Chondroperichondrial clip myringoplasty: a new technique for closure of tympanic membrane perforations

2013 ◽  
Vol 127 (6) ◽  
pp. 562-567 ◽  
Author(s):  
S Ahmed ◽  
N Raza ◽  
S Ullah ◽  
A Shabbir
Keyword(s):  
Tympanic Membrane ◽  
Chronic Otitis Media ◽  
Invasive Technique ◽  
Mucosal Disease ◽  
Tympanic Membrane Perforations ◽  
Select Group ◽  
Custom Made ◽  
A New Technique ◽  
Graft Success ◽  
Conventional Myringoplasty

AbstractObjective:This study aimed to evaluate the feasibility and efficacy of the recently described chondroperichondrial clip myringoplasty technique, and make comparisons with conventional myringoplasty techniques.Methods:The study comprised a select group of patients with chronic otitis media (mucosal disease only), with central tympanic membrane perforations affecting less than 50 per cent of the pars tensa, and an air–bone gap below 35 dB. A modified custom-made cartilage perichondrial graft was placed using the recently described ‘clip’ technique.Results:The graft success rate was 91.3 per cent. Post-operatively, the air–bone gap was within 10 dB in 52 per cent of cases and within 10–20 dB in 48 per cent of cases. There were few minor complications.Conclusion:Chondroperichondrial clip myringoplasty can be considered as an alternative minimally invasive technique for the repair of select cases of tympanic membrane perforations. This technique, which showed impressive results, was associated with minimum morbidity and reduced operative time.

A comparative study of endoscopic cartilage myringoplasty used to treat wet and dry ears with mucosal-type chronic otitis media

2020 ◽  
Vol 134 (9) ◽  
pp. 773-778
Author(s):  
Z Lou ◽  
X Li
Keyword(s):  
Comparative Study ◽  
Success Rate ◽  
Tympanic Membrane ◽  
Otitis Media ◽  
Chronic Otitis Media ◽  
Success Rates ◽  
Hearing Gain ◽  
Tympanic Membrane Perforations ◽  
The Difference ◽  
Graft Success

AbstractObjectiveThe outcomes of dry and wet ears were compared following endoscopic cartilage myringoplasty performed to treat chronic tympanic membrane perforations in patients with mucosal chronic otitis media.MethodsPatients with chronic perforations, and with mucosal chronic otitis media with or without discharge, were recruited; all underwent endoscopic cartilage myringoplasty. The graft success rate and hearing gain were evaluated at six months post-operatively.ResultsThe graft success rates were 85.9 per cent (67 out of 78) in dry ears and 86.2 per cent (25 out of 29) in wet ears; the difference was not significant (p = 0.583). Among the 29 wet ears, the graft success rates were 100 per cent in 11 ears with mucoid discharge and 77.8 per cent in the 18 patients with mucopurulent otorrhoea.ConclusionThe wet or dry status of ears in patients with chronic perforations with mucosal chronic otitis media did not affect graft success rate or hearing gain after endoscopic cartilage myringoplasty. However, ears with mucopurulent discharge were associated with increased failure rates and graft collapse, whereas ears with mucoid discharge were associated with higher graft success rates.

scholarly journals Comparative study between fat plug and inlay butterfly cartilage grafts for myringoplasty in adults

2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Ahmed Gamal Khafagy ◽  
Mohamed El-Begermy ◽  
Marwa Mohamed El-Begermy ◽  
Pretty O. Afifi
Keyword(s):  
Tympanic Membrane ◽  
Chronic Otitis Media ◽  
Fat Graft ◽  
Cartilage Graft ◽  
Tympanic Membrane Perforations ◽  
Number Of Patients ◽  
Significant Difference ◽  
Hearing Outcomes ◽  
Age Range

Abstract Background This study aims to compare the graft uptake rate and hearing improvement of fat graft versus inlay butterfly tragal cartilage in the repair of perforations in chronic otitis media mucosal in adults. In this retrospective study, twenty-eight patients were included with small dry anteroinferior tympanic membrane perforations (less than 1/3 of the tympanic membrane). The age range was 18 to 44 years old. Myringoplasty was done under general anesthesia for 8 patients with a fat graft (FG) and 20 patients with inlay butterfly cartilage graft (IBCG). Six months postoperatively, a follow-up evaluation was done for successful graft uptake and hearing outcomes. Results The success rate of graft uptake in the first group (fat graft) was 6/8 cases (75%) while in the second group (IBCG) was 19/20 (95%) with no statistically significant difference (P = 0.0148). Also, there was no statistical difference between the two groups as regards postoperative ABG, improvement changes in ABG, and number of patients with improved hearing. Conclusions Inlay butterfly cartilage graft is a useful graft in repairing small tympanic membrane perforations as regard graft take and hearing outcomes.

