Comparison of endoscopic butterfly-inlay versus endoscopic push-through myringoplasty in repairing anterior perforations of the tympanic membrane

2020 ◽  
Vol 134 (2) ◽  
pp. 128-134 ◽  
Author(s):  
S Gülşen ◽  
B Erden
Keyword(s):  
Tympanic Membrane ◽  
Operative Time ◽  
Operating Time ◽  
Functional Results ◽  
Success Rates ◽  
Open Label ◽  
Hearing Results ◽  
Reasonable Approach ◽  
Average Operative Time ◽  
Graft Success

AbstractObjectiveThe aim of the present study was to evaluate the surgical and functional results of endoscopic butterfly-inlay cartilage myringoplasty and endoscopic push-through myringoplasty in the treatment of anterior perforation of the tympanic membrane.MethodThis open-label randomised clinical study was conducted on 71 patients with small- and medium-sized anterior perforations of the tympanic membrane. Graft success rate, hearing results, operative time and complications were analysed.ResultsGraft success rates for endoscopic butterfly-inlay cartilage myringoplasty and endoscopic push-through myringoplasty were 94.1 and 91.8 per cent, respectively (p > 0.05). Post-operative air–bone gap values significantly improved in both the endoscopic butterfly-inlay cartilage myringoplasty and endoscopic push-through myringoplasty groups. The average operative time was significantly shorter in the endoscopic butterfly-inlay cartilage myringoplasty group (31.5 minutes) compared to the endoscopic push-through myringoplasty group (41.7 minutes; p < 0.05).ConclusionWhen compared with the endoscopic push-through myringoplasty, the endoscopic butterfly-inlay cartilage myringoplasty technique, which is technically easier to perform, does not require packing and has a shorter operating time. It is a reasonable approach for repair of anterior perforations of the tympanic membrane.

scholarly journals Reconstruction of Continuity Defects of the Mandible with Non-vascularized Bone Grafts. Systematic Literature Review

2016 ◽  
Vol 9 (3) ◽  
pp. 195-205 ◽  
Author(s):  
BabatundeOlayemi Akinbami
Keyword(s):  
Operating Time ◽  
Fixation Method ◽  
Success Rates ◽  
Mandible Reconstruction ◽  
Factors Associated ◽  
Mucosal Lining ◽  
Graft Success ◽  
Reconstructive Techniques ◽  
Continuity Defects

Background The use of NVBG for mandibular defects seems to be gradually giving way for more advanced reconstructive techniques but it has the advantages of shorter operating time and lesser amount of blood loss. The aim of this study was to review the available data on the success and failure rates of use of NVBG and factors associated with failure. Method Studies published from 1978 to 2014 regarding the use of NVBG were searched. Most important information was graft success and failure outcomes. Information on graft success with particular focus on large defects was extracted and the quality of papers was rated. Defects > 6cm were considered long defects. Results Twenty publications were included in this review. The quality of the studies was low and there was high heterogeneity. All articles reported high graft success rates ranging from 67 to 100%. Success in defects > 6cm was considerable, the range was 72–100%. Three main factors were associated with failure; these were defect length, fixation method and infection. Infection contributed the highest complication rate which was 48.2%. Conclusion NVBG seems to be appropriate for mandible reconstruction when there is vascular recipient bed and sufficient soft tissue cover and mucosal lining are achievable.

scholarly journals Boomerang-Shaped vs. Shield-Shaped Chondroperichondrial Cartilage Grafts for Type 1 Tympanoplasty in Children: A Study of 121 Patients

2017 ◽  
Vol 96 (10-11) ◽  
pp. 419-432 ◽  
Author(s):  
Can Özbay ◽  
Fatih Kemal Soy ◽  
Erkan Kulduk ◽  
Riza Dundar ◽  
Ahmet Yükkaldiran ◽  
...  
Keyword(s):  
Tympanic Membrane ◽  
Graft Material ◽  
Success Rates ◽  
Cartilage Grafts ◽  
Type 1 Tympanoplasty ◽  
Grafting Technique ◽  
Study Population ◽  
Graft Success ◽  
The Impact

