Is it the Middle Ear Disease or the Reconstruction Material That Determines the Functional Outcome in Ossicular Chain Reconstruction?

2012 ◽  
Vol 33 (4) ◽  
pp. 580-585 ◽  
Author(s):  
Uygar Levent Demir ◽  
Sait Karaca ◽  
Omer Afsn Ozmen ◽  
Fikret Kasapoglu ◽  
Hamdi Hakan Coskun ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Middle Ear ◽  
Ossicular Chain ◽  
Ossicular Chain Reconstruction ◽  
Middle Ear Disease

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.

Ossicular Chain Reconstruction in a Developing Country

2018 ◽  
Vol 127 (5) ◽  
pp. 306-311 ◽  
Author(s):  
Es-Hak Bedri ◽  
Miriam Redleaf
Keyword(s):  
Tympanic Membrane ◽  
Developing Country ◽  
Middle Ear ◽  
Granulation Tissue ◽  
Ossicular Chain ◽  
Single Stage ◽  
Limited Resources ◽  
Closure Rate ◽  
Average Improvement ◽  
Ossicular Chain Reconstruction

Objectives: In Ethiopia, 2-stage operations with middle ear prostheses are economically unfavorable. We hypothesized that single-stage autologous ossiculoplasty results in acceptable tympanic membrane (TM) and hearing improvements in a setting of limited resources. Methods: One hundred eighty-eight patients (197 ears) who underwent 1-stage autologous ossiculoplasty for ossicular dysfunction are presented. All but 14 of these ears also had perforations of the TM. Conditions of the middle ear were granulation tissue, ossicular disruption only, tympanosclerosis, and cholesteatoma. Reconstructions of the ossicular chain were performed with autologous ossicles only. Results: The closure rate of TM perforations was 95%. Preoperative air bone gaps were 27 to 60 dB (mean [SD] = 44 [7] dB); postoperative air bone gaps were 0 to 50 dB (average [SD] = 23 [10] dB), for an average improvement of 21 dB across all reconstruction types ( P < .001). The largest favorable changes in air bone gaps were with incus and malleus columellas from the footplate to the TM (33 and 23 dB, respectively) ( P < .001). No patient had worsening of sensorineural hearing levels or extrusion of the reconstructed ossicles. Conclusion: Autologous ossiculoplasty performed well in this setting. Acceptable TM closure rates and improvement of air bone gaps were seen in 1-stage operations without the use of prostheses.

A new device for real-time peroperative monitoring of ossicular chain reconstruction during middle ear surgery

2019 ◽  
Vol 34 (4) ◽  
pp. 827-832
Author(s):  
Van Son Nguyen ◽  
Didier Rouxel ◽  
Brice Vincent ◽  
Joël Ducourneau ◽  
Cécile Parietti-Winkler
Keyword(s):  
Real Time ◽  
Middle Ear ◽  
Ossicular Chain ◽  
Middle Ear Surgery ◽  
Ear Surgery ◽  
New Device ◽  
Ossicular Chain Reconstruction

Analysis of surgical treatment for middle-ear cholesterol granuloma

2009 ◽  
Vol 123 (S31) ◽  
pp. 90-96 ◽  
Author(s):  
Y Matsuda ◽  
T Kurita ◽  
Y Ueda ◽  
S Ito ◽  
T Nakashima
Keyword(s):  
Surgical Treatment ◽  
Success Rate ◽  
Middle Ear ◽  
Ossicular Chain ◽  
University Hospital ◽  
Cholesterol Granuloma ◽  
Initial Report ◽  
Ossicular Chain Reconstruction ◽  
The Relationship ◽  
Tympanic Membranes

AbstractCholesterol granuloma is an intractable ear disease. Many studies of this condition have been published since the initial report by Manasse. However, the pathogenesis of this condition is unclear. This study reviewed the treatment of middle-ear cholesterol granuloma in 16 patients undergoing surgical treatment at Kurume University Hospital.The relationship between patients' pre-operative tympanic membrane findings and post-operative course was analysed. Patients with swollen tympanic membranes had significantly poorer outcomes. Patients with retracted tympanic membranes and those undergoing ossicular chain reconstruction had significantly better outcomes. The patients' overall hearing success rate at approximately two weeks post-operatively was 75 per cent. However, by six months post-operatively, the overall hearing success rate had declined to 62.5 per cent. Patients with poor hearing two weeks post-operatively did not acquire better hearing.

