the authors present a simple and easy technique for mastoid reconstruction with PRP and cortical bone pate. Methods: The study design is a case series. Patients had mastoid reconstruction after canal wall down mastoidectomy using PRP and cortical bone pate. Results: This study included 21 patients: 9 males, and 12 females. Sixteen patients had left side disease. All surgical procedures were conducted smoothly within 90 to 135 minutes with no stressful events had been reported. At 12 to 16 months of follow-up, external canal stenosis and mastoid fistulas were not reported. Good healing of the tympanic membrane was seen in 18 patients. No radiological signs suggestive of recurrence were detected and the reconstructed mastoid cavity was smooth and well aerated. Residual tympanic membrane perforations were detected in 3 patients. Conclusion: Autologous materials (PRP and bone pate pate) after canal wall down mastoidectomy appear to be a reliable and effective choice for mastoid reconstruction.

Pseudo mastoid obliteration with conchal cartilage may be a safe alternative technique for cochlear implantation in canal wall down mastoidectomy with large meatoplasty

2020 ◽  
Vol 134 (6) ◽  
pp. 493-496
Author(s):  
C Carnevale ◽  
G Til-Pérez ◽  
D Arancibia-Tagle ◽  
M Tomás-Barberán ◽  
P Sarría-Echegaray
Keyword(s):  
Cochlear Implantation ◽  
Mastoid Cavity ◽  
Canal Wall ◽  
Mastoid Obliteration ◽  
Safe Alternative ◽  
Conchal Cartilage ◽  
External Canal ◽  
Canal Wall Down ◽  
Canal Wall Down Mastoidectomy

AbstractObjectiveSafe cochlear implantation is challenging in patients with canal wall down mastoid cavities, and the presence of large meatoplasties increases the risk of external canal overclosure. This paper describes our results of obliteration of the mastoid cavity with conchal cartilage as an alternative procedure in cases of canal wall down mastoidectomy with very large meatoplasty.MethodsThe cases of seven patients with a canal wall down mastoidectomy cavity who underwent cochlear implantation were retrospectively reviewed. Post-operative complications were analysed. The mean follow-up duration was 4.5 years.ResultsThere was no hint of cholesteatoma recurrence and all patients have been free of symptoms during follow up. Only one patient showed cable extrusion six months after surgery, and implantation of the contralateral ear was needed.ConclusionPseudo-obliteration of the mastoid cavity with a cartilage multi-layered palisade reconstruction covering the electrode may be a safe alternative in selected patients with a large meatoplasty.

scholarly journals One Year Follow-Up of Patient Reported Outcomes Following Third Generation Minimally Invasive Chevron Akin Osteotomies (MICA) in Hallux Valgus Surgery

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0032
Author(s):  
Thomas L. Lewis ◽  
Robbie Ray ◽  
David Gordon
Keyword(s):  
Minimally Invasive ◽  
Hallux Valgus ◽  
Patient Reported Outcomes ◽  
Case Series ◽  
Third Generation ◽  
Short Term ◽  
Patient Reported ◽  
The Mean ◽  
One Year