Many techniques and graft materials have been used for the reconstruction of the tympanic membrane. We conducted a retrospective study to compare anatomic and functional outcomes of type 1 tympanoplasty that we performed with boomerang-shaped chondroperichondrial cartilage grafts (BSGs) and shield-shaped chondroperichondrial cartilage grafts (SSGs) in pediatric patients. Our study population was made up 121 patients—61 boys and 60 girls, aged 7 to 16 years (mean: 12.4)—who had undergone a type 1 tympanoplasty. Patients were divided into two groups according to the grafting technique used; there were 59 patients in the BSG group and 62 patients in the SSG group. Ear examinations were performed at postoperative months 3, 6, 12, and 24, and pure-tone average (PTA) for air-conduction threshold values and air-bone gaps (ABGs) were evaluated at 0.5, 1.0, 2.0, and 4.0 kHz at the same visits. We also investigated the impact of the graft material on functional graft success and intergroup differences (if any) in surgical success. Mean postoperative follow-up periods were 30.5 and 30.2 months in the BSG and SSG groups, respectively. We found that the success rates for tympanic membrane reconstruction were not significantly different in the two groups (91.5 and 88.7%). Postoperatively, the mean PTA and ABG values in both groups at 3, 6, 12, and 24 months were significantly lower than the preoperative values (p < 0.05). There were no significant differences in mean PTA values between the two groups at 3, 6, 12, and 24 months. However, the extent of the decrease in PTA values in the BSG group at 3 months was significantly greater than that of the SSG group (p < 0.05). There were no significant differences in mean ABG values between the two groups at 3, 6, and 12 months, but at 24 months, the value was significantly higher in the BSG group (p < 0.05). Finally, the extent of the decrease in ABG in the BSG group at both 3 and 6 months was significantly greater than that of the SSG group (p < 0.05). We conclude that the BSG procedure is a reliable and safe method of performing pediatric tympanoplasty.

Endoscopic push-through technique compared to microscopic underlay myringoplasty in anterior tympanic membrane perforations

2018 ◽  
Vol 132 (06) ◽  
pp. 509-513 ◽  
Author(s):  
D E M El-Hennawi ◽  
M R Ahmed ◽  
A S Abou-Halawa ◽  
M A Al-Hamtary
Keyword(s):  
Tympanic Membrane ◽  
Operative Time ◽  
Group Versus ◽  
Pure Tone Audiometry ◽  
Randomised Clinical Trial ◽  
Endoscopic Examination ◽  
Open Label ◽  
Tympanic Membrane Perforations ◽  
Estimated Blood Loss ◽  
Endoscopic Group

AbstractBackgroundMicroscopic myringoplasty is the most frequently performed procedure for repairing tympanic membrane perforations. The endoscopic transcanal approach bypasses the narrow ear canal segment and provides a wider view.MethodsAn open-label randomised clinical trial was conducted on 56 patients with small anterior tympanic membrane perforations. Perforations were repaired with an endoscopic push-through technique (n= 28) or a microscopic underlay technique (n= 28). Follow up was conducted using endoscopic examination and pure tone audiometry three months’ post-operatively.ResultsGraft success rate was 92.9 per cent in the endoscopic group versus 85.7 per cent in the microscopic group. The corresponding pre-operative mean air–bone gaps were 17.4 dB and 18.5 dB, improving to 6.1 dB and 9.3 dB post-operatively (p&gt; 0.05). Mean air–bone gap closure was 11.4 dB in the endoscopic group and 9.2 dB in the microscopic group (p&gt; 0.05). Mean operative time and estimated blood loss were 37.0 minutes and 29 ml in the endoscopic group, versus 107 minutes and 153 ml in the microscopic group (bothp&lt; 0.05).ConclusionThe endoscopic push-through technique for anterior tympanic membrane perforations is as effective as microscopic underlay myringoplasty; furthermore, it is less invasive and takes less 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.