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>

scholarly journals Techniques of the tympanomastoidectomy with reconstruction of the posterior bone wall of the external auditory canal

2015 ◽  
Vol 143 (7-8) ◽  
pp. 480-486 ◽  
Author(s):  
Dragan Dankuc ◽  
Ljiljana Vlaski ◽  
Nemanja Pejakovic
Keyword(s):  
Surgical Treatment ◽  
Middle Ear ◽  
External Auditory Canal ◽  
Ossicular Chain ◽  
Sinus Tympani ◽  
Middle Ear Cholesteatoma ◽  
Ossicular Chain Reconstruction ◽  
Oscillating Saw ◽  
Novi Sad ◽  
Nose And Throat

A combined tympanoplasty method, the mobile-bridge tympanoplasty, has been applied at the Clinic for Ear, Nose and Throat Diseases in Novi Sad since 1998. Mobile-bridge tympanoplasty is performed at our Clinic by applying Feldmann?s procedure utilizing a microsurgical oscillating saw. It is a combination of closed and open techniques for surgical treatment of middle ear diseases. In addition to this technique, a method for reconstruction of the posterior bone wall of the external auditory canal was introduced. This procedure is applied in cases of damage or impairment of the bony ear canal wall using mastoid cortical temporal bone graft or modeled cartilage of the concha. Maintenance of general anatomical relations in the middle ear enables good ventilation of pneumatic spaces of the middle ear and Eustachian tube permeability, thus providing good conditions for ossicular chain reconstruction. The incidence of recurrent cholesteatoma in combined mobile-bridge tympanoplasty and tympanoplasty with reconstruction of the posterior bone wall was 6% in total. The incidence values for the recurrent cholesteatoma in closed tympanoplasty and in cases of open techniques were 10%. Mobile-bridge tympanoplasty and reconstruction of the posterior bone wall of external auditory canal are methods of choice in surgical treatment of middle ear cholesteatoma that progressed to the attic space, sinus tympani and facial recess.

Audiometric Outcomes and Middle Ear Disease following Cerebrospinal Fluid Leak Repair

2020 ◽  
Vol 162 (6) ◽  
pp. 942-949
Author(s):  
Kristen L. Yancey ◽  
Nauman F. Manzoor ◽  
David S. Haynes ◽  
Marc L. Bennett ◽  
Matthew O’Malley ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Skull Base ◽  
Middle Ear ◽  
Cerebrospinal Fluid Leak ◽  
Ossicular Chain ◽  
Middle Cranial Fossa ◽  
Lateral Skull Base ◽  
Increase Risk ◽  
Ossicular Chain Reconstruction ◽  
Csf Leaks

Objective To investigate audiometric outcomes and incidence of chronic ear disease following lateral skull base repair (LSBR) of cerebrospinal fluid (CSF) leaks. Study Design Retrospective review. Setting Tertiary skull base center. Subjects and Methods Consecutive adults undergoing LSBR of CSF leaks between 2012 and 2018 were reviewed. Audiometric data included mean air conduction pure-tone average (PTA), air-bone gap (ABG), speech recognition threshold (SRT), and word recognition score (WRS). The incidence and management of the following were collected: effusion, retraction, otitis media and externa, perforation, and cholesteatoma. Results Seventy-three patients underwent transmastoid (n = 5), middle cranial fossa (n = 2), or combined approach (n = 67) for repair of spontaneous leaks (sCSFLs, n = 41) and those occurring in the setting of chronic ear disease (ceCSFLs, n = 32). ABG decreased 7.23 dB ( P = .01) in sCSFL patients. Perforations ( P = .01) were more likely in ceCSFL. No sCSFL patient developed a cholesteatoma, perforation, or infection. Effusions (n = 7) were transient, and retractions (n = 2) were managed conservatively in the sCSFL cohort. Eight ceCSFL patients required tubes, 3 underwent tympanoplasties with (n = 2) and without (n = 1) ossicular chain reconstruction (OCR), and 1 had tympanomastoidectomy with OCR. Conclusion Lateral skull base repair of CSF leaks maintained or improved hearing. Patients with preexisting chronic ear disease were more likely to require additional intervention to sustain adequate middle ear aeration compared to the sCSFL cohort. LSBR of sCSFL does not appear to increase risk for developing chronic ear disease.

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