Middle-ear function with tympanic-membrane perforations. I. Measurements and mechanisms

2001 ◽  
Vol 110 (3) ◽  
pp. 1432-1444 ◽  
Author(s):  
Susan E. Voss ◽  
John J. Rosowski ◽  
Saumil N. Merchant ◽  
William T. Peake
Keyword(s):  
Tympanic Membrane ◽  
Middle Ear ◽  
Tympanic Membrane Perforations

scholarly journals Fat Myringoplasty and its Impact on the Hearing Mechanism of Middle Ear

2015 ◽  
Vol 7 (3) ◽  
pp. 138-140
Author(s):  
Bandar Al-qahtani ◽  
Mohammed Al Tuwaijri ◽  
Mohammed Al Mokhatrish
Keyword(s):  
Tympanic Membrane ◽  
Middle Ear ◽  
Fat Grafting ◽  
Type I ◽  
Tympanic Membrane Perforations ◽  
Large Perforation

ABSTRACT Objectives To address the fat grafting to tympanic membrane perforations—fat myringoplasty type I—and its impact over the hearing mechanism of the middle ear for both small (< 25% of the tympanic membrane) and large perforation (> 75 % of the TM). How to cite this article Al-qahtani B, Al Tuwaijri M, Al Mokhatrish M. Fat Myringoplasty and its Impact on the Hearing Mechanism of Middle Ear. Int J Otorhinolaryngol Clin 2015;7(3):138-140.

Tympanic Membrane Perforations from Water Sports: Treatment and Outcome

1983 ◽  
Vol 91 (6) ◽  
pp. 659-662 ◽  
Author(s):  
Leonard P. Rybak ◽  
David W. Johnson
Keyword(s):  
Tympanic Membrane ◽  
Middle Ear ◽  
Tympanic Membrane Perforations ◽  
Delayed Healing ◽  
History Of ◽  
Water Sports ◽  
Office Paper

A study of 15 patients with 17 tympanic membrane perforations resulting from water sports was carried out. Most small perforations healed spontaneously. Perforations that persisted after 8 weeks were treated surgically, usually with the office paper patch procedure. A frequent history of middle ear problems in these patients suggests that middle ear dysfunction may play a role in the occurrence and delayed healing of traumatic perforations.

scholarly journals Correlation of Site and Size of Tympanic Membrane Perforation and Middle Ear Air Space Volume with Magnitude of Hearing Loss

2019 ◽  
Vol 02 (01) ◽  
pp. 10-15
Author(s):  
Ramandeep Singh Virk ◽  
Krishan Kudawla ◽  
Sandeep Bansal ◽  
Ramya Rathod ◽  
Samarendra Behera
Keyword(s):  
Hearing Loss ◽  
Tympanic Membrane ◽  
Middle Ear ◽  
Tympanic Membrane Perforation ◽  
Tympanic Membrane Perforations ◽  
Air Space ◽  
Membrane Perforation ◽  
Volume Group ◽  
Space Volume ◽  
Lower Frequencies

Abstract Introduction The effects of tympanic membrane perforations on middle ear sound transmission are not well characterized, largely because ears with perforations typically have additional pathological changes. It has been established that the larger the perforation, the greater is the hearing loss (HL). Aim This study aimed to correlate the location and size of tympanic membrane perforation and middle ear air space volume with the magnitude of HL in patients with tubotympanic or inactive mucosal type of chronic otitis media (COM). Materials and Methods A prospective clinical study of patients with tympanic membrane perforations due to COM and without any other ear disease and who attended the Otolaryngology services at our institute between July 2010 and December 2011 was conducted. A total of 300 ears were evaluated by performing otoendoscopy, followed by photo documentation and audiological investigations (pure-tone audiometry and tympanometry). Tympanic membrane perforations were categorized based on their size and location, and the mean air-bone (AB) gap between the various types of perforations was compared and statistically analyzed with significance level of p < 0.05. Results Out of 300 ears, maximum number of ears (n = 124, 41.3%) had large-sized perforations (> 30 mm2) that had a maximum mean AB gap of 26.43 dB, and minimum number of ears (n = 60, 20%) had small-sized perforations (0–9 mm2) that had minimum mean AB gap of 9.12 dB. The remaining were medium-sized perforations that had mean AB gap of 16.13 dB. Depending on the location, maximum were central perforations (n = 198, 66%) and minimum were anterosuperior (AS) perforations (n = 9, 3%). Based on the middle ear volume on tympanometry, maximum ears were of low-volume group (n = 246, 92%) that had larger mean AB gap of 19.96 dB HL when compared with the high-volume group (n = 24, 8%) with 11.80 dB HL. AB gap was maximum at lower frequencies and decreased with increase in frequencies except at 4,000 Hz, that is, 56.9 dB HL at 250 Hz, 42.6 at 500 Hz, 41.5 at 1,000 Hz, 32.4 at 2,000 Hz, and 49.5 at 4,000 Hz. Conclusion HL increases as the area of tympanic membrane perforation increases. There is an inverse relationship between HL and middle ear air space volume. Comparing the small-sized perforations at different sites with the middle ear volume being low, it was found that posterosuperior (PS) perforations had 4 to 7 dB greater HL than AS and anteroinferior (AI). However, the relationship was statistically insignificant. The phase cancellation effect of round window causing greater HL in posteroinferior (PI) perforations does not exist in small- and medium-sized perforations. HL is greater at lower frequencies and less at higher frequencies.

