scholarly journals Hearing Benefit in Allograft Tympanoplasty Using Tutoplast Processed Malleus

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Anja Lieder ◽  
Wolfgang Issing

Objectives.Tutoplast processed human cadaveric ossicular allografts are a safe alternative for ossicular reconstruction where there is insufficient material suitable for autograft ossiculoplasty. We present a series of 7 consecutive cases showing excellent air-bone gap closure following canal-wall-down mastoidectomy for cholesteatoma and reconstruction of the middle ear using Tutoplast processed malleus.Patients and Methods.Tympanoplasty with Tutoplast processed malleus was performed in seven patients to reconstruct the middle ear following canal-wall-down mastoidectomy in a tertiary ENT centre.Main Outcome Measures.Hearing improvement and recurrence-free period were assessed. Pre-and postoperative audiograms were performed.Results.The average pre operative hearing loss was 50 ± 13 dB, with an air-bone gap of 33 ± 7 dB. Post operative audiograms at 25 months demonstrated hearing thresholds of 29 ± 10 dB, with an air-bone gap of 14 ± 6 dB. No prosthesis extrusion was observed, which compares favourably to other commercially available prostheses.Conclusions.Tutoplast processed allografts restore conductive hearing loss in patients undergoing mastoidectomy and provide an excellent alternative when there is insufficient material suitable for autograft ossiculoplasty.

Author(s):  
Poornima S. Bhat ◽  
G. Gandhi ◽  
K. Pradheep

<p class="abstract"><strong>Background:</strong> COM causes considerable morbidity with ear discharge, conductive hearing loss and complications. Ossicular reconstruction is a surgical procedure which intends to improve the quality of hearing and life in such patients. Comparison of the outcomes will help to determine the merits or demerits of a particular procedure.</p><p class="abstract"><strong>Methods:</strong> The study was conducted in the Department of ENT, VIMS, Bellary during the period from December 2010 to May 2012. All the patients with CSOM with ossicular erosion suggested by conductive hearing loss more than 40dB were included in the study. A detailed history taking, thorough clinical examination was done for these patients. Before and after the procedure pure tone audiometry was done to assess the hearing outcome. Post operatively PTA was done in 6<sup>th</sup> week, 3<sup>rd</sup> month, 6<sup>th</sup> month follow up. Hearing improvement was analysed according to the type of procedure. The data collected was tabulated and subjected to statistical analysis.  </p><p class="abstract"><strong>Results:</strong> This study compared the outcomes of hearing gain in canal wall up versus canal wall down mastoidectomy surgeries. Hearing gain was better in canal wall up mastoidectomy (18.36 dB) than canal wall down mastoidectomy surgeries.</p><p class="abstract"><strong>Conclusions:</strong> Hearing outcome was better in intact canal wall mastoidectomy than canal wall down mastoidectomy in our study.</p><p class="abstract"> </p>


1986 ◽  
Vol 95 (5) ◽  
pp. 525-530 ◽  
Author(s):  
Joseph W. Hall ◽  
Eugene L. Derlacki

This study investigated whether conductive hearing loss reduces normal binaural hearing advantages and whether binaural hearing advantages are normal in patients who have had hearing thresholds improved by middle ear surgery. Binaural hearing was assessed at a test frequency of 500 Hz using the masking level difference and interaural time discrimination thresholds. Results indicated that binaural hearing is often poor in conductive lesion patients and that the reduction in binaural hearing is not always consistent with a simple attenuation of the acoustic signal. Poor binaural hearing sometimes occurs even when middle ear surgery has resulted in bilaterally normal hearing thresholds. Our preliminary results are consistent with the interpretation that auditory deprivation due to conductive hearing loss may result in poor binaural auditory processing.


1992 ◽  
Vol 106 (3) ◽  
pp. 285-287 ◽  
Author(s):  
Howard K. Herman ◽  
Charles P. Kimmelman

Congenital anomalies of the middle ear are occasionally encountered during surgery for conductive hearing loss and are unexpected in patients with no other deformities. We reviewed 12 such patients operated on at The New York Eye and Ear Infirmary from 1985 through 1989. Nine of the patients (75%) had unilateral conductive hearing loss whereas three (25%) had bilateral symptoms. One had bilateral congenital middle ear anomalies. Three patients (25%) had anomalies limited to the malleus and scutum. Five patients (47%) had agenesis of the oval window. After reconstructive surgery, 72% of patients had hearing improvement ranging from 13 to 38 dB. The etiology of these anomalies is discussed and their evaluation and surgical indications are presented.


