scholarly journals Effects of Sacrificing Tensor Tympani Muscle Tendon When Manubrium of Malleus Is Foreshortened in Type I Tympanoplasty

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Sohil Vadiya
Keyword(s):  
Effective Procedure ◽  
Type I ◽  
Hearing Improvement ◽  
Uptake Rates ◽  
Group A ◽  
Type I Tympanoplasty ◽  
Tensor Tympani Muscle ◽  
Tensor Tympani Tendon ◽  
Group B

The current study aims at observing effects of sacrificing the tensor tympani tendon when manubrium of malleus is foreshortened or retracted on graft uptake, hearing improvement, and occurrence of complications if any during type I tympanoplasty surgery for central perforations. 42 patients were included in group A where the tensor tendon was sectioned and 42 patients were included in group B where the tensor tympani tendon was retained and kept intact. Graft uptake rates are very good in both groups but hearing improvement was found significantly better in group A than group B. No unusual or undesired complications were seen in any of the cases. Sectioning of tensor tympani tendon is safe and effective procedure in cases where manubrium is foreshortened.

scholarly journals A Comparative Study of Outcomes of Type I Tympanoplasty with or without Fibrin Glue

2019 ◽  
Vol 27 (1) ◽  
pp. 15-18
Author(s):  
Somu Lakshmanan ◽  
Preethi Umamaheswaran
Keyword(s):  
Comparative Study ◽  
Fibrin Glue ◽  
Tertiary Care ◽  
Type I ◽  
Hearing Improvement ◽  
Uptake Rates ◽  
Significant Difference ◽  
Group A ◽  
Type I Tympanoplasty ◽  
Group B

Introduction: Various materials have been used in tympanoplasty to ensure the adherence of the graft with the remnant tympanic membrane. This study aims to compare the clinical outcomes of type I tympanoplasty done with and without fibrin glue. Materials and Methods:           This is a prospective comparative study conducted in a tertiary care centre between August 2014 and July 2016. A sample size of 70 patients was used. The patients were randomly divided into two groups – Group A and Group B. Patients in group A underwent tympanoplasty with fibrin glue and patients in group B underwent tympanoplasty without fibrin glue. The patients were followed up for 6 months and the postoperative hearing improvement and graft uptake rates were compared. Results: The pre-operative mean pure tone average for group A was 34.33±7.3dB; it improved to 22.14±6.5 at the end of 6 months. In group B, it improved from 34.25±8dB to 22.64±7.4dB at the end of 6 months. There was no statistical significance in hearing improvement between both the groups. Though there was no statistically significant difference in the graft uptake rates between group A (94.3%) and group B (91.4%), fibrin glue had better outcomes with larger perforations. Conclusion: The use of fibrin glue in tympanoplasty is safe and it has a particular advantage in the graft uptake in subtotal perforations.

scholarly journals Role of Cortical Mastoidectomy in the Management of Safe Chronic Otitis Media

2020 ◽  
Vol 18 (1) ◽  
pp. 44-48
Author(s):  
Lok Ram Verma ◽  
Dhundi Raj Paudel
Keyword(s):  
Otitis Media ◽  
Chronic Otitis Media ◽  
Inactive Disease ◽  
Type I ◽  
Hearing Improvement ◽  
Beneficial Effects ◽  
Cortical Mastoidectomy ◽  
Group A ◽  
Group B

Introduction: Role of cortical mastoidectomy in tympanoplasty for Chronic Otitis Media Mucosal inactive disease is controversial. Some arguments are in favor and suggest that cortical mastoidectomy increases the air reservoir in the mastoid and also help in achieving the patency of aditus but others believe that the ingrowths of squamous epithelium, potential for injury to the inner ear structures and facial nerve during mastoid surgery outweighs the beneficial effects on tympanic membrane healing. Aims: To assess the hearing improvement and graft uptake in patients undergoing Tympanoplasty and Tympano-mastoidectomy in chronic otitis media mucosal inactive disease. Methods: This was a comparative study comprises of 50 patients with Chronic Otitis Media Mucosal inactive ear, conducted in the patients attending the department of ENT in NGMC teaching hospital from Nov 2017 to May 2019. All cases were operated during a period of one half year. 25 patients were selected for tympanoplasty (Group A) and 25 patients were selected for Tympanoplasty with cortical mastoidectomy (Group B). Results: There were 14(28%) male and 36(72%) female, with mean age of 28. 36 years, ranging from minimum of 13 years to maximum 56 years. The postoperative audiograms were recorded after 3 months. Type I tympanoplasty with cortical mastoidectomy has better graft uptake (96%) as compared to without mastoidectomy (84%). Post-operative hearing improvement is almost equal in tympano-mastoidectomy (13.24 dB) and tympanoplasty (13.04 dB). Conclusion: Post-operative hearing gain almost equal in both study group but graft uptake was better with tympano-mastoidectomy then tympanoplasty alone in present study.