Effect of tympanic membrane perforation on middle-ear sound transmission

2009 ◽  
Vol 123 (S31) ◽  
pp. 81-89 ◽  
Author(s):  
Y Matsuda ◽  
T Kurita ◽  
Y Ueda ◽  
S Ito ◽  
T Nakashima
Keyword(s):  
Image Analysis ◽  
Tympanic Membrane ◽  
Chronic Otitis Media ◽  
Tympanic Membrane Perforation ◽  
Conduction Disturbance ◽  
Low Frequencies ◽  
Tympanic Membrane Perforations ◽  
Precise Evaluation ◽  
Membrane Perforation ◽  
Sound Conduction

AbstractTympanic membrane perforation causes a sound conduction disturbance, and the size of this conduction disturbance is proportional to the perforation area. However, precise evaluation of perforation size is difficult, and there are few detailed reports addressing this issue. Furthermore, such evaluation becomes more difficult for irregularly shaped perforations. This study conducted a quantitative evaluation of tympanic membrane perforations, using image analysis equipment.A significant correlation was found between the degree of sound conduction disturbance and the perforation area; this correlation was greater at low frequencies following a traumatic perforation. The conductive disturbance associated with chronic otitis media was significantly greater at low frequencies. Circular perforations caused only minor conduction disturbance. Perforations in the anteroinferior quadrant were associated with greater conduction disturbance. Traumatic spindle-shaped perforations and malleolar perforations were associated with greater conduction disturbance.

scholarly journals The Effect of External Auditory Canal Packing Duration on Healing After Endoscopic Cartilage Myringoplasty

2020 ◽  
pp. 014556132092211
Author(s):  
Zhengcai Lou
Keyword(s):  
Success Rate ◽  
Tympanic Membrane ◽  
External Auditory Canal ◽  
Cartilage Graft ◽  
Early Group ◽  
Tympanic Membrane Perforations ◽  
Removal Time ◽  
Graft Success ◽  
Late Group ◽  
And Cartilage

Introduction: The external auditory canal (EAC) packing is widely used in otosurgery and is considered to promote hemostasis and to support tympanic membrane grafts. However, few studies have investigated the effects of packing removal time on healing. Objective: We investigated the effect of EAC packing duration on healing after endoscopic cartilage myringoplasty in patients with chronic tympanic membrane perforations (TMPs). Materials and Methods: Patients with chronic TMPs who underwent endoscopic “push-through” cartilage myringoplasty were divided into early and late groups based on the length of time before EAC packing was removed. The graft success rate, eardrum appearance, and hearing gain were assessed 3 months after surgery. Results: The study included 137 patients. Three months after surgery, the graft success rate was 83.5% (66/79) in the early group and 94.8% (55/58) in the late group ( P = .042). The graft was displaced in 8 (10.1%) patients in the early group and in 1 (1.7%) patient in the late group ( P = .050). No epithelialization was found on the surface of the grafts in the early group, whereas epithelialization was nearly complete 4 weeks after surgery in the late group. Conclusions: Delaying removal of the EAC packing after endoscopic cartilage myringoplasty may promote tympanic membrane better healing and cartilage graft epithelialization and improve the appearance of the eardrum.

scholarly journals Effect of Silver Nitrate and Epidermal Growth Factor on Nonhealing Tympanic Membrane Perforations: A Randomized Controlled Study

2018 ◽  
Vol 01 (01) ◽  
pp. 029-033
Author(s):  
Vikram Bhat ◽  
Bijiraj Veetil ◽  
Vidyashree Mathad
Keyword(s):  
Growth Factor ◽  
Epidermal Growth Factor ◽  
Silver Nitrate ◽  
Tympanic Membrane ◽  
Chronic Otitis Media ◽  
Tympanic Membrane Perforations ◽  
Epidermal Growth ◽  
Group 2 ◽  
Chemical Cautery ◽  
Group 1

