scholarly journals Inferior Flap Tympanoplasty: A Novel Technique for Anterior Perforation Closure

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Haim Gavriel ◽  
Ephraim Eviatar
Keyword(s):  
Tympanic Membrane ◽  
Anterior Part ◽  
Tympanic Membrane Perforation ◽  
The Novel ◽  
Posterior Flap ◽  
Membrane Perforation ◽  
The Mean ◽  
Contralateral Ear ◽  
A Prospective Study ◽  
Anterior Perforation

Objective. To report a novel tympanoplasty modification for anterior tympanic membrane perforation closure.Materials and Methods. A prospective study on 13 patients who underwent inferior tympanoplasty between December 2008 and May 2011 was carried out. In our technique, an inferior rather than a posterior flap is raised and the graft is laid from the inferior direction to obtain better access to the anterior part of the tympanic membrane perforation and provide better support.Results. A total of 13 patients underwent the novel inferior tympanoplasty technique with a mean age of 33 years. Six patients had undergone tympanoplasties and/or mastoidectomies in the past, 3 in the contralateral ear. A marginal perforation was observed in 3 cases, total perforation in 2 and subtotal in 1 case. The mean preoperative pure-tone average was 40.4 dB (10 to 90 dB), compared to 26.5 dB (10 to 55 dB) postoperatively. All perforations were found to be closed but one (92.3% success rate).Conclusions. The inferior tympanoplasty technique provides a favorable outcome in terms of tympanic membrane closure and hearing improvement for anterior perforations, even in difficult and complex cases. It is based on a well-known technique and is easy to implement.

Endoscopic Cartilage Myringoplasty with Inside Out Elevation of a Tympanomeatal Flap for Repairing Anterior Tympanic Membrane Perforations

2020 ◽  
Vol 129 (8) ◽  
pp. 795-800 ◽  
Author(s):  
Zhengcai Lou
Keyword(s):  
Tympanic Membrane ◽  
Case Series ◽  
Operation Time ◽  
Tympanic Membrane Perforation ◽  
University Hospital ◽  
Retrospective Case ◽  
Graft Take ◽  
The Mean ◽  
Inside Out ◽  
Anterior Perforation

Objective: We evaluated the graft take rate and hearing gain of endoscopic cartilage myringoplasty with inside out elevation of a tympanomeatal flap for repairing an anterior tympanic membrane perforation. Study design: A retrospective case series Setting: Tertiary university hospital Materials and Methods: The study population consisted of patients with an anterior perforation undergoing endoscopic cartilage myringoplasty with inside out elevation of a tympanomeatal flap. The primary outcome was the graft take rate at 6 months. The secondary outcomes were the air–bone gap (ABG) gain at 3 months and complications. Results: A total of 51 patients with a unilateral anterior marginal perforation were included in this study. The mean operation time was 62.2 ± 8.3 minutes. The graft success rate was 92.2% (47/51) at 6 months. The mean preoperative ABG was 28.07 ± 5.13 dB, while the mean postoperative ABG was 12.24 ± 4.89 dB ( P < .05). No patients reported sensorineural hearing loss, altered taste, facial nerve palsy, vertigo, or tinnitus. Two patients with a middle perforation developed postoperative purulent otorrhea that resulted in residual perforations. The cartilage graft was extruded into the anterior annulus in two patients with large perforations that resulted in graft lateralization in one patient and residual perforation in the other. Conclusions: Endoscopic cartilage myringoplasty with inside out elevation of a tympanomeatal flap is a useful procedure with a low reperforation rate for repairing anterior perforation.

An insight to tympanic membrane perforation pressure through morphometry: A cadaver study

2021 ◽  
Vol 51 (1) ◽  
pp. 10-17
Author(s):  
Derya Ümit Talas ◽  
◽  
Orhan Beger ◽  
Ülkü Çömelekoğlu ◽  
Salim Çakır ◽  
...  
Keyword(s):  
Tensile Strength ◽  
Tympanic Membrane ◽  
Brain Injuries ◽  
Cadaver Study ◽  
Tympanic Membrane Perforation ◽  
Bursting Pressure ◽  
Membrane Perforation ◽  
Fresh Frozen ◽  
The Mean ◽  
And Gender