2020 ◽  
Vol 9 (2) ◽  
pp. 1-6
Author(s):  
Katarzyna Amernik ◽  
Kazimierz Niemczyk ◽  
Renata Twardowska ◽  
Ewa Jaworowska

Introduction: Surgical treatment of deep heating loss with cochlear implant is well know and successful method which can be used both in children and adults. In patients with cholesteatoma or who underwent surgery canal wall down technique special surgical approach schooled be used – lateral/subtotal petrosectomy. Material and method: Patients witch deep bilateral sensorineural hearing loss and cholesteatoma of middle ear or after treatment of cholesteatoma with canal wall down mastoidectomy were included in the study. Retrospective analysis of patient’s data, radiological and audiological testing was performed. Results: In Department of otolaryngology for Children and Adults and Oncologic Laryngology Pomeranian University of Medicine between 2008 and 2018 90 surgeries of cochlear implantations were performed and among which 3 petrosectomies in one child (5years old) and two adults aged 62 and 73 years old who underwent canal wall down mastoidectomy in the past. In all patients single stage procedure was used, petrosectomy with cochlear implantation. Wound healing an postoperative period was uneventful in all cases. Follow up ranges from 26 to 32 months, in control computer tomography there is lack of indirect signs of recurrence of cholesteatoma. In a child, who accordingly is autistic and mentally retardated, good hearing result is observed and speech understanding, without spontaneous speech. In adult patients in free field audiometry hearing level is 35 and 40dB with speech understanding 80%. Discussion: Patients with chronic ear inflammation can be successfully and safely treated with cochlear implantation using petrosectomy technique. Subtotal/lateral petrosectomy is a method of choice when deep sensorineural hearing loss coexists with chronic inflammatory changes of the middle ear.


1976 ◽  
Vol 14 (12) ◽  
pp. 45-46

Up to 3 million people in Britain might be helped by hearing aids.1 2 Most are over 65 years of age, but some are infants. All should be referred to specialist centres for assessment as soon as possible. Hearing aids generally help most in disorders of the middle ear (conductive hearing loss); they can also help those with sensorineural and other forms of hearing loss. The use of an aid often needs to be supplemented by lip reading and other means of auditory training.1 3


Author(s):  
Prashanth Kudure Basavaraj ◽  
Manjunatha H. Anandappa ◽  
Veena Prabhakaran ◽  
Nishtha Sharma ◽  
Shreyas Karkala

<p class="abstract"><strong>Background:</strong> The objective of the study was to compare the over underlay tympanoplasty technique with classical underlay tympanoplasty in terms of hearing impairment, graft acceptance and complications.</p><p class="abstract"><strong>Methods:</strong> 60 patients of chronic otitis media, mucosal, inactive, aged between 16-60 years who presented to ENT OPD with small, medium, large and subtotal perforations having mild to moderate conductive hearing loss were included in the study. After taking informed consent, patients were randomly divided into 2 groups containing 30 patients each. In group A, graft was placed medial to the handle of malleus and medial to the annulus (underlay technique), while in group B, graft was placed lateral to the handle of malleus and medial to the annulus (over underlay technique). Both groups were reviewed after 6 months. Pre-operative and post-operative air bone gap were compared. Surgery was considered successful based on post-operative graft uptake, hearing improvement and maintenance of middle ear space.  </p><p class="abstract"><strong>Results:</strong> In group A, re-perforation was seen in 8 cases (26.7%) whereas only 3 cases (10%) in group B had re-perforation. Medialization was noted among 4 patients in group A (13.3%), and was absent in group B. Lateralization was absent in both the groups. Post-operative hearing threshold in group A was 6.2±4.56 dB and in group B was 11.45±7.38 dB.</p><p class="abstract"><strong>Conclusions:</strong> Over underlay tympanoplasty is a safer technique as compared to classical underlay, showing lower rates of re-perforation or medialization and a significant improvement in hearing. Hence over-underlay is an effective method, having higher success rates.</p>


2020 ◽  
Vol 23 (2) ◽  
pp. 195-198
Author(s):  
Md Zakaria Sarker ◽  
DC Talukder ◽  
Khabir Uddin Patuary ◽  
Md Rafiqul Islam ◽  
Saif Rahman Khan ◽  
...  