Abstract Introduction Most tympanic membrane perforations in chronic otitis media require surgical myringoplasty for closure. This study aimed to find out a simple nonsurgical outpatient procedure to close these perforations that could reduce the hospital stay, medical cost, and morbidity in these patients. Materials and Methods The study was conducted in a tertiary referral hospital in a single-blind randomized controlled trial design with two groups, each with a sample size of 40 ears. Only small-size central nonhealing traumatic and chronic otitis media perforations were recruited. Pure tone audiometry and otomicroscopy were performed in all eligible patients who consented to take part in the study. Group 1 was treated with silver nitrate chemical cautery alone. Group 2 received epidermal growth factor gel application in addition to chemical cautery. Both the groups were followed up for a minimum period of 3 months. The same investigations were performed during follow-up. Results and Observations The outcome was considered a success whether there was closure of perforation or reduction in the size of perforation. The success rate of these nonhealing perforations was found to be significantly higher in group 2 (71.42%) than in group 1 (47.36%). Hearing gain was observed in closed perforations of both the groups. Conclusion Epidermal growth factor application enhances the healing effect of silver nitrate in small nonhealing tympanic membrane perforations. The encouraging results of epidermal growth factor have vast applications in improving outcomes of surgical myringoplasty and treatment of residual perforations remaining after the same.

Endoscopic triple-C tympanoplasty: an alternative approach to anteriorly located tympanic membrane repair

2018 ◽  
Vol 132 (11) ◽  
pp. 1007-1009 ◽  
Author(s):  
H Demirhan ◽  
Ö Yiğit ◽  
B Hamit ◽  
M Çakır
Keyword(s):  
Success Rate ◽  
Tympanic Membrane ◽  
Operating Time ◽  
Case Series ◽  
Membrane Repair ◽  
Anterior Portion ◽  
Tympanic Membrane Perforations ◽  
Alternative Method ◽  
Graft Success

AbstractObjectiveAnteriorly located tympanic membrane perforations can negatively affect surgical success rates. This study aimed to present, using our case series results, endoscopic triple-C (composite chondroperichondrial clip) tympanoplasty as an alternative method in the repair of tympanic membrane anterior quadrant perforations.MethodsThis study included patients with a perforation sized greater than 3 mm, who had an anterior quadrant dominant perforation where the anterior portion could not be seen during microscopic examination; all underwent endoscopic triple-C tympanoplasty.ResultsOperating time was 30–79 minutes (mean, 46.6 minutes). The post-operative graft success rate at six months was 92 per cent (23 out of 25). Mean post-operative follow-up duration was 21.5 ± 7.3 months (range, 11–40 months), and no intratympanic cholesteatoma was observed.ConclusionEndoscopic triple-C tympanoplasty is a comfortable, minimally invasive alternative method to repair anterior tympanic membrane perforations. The graft success rate and the degree of recovery from hearing loss were in accordance with the literature. However, more reliable results may be obtained in a larger series with longer follow-up times.

scholarly journals A STUDY ON CORRELATION OF SIZE AND SITE OF TYMPANIC MEMBRANE PERFORATION WITH DEGREE OF CONDUCTIVE HEARING LOSS IN CHRONIC OTITIS MEDIA

2021 ◽  
Vol VOLUME 9 (ISSUE 1) ◽  
pp. 19-23
Author(s):  
M Lavanya
Keyword(s):  
Hearing Loss ◽  
Tympanic Membrane ◽  
Conductive Hearing Loss ◽  
Chronic Otitis Media ◽  
Tympanic Membrane Perforation ◽  
Tympanic Membrane Perforations ◽  
Posterior Quadrant ◽  
Membrane Perforation ◽  
Duration Of Disease ◽  
Conductive Hearing

Background: Tympanic membrane perforations are common cause of hearing loss. This study was designed to analyze the relation between tympanic membrane perforation and conductive hearing loss. Materials and Methods: In this prospective study, patients with dry tympanic membrane perforations of safe type were included. The patients were divided into groups in according to size, site and duration of perforation. Based on the inclusion and exclusion criteria a total of 100 patients were included in this study. All the patients clinical data was analyzed statistically using paired t-test. Results:Hearing loss increased as the size of perforation increased. Posterior quadrant perforations were associated with more hearing loss as compared to anterior quadrant perforations. Also duration of disease was in linear relation with mean hearingloss. Conclusions: The degree of conductive hearing loss as a result of tympanic membrane perforation would be expected with the size, site and duration of perforation. Keywords: Tympanic membrane, Conductive hearing loss, Perforation, hearing loss, posterior quadrant, ear.