Introduction: A cadaveric experimental investigation aimed to show the rupture pressure of the tympanic membrane (TM) for otologists to evaluate its tensile strength. Methods: Twenty adult ears in 10 fresh frozen whole cadaveric heads (four males, six females) mean age 72.8 (SD 13.8) years (range 40–86) were studied. The tensile strength of the TM was evaluated with bursting pressure of the membrane. The dimensions of the membranes and perforations were measured with digital imaging software. Results: The mean bursting pressure of the TM was 97.71 (SD 36.20) kPa. The mean area, vertical and horizontal diameters of the TM were 57.46 (16.23) mm2, 9.54 (1.27) mm, 7.99 (1.08) mm respectively. The mean area, length and width of the perforations were 0.55 (0.25) mm2, 1.37 (0.50) mm, and 0.52 (0.22) mm, respectively. Comparisons of TM dimension, bursting pressure, and perforation size by laterality and gender showed no significant differences. The bursting pressure did not correlate (positively or negatively) with the TM or perforation sizes. Conclusions: The TM can rupture during activities such as freediving or scuba diving, potentially leading to serious problems including brain injuries. Studying such events via cadaveric studies and data from case studies is of fundamental importance. The minimum experimental bursting pressures might better be taken into consideration rather than average values as the danger threshold for prevention of TM damage (and complications thereof) by barotrauma.

Outcome of Graft Uptake and Hearing Results between ‘U’ Flap Technique and Conventional Tympanomeatal Flap Technique for Anterior and Subtotal Tympanic Membrane Perforation

2018 ◽  
Vol 16 (3) ◽  
pp. 297-301 ◽  
Author(s):  
Sundar Dhungana ◽  
Pabina Rayamajhi ◽  
Rakesh Prakash Shrivastav
Keyword(s):  
Tympanic Membrane ◽  
Uptake Rate ◽  
Chronic Otitis Media ◽  
Tympanic Membrane Perforation ◽  
Hearing Results ◽  
Flap Technique ◽  
Significant Difference ◽  
Membrane Perforation ◽  
Subtotal Perforation ◽  
The Mean

Background: Myringoplasty done for anterior and subtotal perforation needs expertise and practice than conventional underlay myringoplasty. The objective of this study was to compare the graft uptake and postoperative hearing results between ‘U’ flap and conventional tympanomeatal flap technique in anterior and subtotal tympanic membrane perforation.Methods: Sixty three patients of age fifteen years and above with chronic otitis media mucosal type with any sizedanterior and subtotal perforationof tympanic membrane were randomly allocated for myringoplasty by lottery method. There were thirty one cases in ‘U’ flap group and thirty twocases in conventional tympanomeatal flap group. Graft uptake and hearing results were assessed after six weeks and results were compared within and between the groups.Results: Graft uptake rate was 90.3%(28/31) in‘U’ flap group and it was 87.5%(28/32) in conventional tympanomeatal flap group with no statistically significant difference (p= 0.772) between the two groups. The mean pre and post-operative air bone gap in ‘U’ flap group were 23.63dB±7.77dB; 13.26dB±5.50dB and that in the conventional tympanomeatal flap group were 20.88±9.88dB, 9.42dB±6.70dB respectively. There was no statistically significant difference in hearing results between the two groups (p= 0.504).Conclusions: The graft uptake rate and hearing results of ‘U’ flap group were comparable and showed no statistically significant difference to those of conventional tympanomeatal flap group.

Xenograft versus autograft in tympanoplasty

1993 ◽  
Vol 107 (10) ◽  
pp. 892-894 ◽  
Author(s):  
Vincent P. Callanan ◽  
Aongus J. Curran ◽  
Peter K. Gormley
Keyword(s):  
Retrospective Study ◽  
Success Rate ◽  
Tympanic Membrane ◽  
Salvage Surgery ◽  
Tympanic Membrane Perforation ◽  
Graft Material ◽  
Temporalis Fascia ◽  
Membrane Perforation ◽  
Contralateral Ear ◽  
Autograft Group

AbstractThis retrospective study compares the tympanoplasty success rate when using a xenograft (Zenoderm) or an autograft (temporalis fascia).Fifty-three ears were operated on over a three-year period. All the tympanoplasty operations were performed by the same surgeon. There were 43 ears in the temporalis fascia autograft group and 10 ears in the Zenoderm xenograft group. Both groups were similar with respect to patient age, type of tympanoplasty, area of tympanic membrane perforation and condition of the contralateral ear.The tympanoplasty success rate in the temporalis fascia autograft group was 95 per cent. The tympanoplasty success rate in the Zenoderm xenograft group was only 40 per cent. All Zenoderm tympanoplasty failures were regrafted with temporalis fascia autograft. There was a 100 per cent success rate with this salvage surgery.In conclusion, we suggest that Zenoderm is not a suitable graft material for tympanoplasty.