Category: Bunion Introduction/Purpose: The aim of this study was to explore the short-term results of third generation (using screw fixation) Minimally Invasive Chevron and Akin osteotomies (MICA) for hallux valgus correction. There is a paucity of published data regarding the outcomes of this relatively new technique. We present the largest series in the literature, using three separate validated patient-reported outcome measures (EQ-5DL, VAS Pain and Manchester Oxford Foot Questionnaire (MOXFQ), for this time point. Methods: A single surgeon case series of patients with hallux valgus underwent primary third generation minimally invasive chevron and akin osteotomies (MICA) for hallux valgus correction. Between August 2015 and January 2019, 430 MICAs were performed in 295 patients that were eligible for 1 year follow up. Baseline and 1 year post-operative patient reported outcomes were collected for 242 feet in 194 patients (182 females; 12 males). Paired t-tests were used to determine the statistical significance of the difference between pre- and post-operative scores. Results: The mean age was 55.9 (range 16.3-84.9, standard deviation (s.d.) 12.5). At one year follow up, the mean MOXFQ scores had improved for each domain: Pain; baseline 41.9 (range 0-100, s.d. 21.8), reduced to 13.8 (range 0-90, s.d. 17.7, p<0.001); Walking; baseline 34.6 (range 0-100, s.d. 24.3) reduced to 9.8 (range 0-89.0, s.d. 18.0, p<0.001); Social interaction; baseline 45.4 (range 0-100, s.d. 22.8), reduced to 8.2 (range 0-75.0, s.d. 14.7, p<0.001). Mean VAS Pain score improved from 29.8 (range 0.0-90.0, s.d. 22.1) to 8.2 (range 0.00-64.0, s.d. 12.8, p<0.001). Mean EQ-5D index score improved from 0.755 (range 0.066-1.000, s.d. 0.136) to 0.891 (range 0.350-1.000, s.d. 0.124, p<0.001). Mean EQ-5D VAS score improved from 83.4 (range 28- 100, s.d. 12.4) to 85.6 (range 0-100, s.d. 14.2, p=0.047). Conclusion: This is the largest prospective case series of short-term patient reported outcomes using a validated assessment method for hallux valgus, following third generation MICA to date. These data show that this technique is effective at improving foot and ankle specific patient reported outcomes at 1 year. This cohort is being followed over the longer term.

scholarly journals Five Years Prospective Study on Implant Failure and Marginal Bone Remodeling Expected Using Bone Level Implants with Sandblasted/Acid-Etched Surface and Conical Connection

2021 ◽  
Author(s):  
Marco Tallarico ◽  
Aurea Immacolata Lumbau ◽  
Silvio Mario Meloni ◽  
Irene Ieria ◽  
Chang-Joo Park ◽  
...  
Keyword(s):  
Bone Remodeling ◽  
Case Series ◽  
Insertion Torque ◽  
Case Series Study ◽  
The Mean ◽  
Prospective Case Series ◽  
One Year ◽  
The One ◽  
Series Study

Aim: the purpose of the present prospective, case series study were to report implant survival rate and marginal bone remodeling expected five years after loading using dental implants placed in in the daily practice. Material and Methods: this research was designed as an open-cohort, prospective case series study. Any completely or partially edentulous patients scheduled to receive at least one bone leve were considered eligible for this study. Primary outcomes were: cumulative implant (ISR) and prosthetic (PSR) survival rates, and any complications experienced up the five years follow-up. Secondary outcomes were: marginal bone remodeling, implant insertion torque, implant stability quotient (ISQ), and thickness of gingival biotype. Results: ninety consecutive patients (34 males and 56 females; mean age 53.2&plusmn;15.4 years; range of 24&ndash;81 years), 243 implants were placed and followed for at least five years after loading (mean of 65.4&plusmn;3.1 months; range of 60&ndash;72 months). The mean implant insertion torque was 42.9&plusmn;4.8 Ncm (range from 15 to 45 Ncm). Overall, 83.5% of the implants (n=203) were placed with an insertion torque between 35 and 45 Ncm. At the one year follow-up, no drop-outs were recorded, but 17 patients (18.9%) with 18 restorations (12.6%) delivered on 34 implants (14%) were lost at the five years examination. At the five-year examination, six implants failed in six patients, resulting in a cumulative ISR of 97.5%. At the five-year follow-up, four prostheses failed (2.8%) resulting in a cumulative PSR of 97.2%. At the five-year examination, five complications were reported by five different patients, resulting in a prosthetic success rate of 96.5%, measured at patient level. Five years after loading, mean MBL was 0.41 &plusmn; 0.30 mm (95% CI: 0.26&ndash;0.34). Difference from the one year data was 0.04 &plusmn; 0.19 mm (95% CI: 0.01&ndash;0.07). The mean ISQ value at implant placement was 71.6 &plusmn; 5.5 (range of 45&ndash;88). Six months later, the mean ISQ was 76.7 &plusmn; 4.4 (range of 66&ndash;89). The difference was statistically significant (P=0.0001). Statistically significant higher MBL was found for smokers, and patient with thin gingival biotype. Conclusions: High implant survival and success rates could be expected with stable marginal bone remodeling up to five years after loading. Smoking and thin tissue biotype were the most important variabilities associated with higher MBL. Further research are needed to confirm these results.