Tympanic Membrane Perforations and Tympanostomy Tubes

1994 ◽  
Vol 103 (5_suppl) ◽  
pp. 27-30 ◽  
Author(s):  
Sam Levine ◽  
Kathleen Daly ◽  
G. Scott Giebink
Keyword(s):  
Tympanic Membrane ◽  
Otitis Media ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Chronic Otitis Media ◽  
Tympanic Membrane Perforations ◽  
Tympanostomy Tubes ◽  
Preoperative Factor ◽  
Middle Ear Disease

Tympanoplasty and tympanostomy tubes were developed at the same time and have dramatically changed the treatment of chronic middle ear disease. One hundred forty-nine children who had tubes inserted between ages 6 months and 8 years for chronic otitis media with effusion have been prospectively followed up for an average of 4 years. Fourteen percent developed tympanic membrane perforations. No preoperative factor completely predicted the development of perforation. a majority of the perforations closed spontaneously. Three ears had noncontiguous observations of perforations during follow-up. The implications of these findings are discussed with respect to tympanoplasty.

scholarly journals Myringoplasty with and without Cortical Mastoidectomy in Treatment of Non-cholesteatomatous Chronic Otitis Media: A Comparative Study

2014 ◽  
Vol 7 ◽  
pp. CMENT.S17980 ◽  
Author(s):  
Hazem Mohammed Abdel Tawab ◽  
Fadi Mahmoud Gharib ◽  
Tareq M. Algarf ◽  
Louay S. EISharkawy
Keyword(s):  
Otitis Media ◽  
Chronic Otitis Media ◽  
Suppurative Otitis Media ◽  
Tympanic Membrane Perforations ◽  
Cortical Mastoidectomy ◽  
Significant Difference ◽  
Graft Success ◽  
A Prospective Study ◽  
Department Faculty

Objective To compare the outcome and success of repair of uncomplicated tympanic membrane perforations with myringoplasty alone and when combined with mastoidectomy. Methods A prospective study where 40 patients with non-cholesteatomatous chronic suppurative otitis media (CSOM) were recruited during the period of June 2013 to December 2013 from the outpatient clinic of Otorhinolaryngology department, Faculty of medicine, Cairo University. Patients were managed medically and after dryness of their perforations they were operated upon. Twenty patients underwent simple myringoplasty alone and 20 patients underwent myringoplasty with cortical mastoidectomy. Underlay technique with temporalis fascia was done for all patients. Follow-up period was at least 3 months. Results Hearing improvement was comparable in both groups. There was no significant difference in graft uptake between the myringoplasty alone group (70%) and cortical mastoidectomy group (80%) ( P = 0.7). There was no significant difference in ear dryness between the myringoplasty alone group (75%) and cortical mastoidectomy group (90%) ( P = 0.4). Conclusion Mastoidectomy performed in non-cholesteatomatous CSOM in this study gives no statistically significant benefit over simple myringoplasty as regards graft success rate and dryness of the middle ear with comparable hearing outcome.

scholarly journals Effect of Epidermal Growth Factor with Silastic Scaffold on Tympanic Membrane Perforations of Chronic Otitis Media

2021 ◽  
Author(s):  
Vikram Kemmannu Bhat ◽  
Suhas Suresh Desai ◽  
Darshan Hiremath
Keyword(s):  
Growth Factor ◽  
Epidermal Growth Factor ◽  
Tympanic Membrane ◽  
Otitis Media ◽  
Nitrate Solution ◽  
Chronic Otitis Media ◽  
Pure Tone Audiometry ◽  
Disease Stage ◽  
Tympanic Membrane Perforations ◽  
Epidermal Growth

Abstract Aims The burden of chronic otitis media continues to be high, especially in developing countries. The demand for corrective procedure of surgical myringoplasty, which is considered the gold standard for tympanic membrane perforations, is also growing. Hence, there is a need to innovate simpler alternative office procedures that could save effort, time, waiting period, and expenditure. Materials and Methods This prospective study of 84 patients with mucosal chronic otitis media was undertaken in a tertiary referral hospital. All patients underwent eustachian tube function test, diagnostic nasal endoscopy, and pure tone audiometry. The size of the perforation was assessed endoscopically. All perforations were freshened first with silver nitrate solution. Silastic pieces were placed medial and lateral to the perforation with epidermal growth factor gel in between. Patients were followed up for 3 months. Results The perforations were classified into three groups (healed, partially healed, and nonhealed) based on the treatment response at the end of the first and third follow-up months. Completely healed and partially healed perforations were considered as “success” and were found to be 79% in this study. Significant association was found between healing status and type of anesthesia. However, the disease stage, size of perforation, and the duration of procedure did not affect the healing status. Conclusion Silastic enhanced myringoplasty with epidermal growth factor is a simple, effective, and economical procedure that can become an alternative to surgical myringoplasty for chronic otitis media.

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