scholarly journals Audiological evaluation in between patients with type 1 tympanoplasty alone and type 1 tympanoplasty with cortical mastoidectomy

2017 ◽  
Vol 4 (1) ◽  
pp. 45
Author(s):  
K. Mallikarjuna Swamy ◽  
Arati Ganiger
Keyword(s):  
Hearing Loss ◽  
Pure Tone Audiometry ◽  
Type I ◽  
Hearing Improvement ◽  
Temporalis Fascia ◽  
Type 1 Tympanoplasty ◽  
Postoperative Assessment ◽  
Group A ◽  
Group B

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Evaluation of success of tympanoplasty depends on various host and surgical factors has been subject of interest for many years and still continues to be challenge</span><span lang="EN-IN">. </span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">Present study was undertaken to observe results of type I tympanoplasty using tragal cartilage and perichondrium with temporalis fascia grafts using endomeatal and postauricular approach.  </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">Study group comprises of 30 patients in Group A and B operated by tympanoplasty type I by endomeatal and postauricular techniques. Success was 96.3% in Group A and 94.7% in Group B for closure of membrane perforation.<strong> </strong>During postoperative period average time taken for wound healing was 23 days in Group A and 35 days in Group B. Preoperative and postoperative assessment of hearing performed with pure tone audiometry revealed an average hearing loss of 36.50 dB in Group A before surgery and postoperative assessment at end of 1 year revealed hearing improvement of 14.23 dB. In Group B preoperative assessment revealed hearing loss of 38.23 dB lowered to 15.12 dB after surgery. When hearing improvement in both groups were compared preoperatively and postoperatively, in Group A there was improvement of 22.27 dB while in Group B was 23.11 dB. The hearing improvements in both the groups appear to be similar when the results were compared. In present study overall success rate was 89.7% which is comparable to outcome of surgery performed with post auricular approach with temporalis fascia graft which is 91.3%. When postoperative complications were studied it was observed that Group A had fewer numbers of complications as over Group B which was documented in Table 2. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Success of tympanoplasty depends on several host and surgical factors. Tragal perichondrium appears as proven alternate for closure of perforation of tympanic membrane. Cosmetically endomeatal approach appears promising over post auricular approach.</span></p>

scholarly journals A prospective observational study of comparison of tympanoplasty using endomeatal approach using tragal cartilage and perichondrium with post auricular approach using temporalis fascia graft: an institutional study

2017 ◽  
Vol 4 (1) ◽  
pp. 41
Author(s):  
V. Krishna Chaitanya ◽  
N. Janardhan ◽  
Teja . ◽  
Vinay Singh Bhat ◽  
Rajaram .
Keyword(s):  
Hearing Loss ◽  
Pure Tone Audiometry ◽  
Preoperative Assessment ◽  
Type I ◽  
Hearing Improvement ◽  
Temporalis Fascia ◽  
Postoperative Assessment ◽  
Fascia Graft ◽  
Group A ◽  
Group B

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Evaluation of success of tympanoplasty depends on various host and surgical factors has been subject of interest for many years and still continues to be challenge</span><span lang="EN-IN">. </span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">Present study was undertaken to observe results of type I tympanoplasty using tragal cartilage and perichondrium with temporalis fascia grafts using endomeatal and postauricular approach.  </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">Study group comprises of 30 patients in Group A and B operated by tympanoplasty type I by endomeatal and postauricular techniques. Success was 96.3% in Group A and 94.7% in Group B for closure of membrane perforation.<strong> </strong>During postoperative period average time taken for wound healing was 23 days in Group A and 35 days in Group B. Preoperative and postoperative assessment of hearing performed with pure tone audiometry revealed an average hearing loss of 36.50 dB in Group A before surgery and postoperative assessment at end of 1 year revealed hearing improvement of 14.23 dB. In Group B preoperative assessment revealed hearing loss of 38.23 dB lowered to 15.12 dB after surgery. When hearing improvement in both groups were compared preoperatively and postoperatively, in Group A there was improvement of 22.27 dB while in Group B was 23.11 dB. The hearing improvements in both the groups appear to be similar when the results were compared. In present study overall success rate was 89.7% which is comparable to outcome of surgery performed with post auricular approach with temporalis fascia graft which is 91.3%. When postoperative complications were studied it was observed that Group A had fewer numbers of complications as over Group B which was documented in Table 2. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Success of tympanoplasty depends on several host and surgical factors. Tragal perichondrium appears as proven alternate for closure of perforation of tympanic membrane. Cosmetically endomeatal approach appears promising over post auricular approach.</span></p>