Middle ear Transmission Losses Caused by Tympanic Membrane Perforations in Cats

1976 ◽  
Vol 81 (3-6) ◽  
pp. 330-336 ◽  
Author(s):  
J. Tonndorf ◽  
Florence McArdle ◽  
B. Kruger
Keyword(s):  
Tympanic Membrane ◽  
Middle Ear ◽  
Transmission Losses ◽  
Tympanic Membrane Perforations

scholarly journals Epitympanic Diaphragm: Endoscopic Functional Tympanoplasty

2018 ◽  
Vol 01 (01) ◽  
pp. 023-028
Author(s):  
Sreerama Boddepalli ◽  
Rajesh Boddepalli
Keyword(s):  
Gas Exchange ◽  
Tympanic Membrane ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Normal Mucosa ◽  
Tympanic Membrane Perforation ◽  
Middle Ear Mucosa ◽  
Tympanic Membrane Perforations ◽  
Membrane Perforation ◽  
Middle Ear Cleft

Abstract Background Simple closure of tympanic membrane perforation is not a successful myringoplasty. It has to obey a lot of functional aspects of the middle ear cleft. Certain factors play a role in failure cases. The endoscopic functional myringoplasty or tympanoplasty is a clear visualization of all the parts of the middle ear; examination and removal of the disease from the hidden parts of the middle ear, examination of inter-attico-tympanic diaphragm; and removal of blocks, if any, in isthmus, to reestablish the gas exchange pathways and finally preserve the middle ear mucosa at maximum to further restore the ventilation. Methods Endoscopic tympanoplasty was performed in 100 patients with large tympanic membrane perforations and patent eustachian tube, using 4-mm “0” and “45” degree endoscopes by proper visualization of the tympanic diaphragm and isthmus in every patient and clearing its blockage if present. Results Among the 100 patients, 78 had epitympanic diaphragm blockage at the level of isthmus, 5 patients were found with closed tensor tympani folds, both vertical and horizontal without any ventilatory routes in them. Although in all the patients the eustachian tube was patent, we found majority of them had a dysventilation at the level of the epitympanic diaphragm. Thus, by performing endoscopic ventilatory pathway clearance and tympanoplasty, we achieved 94% positive results. Conclusion Epitympanic diaphragm is a functional barrier between upper and lower compartments of the middle ear cleft, which play important role in the ventilation and partial pressure regulation, blockage of its isthmus may lead to tympanic membrane retractions and perforations. With the aid of endoscopes of various degrees, removing any pathological blocks, recreating proper ventilation, reestablishing gas exchange mechanism, and maximum preservation of normal mucosa for the gas exchange are the aims of an endoscopic functional tympanoplasty procedure.

Middle-ear function with tympanic-membrane perforations. II. A simple model

2001 ◽  
Vol 110 (3) ◽  
pp. 1445-1452 ◽  
Author(s):  
Susan E. Voss ◽  
John J. Rosowski ◽  
Saumil N. Merchant ◽  
William T. Peake
Keyword(s):  
Simple Model ◽  
Tympanic Membrane ◽  
Middle Ear ◽  
Tympanic Membrane Perforations

Observations of Middle Ear Pressures

1980 ◽  
Vol 89 (3_suppl) ◽  
pp. 56-60 ◽  
Author(s):  
Richard A. Buckingham ◽  
Jose L. Ferrer
Keyword(s):  
Tympanic Membrane ◽  
Middle Ear ◽  
Motion Picture ◽  
Saline Solution ◽  
Positive Pressure ◽  
Motion Picture Film ◽  
Sterile Saline ◽  
Tympanic Membrane Perforations ◽  
Middle Ear Pressure ◽  
Direct Measurements

Previous direct measurements of middle ear pressure in ears with serous otitis resulted in the range of from 0 to − 10 mm H2O pressure. To confirm these findings we attempted to quantify middle ear pressures by doing myringotomies in serous otitis patients through sterile saline solution. We compared the rate of aspiration of the saline in ears with serous otitis to the rate of aspiration of saline after an experimental myringotomy in an ear model in which known pressures were imposed. To record our findings we used motion picture photography. Layering a film of sterile oil suspension of oxytetracycline and hydrocortisone over dry tympanic membrane perforations resulted in the demonstration of a pulsatile positive pressure of about 6 mm water in many of the ears which we tested. The oil film often formed an external bubble which ruptured after several minutes. In some ears there was no change in pressure and in only a small percentage there was evidence of a decreased pressure by absorption of air in the middle ear during the period of observation. This positive pressure is unrelated to swallowing and suggests that the current theories of middle ear aeration via opening of the eustachian tube may not be valid. These findings were demonstrated with motion picture film.

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