Myringoplasty for the anterior perforation: experience with the Kerr flap

1992 ◽  
Vol 106 (1) ◽  
pp. 14-16 ◽  
Author(s):  
J. F. Sharp ◽  
T. F. Terzis ◽  
J. Robinson
Keyword(s):  
Tympanic Membrane ◽  
Graft Failure ◽  
Tympanic Membrane Perforation ◽  
Confidence Limits ◽  
Closure Rate ◽  
Surgical Closure ◽  
Membrane Perforation ◽  
Anterior Support ◽  
Threshold Gain ◽  
Anterior Perforation

AbstractSurgical closure of the anteriorly located tympanic membrane perforation can present a problem. The lack of anterior support for the graft frequently leads to graft failure if an underlay method is used whereas anterior blunting is a complication of onlay techniques in this situation. The experience with the Kerr flap, an underlay graft fashioned to include a tab of fascia which is placed laterally under the annulus and the anterior meatal skin, is presented. This method gave a 97.5 per cent closure rate with no cases of anterior marginal blunting and a mean auditory threshold gain of 8.5 dB (95 per cent confidence limits 5 to 11.9 dB, P<O.O1) was achieved at the frequencies tested. The use of the Kerr flap is recommended when repairing the anteriorly placed tympanic membrane perforation

scholarly journals Randomized Clinical Trial Comparing Bucket Handle and Cartilage Tympanoplasty Techniques for the Reconstruction of Subtotal or Anterior Tympanic Membrane Perforation

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Alimohamad Asghari ◽  
Mohammad Mohseni ◽  
Ahmad Daneshi ◽  
Yasser Nasoori ◽  
Sara Rostami ◽  
...  
Keyword(s):  
Tympanic Membrane ◽  
Chronic Otitis Media ◽  
Tympanic Membrane Perforation ◽  
Case Group ◽  
Cartilage Tympanoplasty ◽  
Membrane Perforation ◽  
Registration Number ◽  
Bucket Handle ◽  
And Cartilage ◽  
Anterior Perforation

Objective. The purpose of the study is to compare the clinical outcome of the two techniques of Bucket Handle Tympanoplasty and Cartilage Tympanoplasty in achieving success in graft survival as well as acceptable auditory results. 60 patients who suffered chronic otitis media with anterior perforation of the tympanic membrane were chosen. The patients were randomly assigned using Block Randomization Method of two groups including patients who underwent Bucket Handle Tympanoplasty (n=30) or those that underwent Cartilage Tympanoplasty (n=30). The patients were followed up for 1, 3, 6, and 12 months postoperatively. Results. The mean PTA was lower in Bucket Handle Tympanoplasty group as case group compared to Cartilage Tympanoplasty group as the control (P=0.023). No significant statistical differences had identified passing through the time, in terms of PTA outcome (P Value = 0.547) and SRT outcome (P Value = 0.352), between Bucket Handle Tympanoplasty group and the Cartilage Tympanoplasty group. In total, postoperative tympanic membrane perforation was found in 10.0% of patients in Cartilage Tympanoplasty group and 13.3% in Bucket Handle Tympanoplasty group with no difference (P=0.500). Conclusions. Hearing improvements in both methods were similar. Registration Number. The trial is registered with IRCT2016022626773N1.

An observational study of the management of traumatic tympanic membrane perforations

2002 ◽  
Vol 116 (3) ◽  
pp. 181-184 ◽  
Author(s):  
J. E. O. Amadasun
Keyword(s):  
Observational Study ◽  
Prospective Study ◽  
Tympanic Membrane ◽  
Tympanic Membrane Perforation ◽  
Control Group ◽  
Tympanic Membrane Perforations ◽  
Membrane Perforation ◽  
A Prospective Study

