Ossicular chain reconstruction with a titanium prosthesis

2009 ◽  
Vol 123 (10) ◽  
pp. 1082-1086 ◽  
Author(s):  
J A Roth ◽  
S R Pandit ◽  
M Soma ◽  
T R Kertesz
Keyword(s):  
Retrospective Chart Review ◽  
Functional Results ◽  
Ossicular Chain ◽  
Partial Reconstruction ◽  
Ossicular Chain Reconstruction ◽  
Total Reconstruction ◽  
First Time ◽  
Conductive Hearing ◽  
Reconstruction Group ◽  
The Ideal

AbstractObjective:Ossicular chain damage from chronic ear disease is a significant problem in the Australian population. The ideal ossicular chain reconstruction prosthesis has yet to be defined. This paper examines, for the first time, the use of a titanium prosthesis for ossicular chain reconstruction in Australian patients.Study design:Retrospective chart review.Subjects and methods:All patients undergoing ossicular chain reconstruction with a titanium prosthesis between 1 February 2002 and 31 March 2007.Results:Results showed a low complication rate, with only one extrusion out of 55 cases (1.8 per cent). Successful rehabilitation of conductive hearing loss (i.e. to ≤20 dB air–bone gap) was obtained in 85 per cent of the partial ossicular chain reconstruction group and 77 per cent of the total ossicular chain reconstruction group. Pure tone thresholds improved by an average 18 dB in the partial reconstruction group and 25 dB in the total reconstruction group.Conclusion:Titanium is an ideal material for ossicular chain reconstruction due to its ease of insertion, low rate of extrusion and good functional results.

Ossicular Discontinuity and Exostoses in Proteus Syndrome: A Case Report

2005 ◽  
Vol 114 (3) ◽  
pp. 242-246
Author(s):  
Joni K. Doherty ◽  
Dennis R. Maceri
Keyword(s):  
Hearing Loss ◽  
High Frequency ◽  
Conductive Hearing Loss ◽  
Ossicular Chain ◽  
Typical Feature ◽  
Proteus Syndrome ◽  
Frequency Range ◽  
Pure Tone Average ◽  
Ossicular Chain Reconstruction ◽  
Conductive Hearing

Proteus syndrome (PS) is a rare hamartomatous disorder characterized by mosaic overgrowth of multiple tissues that manifests early in life and is progressive. The presence of unilateral external auditory canal exostoses in a patient who is not a swimmer or surfer is suggestive of PS. However, hearing loss is not a typical feature. Here, we describe exostoses and ossicular discontinuity with conductive hearing loss in a patient with PS. The treatment consisted of canalplasty and ossicular chain reconstruction. A postoperative reduction was demonstrated in the patient's air-bone gap, from 21 dB to 13 dB for the pure tone average (four frequencies) and from 41 dB to 15 dB in the high-frequency range (6,000 to 8,000 Hz). Causes of ossicular discontinuity are discussed. Routine annual audiometric and otolaryngological evaluation should be considered in all patients with temporal bone inyolvement of PS.

scholarly journals Misplaced incus: an unusual complication of a temporal bone fracture

2019 ◽  
Vol 12 (3) ◽  
pp. e228207
Author(s):  
Katherine Pollaers ◽  
Christopher Broadbent ◽  
Jafri Kuthubutheen
Keyword(s):  
Hearing Loss ◽  
Temporal Bone ◽  
Bone Fractures ◽  
Ossicular Chain ◽  
Unusual Complication ◽  
Temporal Bone Fracture ◽  
Patient Reported ◽  
Ossicular Chain Reconstruction ◽  
Hearing Outcomes ◽  
Conductive Hearing

A 24-year-old man sustained significant injuries as a result of a motor bicycle accident. CT scans demonstrated multiple intracranial injuries including bilateral temporal bone fractures. On emergence from sedation, the patient reported right-sided hearing loss which was attributed to ossicular chain disruption after the incus was found to be in the external auditory canal. Unexpectedly, the initial conductive hearing loss resolved with conservative management and an ossicular chain reconstruction was not required. This is an unusual case of impressive long-term good hearing outcomes following complete dislocation of the incus and extrusion from the middle ear.