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.

Hearing results after stapedotomy for otosclerosis: comparison of prosthesis variables

2021 ◽  
Vol 135 (1) ◽  
pp. 28-32
Author(s):  
H Odat ◽  
Y Kanaan ◽  
M Alali ◽  
M Al-Qudah
Keyword(s):  
Success Rate ◽  
Operative Time ◽  
Success Rates ◽  
Hearing Results ◽  
Shaft Diameter ◽  
Style Manual

AbstractObjectiveTo evaluate the influence of different piston variables on hearing following stapedotomy.MethodsData were analysed in groups according to: piston material (titanium vs fluoroplastic), shaft diameter (0.4 mm vs 0.5 mm) and crimping style (manual crimping vs self-crimping). Pre- and post-operative average air–bone gap, air–bone gap difference, success rate and operative time were evaluated.Results and conclusionFifty-one patients (58 ears) were included. A post-operative air–bone gap of 10 dB or lower was achieved in 44 cases, with a success rate of 75.9 per cent; 52 cases (89.7 per cent) had an air–bone gap of 20 dB or lower. The success rate was higher, but not significantly, in fluoroplastic than in titanium pistons (85 per cent vs 70 per cent). Pistons with shaft diameters of 0.5 mm and 0.4 mm had success rates of 79 per cent and 72 per cent, respectively. No significant differences were found for any audiometric parameters. There were no significant differences between manual crimping and self-crimping pistons in terms of audiometric results or success rate.

scholarly journals Outcomes of distal femoral arthroplasty after periprosthetic fractures: minimum 2-year follow-up

2021 ◽  
Vol 87 (1) ◽  
pp. 111-116
Author(s):  
Y Warschawski ◽  
S Garceau ◽  
M Bonyun ◽  
O Dahduli ◽  
J Wolfstadt ◽  
...  
Keyword(s):  
Operative Time ◽  
Knee Dislocation ◽  
Consecutive Series ◽  
Success Rates ◽  
Short Term ◽  
Average Operative Time ◽  
Total Knee ◽  
The Mean ◽  
Periprosthetic Infections

Purpose : distal femoral periprosthetic fracture (DFPPF) is a serious complication following total knee arthroplasty (TKA). Recently, treatment of DFPPF with distal femoral arthroplasty (DFA) has gained popularity because of its posited benefits for both patients and the medical system. Short-term follow-up trials investigating DFA have demonstrated acceptable results with regards to function, pain relief and lower postoperative complications than ORIF in elderly patients. The purpose of the current study was to evaluate a consecutive series of DFPPF treated with DFA, with a minimum 2- year follow-up. Methods : We performed a retrospective study asses- sing the outcomes of distal femoral arthroplasty (DFA) for patients diagnosed with DFPPF. Results : Twenty patients were identified. The mean age of patients was 76.3 (SD, 9.41), the average time from the fracture to revision surgery was 6.7 days (SD, 11.35), The average operative time was 93.5 minutes (SD,16.6). The average follow-up time was 50.15 months (SD, 20.87). During this time, two patients (10%) had complications. One patient experienced a knee dislocation and the second patient had recurrent periprosthetic infections. At final follow up, the mean knee society score was 86.25 (SD, 9.44), the mean Forgotten joint score was 62.16(SD, 23.45) and 93.7 percent of patients were ambulatory. Conclusion : DFA following DFPPF is associated with high success rates and provides patients with the opportunity for return of function in a safe and reliable manner.

scholarly journals Evaluating Facelift Complications and the Effectiveness of the Smasectomy Technique: A Single Center’s 15-Year Experience