Controversies of how best to treat fresh tympanic membrane perforations have always existed. While some otolaryngologists prefer the paper patch method, others prefer modified myringoplasty. A prospective study is needed to investigate the most effective and least expensive management of this common ear trauma.This study examined prospectively, in three sections, a group of patients with a cellophane patch (n = 6), another group with a gentamicin ointment seal (n = 15) and a control group (n = 9) with a gentamicin plug placed at the distal end of the external auditory cavity. Successful healing of the traumatic tympanic membrane perforations was achieved in 50 per cent of the cellophane seal group, 86.7 per cent of the gentamicin ointment seal group and 77.8 per cent of the control group. This study shows that the management of a fresh tympanic membrane perforation should be limited to cleaning the traumatized ear and preventing infection.

scholarly journals Outcome of Graft Uptake and Hearing Results between ‘U’ Flap Technique and Conventional Tympanomeatal Flap Technique for Anterior and Subtotal Tympanic Membrane Perforation

2018 ◽  
Vol 16 (3) ◽  
pp. 297-301
Author(s):  
Sundar Dhungana ◽  
Pabina Rayamajhi ◽  
Rakesh Prakash Shrivastav
Keyword(s):  
Tympanic Membrane ◽  
Uptake Rate ◽  
Chronic Otitis Media ◽  
Tympanic Membrane Perforation ◽  
Hearing Results ◽  
Flap Technique ◽  
Significant Difference ◽  
Membrane Perforation ◽  
Subtotal Perforation ◽  
Anterior Perforation

Background: Myringoplasty done for anterior and subtotal perforation needs expertise and practice than conventional underlay myringoplasty. The objective of this study was to compare the graft uptake and postoperative hearing results between ‘U’ flap and conventional tympanomeatal flap technique in anterior and subtotal tympanic membrane perforation.Methods: Sixty three patients of age fifteen years and above with chronic otitis media mucosal type with any sized anterior and subtotal perforation of tympanic membrane were randomly allocated for myringoplasty by lottery method. There were thirty one cases in ‘U’ flap group and thirty two cases in conventional tympanomeatal flap group. Graft uptake and hearing results were assessed after six weeks and results were compared within and between the groups.Results: Graft uptake rate was 90.3%(28/31) in‘U’ flap group and it was 87.5%(28/32) in conventional tympanomeatal flap group with no statistically significant difference (p= 0.772) between the two groups. The mean pre and post-operative air bone gap in ‘U’ flap group were 23.63dB±7.77dB; 13.26dB±5.50dB and that in the conventional tympanomeatal flap group were 20.88±9.88dB, 9.42dB±6.70dB respectively. There was no statistically significant difference in hearing results between the two groups (p= 0.504).Conclusions: The graft uptake rate and hearing results of ‘U’ flap group were comparable and showed no statistically significant difference to those of conventional tympanomeatal flap group. Keywords: Anterior perforation; myringoplasty; subtotal perforation; ‘U’ flap.

Myringoplasty: impact of perforation size on closure and audiological improvement

2009 ◽  
Vol 123 (9) ◽  
pp. 973-977 ◽  
Author(s):  
J D Wasson ◽  
C E Papadimitriou ◽  
H Pau
Keyword(s):  
Tympanic Membrane ◽  
Tympanic Membrane Perforation ◽  
Smoking History ◽  
Graft Material ◽  
Tympanic Membrane Perforations ◽  
Membrane Perforation ◽  
Size Grade ◽  
The Mean ◽  
The Impact ◽  
Air Conduction

AbstractObjectives:To investigate the impact of perforation size and other variables on the success of myringoplasty, and also to determine audiological gain following successful closure of tympanic membrane perforations of various sizes.Study design:Retrospective analysis of 130 case notes.Main outcome measures:(1) Successful closure of tympanic membrane following myringoplasty, in relation to recorded variables (i.e. perforation size, grade of surgeon, surgical technique, graft material, previous myringoplasty and smoking history). (2) Mean, four-frequency, air conduction audiometric gain following successful myringoplasty for various, pre-operatively categorised tympanic membrane perforation sizes.Results and Conclusion:The collective myringoplasty success rate was 80.8 per cent (105/130); for successful patients, the mean air conduction audiometric gain was −6.8 dB (t = 5.29, p < 0.0001). Neither perforation size nor any other assessed variable was a statistically significant determinant factor for successful myringoplasty. Air conduction audiometric gains following successful myringoplasty were directly correlated with pre-operative perforation size (−4.0 dB for 0–20 per cent perforations, −5.0 dB for 21–40 per cent, −9.1 dB for 41–60 per cent, −10.8 dB for 61–80 per cent and −13.3 dB for 81–100 per cent).

Sign in / Sign up

Export Citation Format

Share Document