Conductive hearing loss after head trauma: review of ossicular pathology, management and outcomes

2008 ◽  
Vol 123 (2) ◽  
pp. 177-181 ◽  
Author(s):  
O J Basson ◽  
A C van Lierop
Keyword(s):  
Hearing Loss ◽  
Head Trauma ◽  
Conductive Hearing Loss ◽  
Retrospective Chart Review ◽  
Ossicular Chain ◽  
Average Improvement ◽  
History Of ◽  
Incudostapedial Joint ◽  
Conductive Hearing

AbstractIntroduction:This paper reviews our experience of ossicular chain injuries following head trauma treated at Groote Schuur Hospital, Cape Town, South Africa.Materials and methods:We performed a retrospective chart review of all patients with a history of head trauma and a conductive hearing loss who had undergone exploratory tympanotomy. Sixteen patients were included in the study.Results:Injury was most common at the incudostapedial joint (63 per cent). Disarticulations of the icudostapedial joint were treated with cartilage interposition in all cases. Audiography showed an improvement in 12 of the patients, with an average improvement of 35 dB.Discussion:We discuss the various options available to the otologist to repair ossicular disruptions after trauma. In this series, cartilage autografts were used in most incudostapedial joint injuries, with excellent closure of the air–bone gap.Conclusion:Cartilage interposition was a very successful method of repairing incudostapedial joint dislocation in this series, at short term follow up.

Congenital Middle Ear Anomalies: Anatomical and Functional Results of Surgery

2015 ◽  
Vol 20 (4) ◽  
pp. 237-242 ◽  
Author(s):  
Stéphanie Quesnel ◽  
Tarik Benchaa ◽  
Sophie Bernard ◽  
François Martine ◽  
Paul Viala ◽  
...  
Keyword(s):  
Middle Ear ◽  
Retrospective Chart Review ◽  
Functional Results ◽  
Ossicular Chain ◽  
Class Ii ◽  
Class I ◽  
Consecutive Series ◽  
Class Iii ◽  
Ear Anomalies

The aim of this study was to describe the audiometric results following surgery in a consecutive series of pediatric patients with a congenital middle ear disorder. Retrospective chart review was performed for 29 consecutive children who underwent 33 middle ear surgeries for congenital ossicular chain anomaly between 1990 and 2012. Anomalies were classified into four groups according to the Teunissen and Cremers classification. Audiological parameters using four frequency averages (0.5, 1, 2 and 4 kHz) were assessed pre- and postoperatively. Clinical and audiometric follow-up times were, respectively, 49 ± 8 and 35 ± 5 months (mean ± SEM). Fifty-eight percent of all patients achieved an air-bone gap (ABG) ≤20 dB, 62.5% in class I, 50% in class II and 57.9% in class III. The improvement of the mean ABG was 13.6 dB, 19.2 dB for class I, 0.2 dB in class II and 15.4 dB in class III. Overall mean pure-tone averages improved 14.8 dB with 13.9 dB for class I; there was no improvement for class II and 20.2 dB for class III. The sensorineural hearing loss rate was 9%. This pediatric series showed that hearing results depend on type of anomaly. Class I and class III showed better hearing improvement than class II.

The Republic

2019 ◽  
pp. 205-229
Author(s):  
Dominic Scott
Keyword(s):  
Political Theory ◽  
Left Behind ◽  
Ideal State ◽  
The Republic ◽  
Individual Justice ◽  
The Individual ◽  
Political Right ◽  
First Time ◽  
The Ideal

This chapter presents a reading of Plato’s Republic. The Republic is among Plato’s most complex works. From its title, the first-time reader will expect a dialogue about political theory, yet the work starts from the perspective of the individual, coming to focus on the question of how, if at all, justice contributes to an agent’s happiness. Only after this question has been fully set out does the work evolve into an investigation of politics—of the ideal state and of the institutions that sustain it, especially those having to do with education. But the interest in individual justice and happiness is never left behind. Rather, the work weaves in and out of the two perspectives, individual and political, right through to its conclusion. All this may leave one wondering about the unity of the work. The chapter shows that, despite the enormous range of topics discussed, the Republic fits together as a coherent whole.

Ossicular chain reconstruction: endoscopic or microscopic?