Comparative Study of effectiveness of mobilization with movement (MWM) and End range mobilization (ERM) techniques in frozen shoulder

2018 ◽  
Vol 4 (4) ◽  
pp. 519-522
Author(s):  
Jeyakumar S ◽  
Jagatheesan Alagesan ◽  
T.S. Muthukumar
Keyword(s):  
Range Of Motion ◽  
Frozen Shoulder ◽  
Type I ◽  
Mean Values ◽  
Functional Activities ◽  
Group A ◽  
The Mean ◽  
Group B

Background: Frozen shoulder is disorder of the connective tissue that limits the normal Range of motion of the shoulder in diabetes, frozen shoulder is thought to be caused by changes to the collagen in the shoulder joint as a result of long term Hypoglycemia. Mobilization is a therapeutic movement of the joint. The goal is to restore normal joint motion and rhythm. The use of mobilization with movement for peripheral joints was developed by mulligan. This technique combines a sustained application of manual technique “gliding” force to the joint with concurrent physiologic motion of joint, either actively or passively. This study aims to find out the effects of mobilization with movement and end range mobilization in frozen shoulder in Type I diabetics. Materials and Methods: 30 subjects both male and female, suffering with shoulder pain and clinically diagnosed with frozen shoulder was recruited for the study and divided into two groups with 15 patients each based on convenient sampling method. Group A patients received mobilization with movement and Group B patients received end range mobilization for three weeks. The outcome measurements were SPADI, Functional hand to back scale, abduction range of motion using goniometer and VAS. Results: The mean values of all parameters showed significant differences in group A as compared to group B in terms of decreased pain, increased abduction range and other outcome measures. Conclusion: Based on the results it has been concluded that treating the type 1 diabetic patient with frozen shoulder, mobilization with movement exercise shows better results than end range mobilization in reducing pain and increase functional activities and mobility in frozen shoulder.

scholarly journals A COMPARISON BETWEEN SYNTHETIC AND BIOSYNTHETIC MESHES IN THE SURGICAL TREATMENT OF SEVERE GENITAL PROLAPSE: RESULTS AND COMPLICATIONS

2010 ◽  
Vol 23 (3) ◽  
pp. 21
Author(s):  
S. Dati ◽  
V. De Lellis ◽  
P. Palermo ◽  
G. Carta
Keyword(s):  
Genital Prolapse ◽  
Pelvic Organ ◽  
Wilcoxon Test ◽  
Type I ◽  
Replacement Surgery ◽  
Group A ◽  
Group B ◽  
Work Up

The effectiveness, tolerability and complications of two surgical procedures using prosthetic materials with different physical and structural properties were assessed with a full Urogynecology work-up, through a retrospective study of 158 patients with severe genital prolapse (POP-Q staging III-IV) selected from November 2006 to April 2009. Eighty-six patients underwent fascial replacement surgery with ProliftTM System with a dual transobturator access in the anterior district and a transperineal posterior access with a synthetic polypropylene type I mesh (Group A). Seventy-two patients who underwent pelvic organ prolapse surgery with Avaulta/Avaulta PlusTM System with a dual transobturator access in the anterior district and a dual transperineal posterior access with a biosynthetic polypropylene type I mesh coated with a film of hydrophilic porcine collagen were placed in Group B. There were no intra and postoperative complications. Results of mean 20.8 month follow-up showed an effective anatomical cure rate of 89.5% in group A and 86.1% in group B and a low percentage of erosive complications, 8.1% and 5.6% respectively. Validated questionnaires for prolapse, the UDI 6 s.f., the IIQ7 s.f. and the PISQ-12 all showed a statistically significant improvement of quality of life in patients undergoing the two procedures (Wilcoxon test: P&lt;0.001).

scholarly journals Maintenance treatment of diabetic patients, associating arterial obstructive tibio-peroneal disease

1995 ◽  
Vol 113 (1) ◽  
pp. 701-705
Author(s):  
Nelson Wolosker ◽  
Ruben Miguel Ayzin Rosoky ◽  
Baptista Muraco Neto ◽  
Berilo Langer
Keyword(s):  
Maintenance Treatment ◽  
Diabetic Patients ◽  
Type I ◽  
Group I ◽  
Significant Difference ◽  
Therapeutic Procedures ◽  
Arterial Pulsation ◽  
Group A ◽  
Group B ◽  
Better Than