scholarly journals Solar maculopathy: prognosis over one year follow up

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Marwa Mahmoud Abdellah ◽  
Engy Mohammed Mostafa ◽  
Mohamed Abdelatif Anber ◽  
Islam Saad El Saman ◽  
Mohammed Ezz Eldawla
Keyword(s):  
Visual Acuity ◽  
Case Series ◽  
Good Prognosis ◽  
Spectral Domain ◽  
Ocular Coherence Tomography ◽  
The Mean ◽  
One Year ◽  
Retinal Hole ◽  
Sd Oct

Abstract Background To document the visual acuity, spectral domain optical coherence tomography (SD-OCT) findings and prognosis in10 eyes of 6 patients with foveal damage from solar retinopathy in 1 year. Methods This was a prospective, observational case series of patients presented by solar maculopathy at Ophthalmology department, Sohag University. All patients underwent visual acuity (VA) testing, refraction, dilated fundus examination fluorescein angiography (FA) and SD-OCT (spectral Domain ocular coherence Tomography) imaging and follow up for 1 year. Results The mean age was 16.5 years (range 9–27 years, both eyes are affected in 4 patients. The mean spherical equivalent (SE) was – 0.25 ± 0.50 D. The visual acuity of the affected eyes ranged from 0.4 to 0.9 on presentation. At presentation Significant foveal pathology was identified on SD-OCT in 10 eyes, All eyes showed disruption of the photoreceptor ellipsoid zone and the interdigitation zone on SD-OCT, Follow up of the cases continued for 1 year.100% of cases showed improvement in VA: 20% eyes regained 1, 50% eyes with VA of 0.9; two eyes 20% 0.8 and one eyes (10%) with 0.4. The improvement began after 1 week and reached its maximum and became stationary after the 6th month of follow up, the outer retinal hole persist in OCT in 80% of cases. Conclusion Solar maculopathy has a good prognosis yet shows no improvement after 6 months. Young age might pose as a risk factor.

scholarly journals CAVITY LESS MASTOID SURGERY

2019 ◽  
Vol VOLUME 7 (VOLUME 7 NUMBER 2 NOV 2018) ◽  
pp. 6-14
Author(s):  
Pankaj Srivastava
Keyword(s):  
Operating Time ◽  
Mastoid Cavity ◽  
Key Words Cholesteatoma ◽  
Cavity Filling ◽  
Canal Wall Down ◽  
Canal Wall Down Mastoidectomy ◽  
Mastoid Surgery ◽  
Early Healing ◽  
Air Cells

After complete canal down Mastoidectomy two types of mastoid cavities are found - First -completely sclerosed – means no visible mastoid air cells remain in the operated mastoid cavity-here a large and thin fascia is laid to cover all the cavity and it epithelises by primary early healing& gives long term dry cavity and Second - cellular cavity in which after complete Mastoidectomy, there still remain some cells at the floor. (it is always not possible to exenterate all the air cells or at least impractical because it may take long operating time or may create unnecessary large cavity) - If this cavity is lined by fascia or cavity filling is done, the remaining air cells mucosa will grow, keep on secreting mucus, granulate and the Mastoid cavity will no longer be dry. A new method of solving this problem is designed- Conchal cartilage which is harvested at the time of meatoplasty is thinned out and laid down in the cavity with convexity upwards so that it creates a small cavity communicating to aditus and then to middle ear and large fascia is lined over it.It provides primary healed, early and long term, small, dry and healthy Mastoid cavity. Key words: Cholesteatoma, canal wall down Mastoidectomy, mastoid cavity

Sign in / Sign up

Export Citation Format

Share Document