2021 ◽  
Author(s):  
Orr Shauly ◽  
Gregory L Stone ◽  
Rebeca Shin ◽  
W Grant Stevens ◽  
Daniel J Gould
Keyword(s):  
Operative Time ◽  
Operating Time ◽  
Retrospective Chart Review ◽  
Patient Characteristics ◽  
The United States ◽  
Aesthetic Results ◽  
Facial Nerve Injuries ◽  
Average Operative Time ◽  
Anesthesia Time ◽  
Aesthetic Procedures

Abstract Background Facelift continues to be one of the most common aesthetic procedures performed in the United States. Although there exist many techniques and variations, SMAS manipulation, by way of plication, overlap or SMASectomy are common and have been shown to result in favorable cosmesis and durability. However, there is a lack of current complications data in the discussion of this technique. Objectives To assess the benefits and risks of the SMASectomy technique. Methods The records of all patients who underwent a facelift procedure between December 2004 and March 2019, were reviewed for this study. All procedures were performed at an AAAASF-accredited outpatient facility in Marina Del Rey, CA. This represents data on 241 total patients. Retrospective chart review was performed to include data on patient characteristics, operative technique, and complications. Results Average operative time of 152.68 ± 51.50 minutes and anesthesia time of 175.00 ± 54.07 minutes was observed amongst those patients that underwent SMASectomy. This was significantly lower (p &lt; 0.000001) than those that did not undergo SMASectomy (average operative time of 265.25 ± 85.25 minutes and anesthesia time of 294.22 ± 85.31 minutes). There were no observed facial nerve injuries among patients that underwent SMASectomy. No DVT events were observed in this patient population. Conclusions In the hands of an experienced surgeon, the SMASectomy facelift technique offers the unique advantage of significantly reducing operating time and anesthesia time and can provide extremely favorable and long-lasting aesthetic results.

Short-term Subjective and Objective Outcomes of Patients Receiving Endoscopic Transcanal Myringoplasty for Repairing Tympanic Perforations

2017 ◽  
Vol 158 (2) ◽  
pp. 337-342 ◽  
Author(s):  
Chih-Chieh Tseng ◽  
Ming-Tang Lai ◽  
Chia-Che Wu ◽  
Sheng-Po Yuan ◽  
Yi-Fang Ding
Keyword(s):  
Tertiary Care ◽  
Routine Activities ◽  
University Hospital ◽  
Secondary Outcome ◽  
Success Rates ◽  
Short Term ◽  
Hearing Results ◽  
The Mean ◽  
Graft Success ◽  
Objective Outcomes

Objective Endoscopic transcanal myringoplasty (ETM) has been an emerging technique for repairing tympanic perforations since the late 1990s. Objective outcomes (ie, graft success rates and hearing results) of patients who received ETM are well documented; however, subjective outcomes of these patients have rarely been reported. Hence, this study evaluated subjective and objective outcomes of patients who received ETM for repairing tympanic perforations. Study Design Prospective study. Setting Tertiary care university hospital. Patients and Methods Patients who underwent ETM for perforations of the tympanic membrane were included. We evaluated subjective variables of patients receiving ETM as the primary outcome and objective variables as the secondary outcome. Results In total, 91 ears that underwent ETM were included. The mean pain scale score was 0.1 (range, 0-2) on postoperative day 3. The mean duration of pain medication was 2.0 (range, 0-3) days. The mean number of days required to resume routine activities was 1.0 (range, 1-2) days. The overall graft success was determined postoperatively at 3 months in 80 of 91 ears (87.9%). Closure of the air-bone gap to within 20 dB was achieved in 79 (86.8%) ears. Conclusion In this study, patients who received ETM had mild postoperative pain and resumed routine activities early. These patients also exhibited favorable graft success rates and hearing results at 3 months postoperatively. On the basis of our results, we conclude that patients who receive ETM for the repair of tympanic perforations have favorable short-term subjective and objective outcomes.

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