When a melito-diabetic patient presents trophic infected injury on the limb, it is essential an evaluation of the circulatory conditions for therapeutic procedures orientation. In some circumstances, although arterial pulsation is absent, there is no ischemia of tissues. In these cases, the maintenance treatment, with eventual resection of the necrosed and infected tissues may be adopted. Evolution of 70 diabetic patients with trophic injuries on extremities were submitted to a maintenance treatment. Age of patients varied from 28 to 88 years, with an average of 56.8. The most occurrence was verified in women, with 42 cases. Diabetes non-dependant on insuline (type II) was observed in 64 patients (91.5%), being the remaining 6 patients of type I. Diabetic retinopathy was observed in 14 (20%) of the patients, neuropathy in 22 (31%) and nephropathy in 8 patients (11.4%). All the patients presented arterial pulsation until the popliteal region. They were divided in 2 groups, considering trunk arteries of legs: Group I, pervial legs arteries, composed by 48 patients; Group II, occluded legs arteries, with 22 patients. In what refers to the anatomic local of the injuries, patients were classified in three groups: Group A, formed by 32 patients (45.7%), presenting injuries in one or two toes only, without affecting the metatarsic region; Group B, formed by 16 patients (22.9%), trophic injuries affecting the metatarsic region and Group C, formed by 22 patients (31.4%), injuries affecting the calcaneous region. Injuries in both of the groups were caused by mechanical traumatism. Duration of the injury in the inferior member varied from 7 to 48 days, resulting in a 12 days average. Analyzing pervicacity in trunk arterias and evolution of patients, it may be observed that there has been a significantly better result in those with all the pulses present (81.3% x 45.5%)(p<0,01). Studying the injury locals associated to the evaluation of the cases, we may observe that for injuries in the extreme digital, result is significantly better than in locals more nearly. When distal pulses are absent, there is no significant difference in the result of the treatment, being performed in distal injuries or in the more near ones (p>0,05)(Table IV).

scholarly journals Comparative study between over underlay with classical underlay techniques of tympanoplasty

2020 ◽  
Vol 6 (5) ◽  
pp. 918
Author(s):  
Prashanth Kudure Basavaraj ◽  
Manjunatha H. Anandappa ◽  
Veena Prabhakaran ◽  
Nishtha Sharma ◽  
Shreyas Karkala
Keyword(s):  
Hearing Loss ◽  
Informed Consent ◽  
Conductive Hearing Loss ◽  
Hearing Threshold ◽  
Chronic Otitis Media ◽  
Success Rates ◽  
Hearing Improvement ◽  
Group A ◽  
Group B ◽  
Conductive Hearing

<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>

scholarly journals Comparative study of endoscopic tympanoplasty and conventional tympanoplasty

2020 ◽  
Vol 6 (10) ◽  
pp. 1804
Author(s):  
Priyanka Aggarwal ◽  
Barjinder Singh Sohal ◽  
J. P. Goyal
Keyword(s):  
Success Rate ◽  
Cost Effective ◽  
Patient Comfort ◽  
Hearing Improvement ◽  
Post Operation ◽  
Group A ◽  
Group B ◽  
The Cost ◽  
Results Of Surgery ◽  
Endoscopic Tympanoplasty

<p><strong>Background:</strong> To compare the results of endoscopic tympanoplasty with that of conventional tympanoplasty and to evaluate and compare the graft uptake in both of these methods. The study was done to evaluate the improvement in hearing after tympanoplasty and the problems faced while doing the endoscope assisted tympanoplasty.</p><p><strong>Methods: </strong>Between July 2010 to June 2013, 50 patients underwent tympanoplasty, 25 were endoscope assisted (group A) and 25 were microscope assisted (group B). Results of surgery were compared at the end of three and six months post operation.</p><p><strong>Results: </strong>The success rate in terms of graft uptake rate was 88% with endoscope assisted tympanoplasty and 84% with other microscope assisted tympanoplasty. Overall success rate was 86.0%. Mean hearing improvement was (16.24±10.21 dB) and (14.28±7.10 dB) in group A and group B respectively.</p><p><strong>Conclusions: </strong>Tympanoplasty with its visualization of hidden corners, justifies tympanoplasty by using endoscope in selected cases with comparable improved results in the literature. Furthermore, the cost of the endoscope is much less (about 10%) in comparision to operating microscope, making it more cost effective in developing countries. However, the endoscope cannot be employed in every case as one hand is blocked. In terms of Patient comfort, the endoscope assisted outnumbers the benefits of other conventional methods.<strong></strong></p>

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