To evaluate the hearing outcome in canal wall down mastoidectomy with middle ear reconstruction, prospective longitudinal study was done at National Institute of ENT, Dhaka from March 2015 to September 2016. Total 22 patients were included in the study undergoing canal wall down mastoidectomy with 6 months postoperative followup. Hearing outcomes were observed and compared with the preoperative hearing tests. Among the 22 patients 9 (39.1% of subjects) patients had hearing gain, 12 (52.2%) had hearing loss and 1 (4.3%) had no change in hearing postoperatively.Although disease clearance is the main objective in canal wall down mastoidectomy, hearing gain can be achieved if combined with ossiculoplasty and tympanoplasty. The hearing gain or loss depends upon the extension of disease and status of the ossicular chain. Most patients usually experience hearing loss more than the preoperative period due to removal of ossicle or ossicles for the sake of disease clearance. Bangladesh J Otorhinolaryngol; October 2017; 23(2): 195-198


1974 ◽  
Vol 83 (1) ◽  
pp. 125-127 ◽  
Author(s):  
Vincent W. Byers

The conductive SISI (short increment sensitivity index) test is an indirect procedure to estimate bone-conduction thresholds for middle ear pathology patients. A series of SISI tests are run, beginning at 20 dB S.L. and increasing in 10 dB S.L. steps, until a 100% SISI score is obtained. The following equation predicts the bone-conduction threshold: [Formula: see text] The results of 25 conductive SISI tests on a conductive hearing loss group indicate that the equation approximates the measured B.C. threshold. There was no statistical difference between the predicated B.C. thresholds (12.4 dB) and measured B.C. thresholds (10.4 dB) for the group.


1998 ◽  
Vol 119 (1) ◽  
pp. 125-130 ◽  
Author(s):  
Juha-Pekka Vasama ◽  
Jyrki P. Mäkelä ◽  
Hans A. Ramsay

We recorded auditory-evoked magnetic responses with a whole-scalp 122-channel neuromagnetometer from seven adult patients with unilateral conductive hearing loss before and after middle ear surgery. The stimuli were 50-msec 1-kHz tone bursts, delivered to the healthy, nonoperated ear at interstimulus intervals of 1, 2, and 4 seconds. The mean preoperative pure-tone average in the affected ear was 57 dB hearing level; the mean postoperative pure-tone average was 17 dB. The 100-msec auditory-evoked response originating in the auditory cortex peaked, on average, 7 msecs earlier after than before surgery over the hemisphere contralateral to the stimulated ear and 2 msecs earlier over the ipsilateral hemisphere. The contralateral response strengths increased by 5% after surgery; ipsilateral strengths increased by 11%. The variation of the response latency and amplitude in the patients who underwent surgery was similar to that of seven control subjects. The postoperative source locations did not differ noticeably from preoperative ones. These findings suggest that temporary unilateral conductive hearing loss in adult patients modifies the function of the auditory neural pathway. (Otolaryngol Head Neck Surg 1998;119:125-30.)


2017 ◽  
Vol 96 (10-11) ◽  
pp. 426-432
Author(s):  
Z. Jason Qian ◽  
Amy M. Coffey ◽  
Kathleen M. O'Toole ◽  
Anil K. Lalwani

Benign middle ear tumors represent a rare group of neoplasms that vary widely in their pathology, anatomy, and clinical findings. These factors have made it difficult to establish guidelines for the resection of such tumors. Here we present 7 unique cases of these rare and diverse tumors and draw from our experience to recommend optimal surgical management. Based on our experience, a postauricular incision is necessary in nearly all cases. Mastoidectomy is required for tumors that extend into the mastoid cavity. Whenever exposure or hemostasis is believed to be inadequate with simple mastoidectomy, canal-wall-down mastoidectomy should be performed. Finally, disarticulation of the ossicular chain greatly facilitates tumor excision and should be performed early in the procedure.


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