2021 ◽  
pp. 1-7
Author(s):  
E A Guneri ◽  
A Cakir Cetin
Keyword(s):  
Word Recognition ◽  
Middle Ear ◽  
Risk Index ◽  
Ossicular Chain ◽  
Recognition Score ◽  
Reconstruction Surgery ◽  
Ossicular Chain Reconstruction ◽  
Operation Duration ◽  
Air Conduction

Abstract Objective To compare the results of endoscopic and microscopic ossicular chain reconstruction surgery. Methods Patients undergoing ossicular chain reconstruction surgery via an endoscopic (n = 31) or microscopic (n = 34) technique were analysed for age, gender, Middle Ear Risk Index, ossicular chain defect, incision type, ossicular chain reconstruction surgery material, mean air conduction threshold, air–bone gap, air–bone gap gain, word recognition score, mean operation duration and mean post-operative follow up. Results Post-operative air conduction, air–bone gap and word recognition score improved significantly in both groups (within-subject p < 0.001 for air conduction and air–bone gap, and 0.026 for word recognition score); differences between groups were not significant (between-subject p = 0.192 for air conduction, 0.102 for air–bone gap, and 0.709 for word recognition score). Other parameters were similar between groups, except for incision type. However, endoscopic ossicular chain reconstruction surgery was associated with a significantly shorter operation duration (p < 0.001). Conclusion Endoscopic ossicular chain reconstruction surgery can achieve comparable surgical and audiological outcomes to those of microscopic ossicular chain reconstruction surgery in a shorter time.

Philosophy and Education

1998 ◽  
pp. 32-36
Author(s):  
Luciana Bellatalla
Keyword(s):  
Western Culture ◽  
Cultural Tradition ◽  
The World ◽  
Dialogic Approach ◽  
First Time ◽  
The Ideal

From its first appearance in western culture, philosophy has been considered able to build up reality, to educate people, and to disclose truth. Plato proposed philosophers as governors in life-long pursuit of philosophical learning. Socrates was the ideal paradigm of an educating philosopher: he tried to wake up human minds so that they could be aware of themselves and of the world, criticizing tradition and prejudices in a logically consistent perspective. A critical and dialogic approach—not by mere chance defined as "Socratic"—to problems has been considered until now the most profitable method of teaching. Socrates is a pioneer in discussing the question of a philosophical (paideia), as he defined his method "maieutic." He was not an authoritarian teacher, but a sparring partner in the process of self-education. Moreover, he considered himself as the most learned and, at the same time, the wisest in Greece, just because he was conscious of his ignorance. Therefore, he understood for the first time in our cultural tradition that knowledge is an endless process rather than a product, within marked bounds.

The Activities of the Tube Feet of Asterias Rubens L

1947 ◽  
Vol s3-88 (1) ◽  
pp. 1-14
Author(s):  
J. E. SMITH
Keyword(s):  
Forward Direction ◽  
The Other ◽  
Asterias Rubens ◽  
Ideal Form ◽  
First Time ◽  
Intrinsic Musculature ◽  
Tube Feet ◽  
Postural Muscles ◽  
The Ideal

1. An account is given of the muscular anatomy of the foot and ampulla of Asterias rubens. An intrinsic musculature of the sucker figured by Cuénot (1891) and Chadwick (1923) is shown not to be present; on the other hand, postural muscles responsible for orientating the podium, levator fibres which ‘cup’ the sucker, and radial fibres which flatten it are described and figured for the first time. 2. The role of the different muscle systems, the collagen connective tissue, and the fluid of the hydrocoel in protracting and retracting the foot, and in effecting the attachment and detachment of the sucker, is discussed. 3. Evidence is presented, to show that postural pointing of the foot is brought about by the contraction of a ring of muscles encircling the base of the podium. The orienting muscles are functionally, but not anatomically, distinct from the longitudinal fibres of the retractor sheath. 4. The ambulatory step is shown to comprise a series of linked phases of static posture and of movement. Each phase is characterized by the contraction of one member of each of the two opposing pairs of muscles engaged in the development of the step. The two pairs of muscles are (1) the anterior and posterior orienting fibres, and (2) the protractors and retractors of the foot. In its ideal form the step comprises four phases of static posture alternating with four movements. Each movement is ushered in by a reversal of the contraction-relaxation relationships of one of the two pairs of opposing muscle systems. Four such changes are possible and they occur in a sequence that ensures the orderly succession of the four movements of protraction, swing back, retraction, and swing forward, of which movements the idealized stepping cycle is composed. 5. The actual locomotory step departs from the ideal form in two respects: (1) it is liable to become disrupted by a delay in the initiation of the protraction or of the backswing movement, and (2) withdrawal of the podium occurs simultaneously with its re-orientation in the forward direction. It is pointed out that these variations are explicable on the assumption that, in the two series of opposing muscle pairs, the retractor fibres are more readily excited to contract than are their antagonists, and the anterior postural muscles than the posterior postural fibres.

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