scholarly journals The Long-Term Stability of Fat-Graft Myringoplasty in the Closure of Tympanic Membrane Perforations and Hearing Restoration

ORL ◽  
2020 ◽  
pp. 1-8
Author(s):  
Jae Sang Han ◽  
Jung Ju Han ◽  
Jung Mee Park ◽  
Jae-Hyun Seo ◽  
Kyoung Ho Park
Keyword(s):  
Tympanic Membrane ◽  
Fat Graft ◽  
Closure Rate ◽  
Tertiary Referral Center ◽  
Term Stability ◽  
Long Term Stability ◽  
Tympanic Membrane Perforations ◽  
The Mean

<b><i>Background/Aims:</i></b> This study was conducted to evaluate the long-term stability of fat-graft myringoplasty (FGM) for chronic tympanic membrane perforations, analyzing the perforation closure rate and re-gained hearing outcome with respect to the size and location of the perforations. <b><i>Methods:</i></b> Between August 2007 and June 2018, a total of 193 patients who underwent FGM due to chronic tympanic membrane perforation at a tertiary referral center were enrolled and analyzed. <b><i>Results:</i></b> The mean follow-up was 14.6 months (range 6–39). The complete perforation closure rate after FGM was 89.6%, with no statistical difference among the perforation size groups. The mean postoperative air-bone gap (ABG) was 11.0 dB and mean ABG improvement was 4.9 dB. <b><i>Conclusion:</i></b> Our FGM technique had a favorable tympanic closure rate for small to large perforations, and yielded relatively good hearing improvement in the mid-size perforation cases over long-term follow-up periods. According to the topographic evaluation of FGM, this procedure resulted in a reliable perforation closure rate and audiological results regardless of the perforation site.

scholarly journals Evaluation of the Stability of Intracranial Aneurysms Occluded with Guglielmi Detachable Coils

2001 ◽  
Vol 7 (1_suppl) ◽  
pp. 143-148 ◽  
Author(s):  
S. Tamatani ◽  
Y. Ito ◽  
T. Koike ◽  
H. Abe ◽  
T. Kumagai ◽  
...  
Keyword(s):  
Guglielmi Detachable Coils ◽  
Aneurysm Neck ◽  
Term Stability ◽  
Long Term Stability ◽  
Detachable Coils ◽  
The Mean ◽  
The Stability ◽  
Small Aneurysms

The purpose of this study is to evaluate the long-term stability of embolized aneurysms using the volume embolization rate (VER). One hundred and six aneurysms in 96 patients who were treated with Guglielmi detachable coils were selected for this study. Follow-up angiography was performed at six or more months after initial treatment. Every aneurysm was packed as densely as possible, however, the percentage of stability varied according to the size of the aneurysm or the size of the aneurysm neck. The percentage of stable aneurysm was 82% (56/68) in small aneurysms with small necks, 68% (13/19) in small aneurysms with wide necks and 42% (8/19) in large aneurysms. The mean VER of embolized aneurysms in each size was 30%, 22% and 17%, respectively. There was a correlation between the percentage of stable aneurysms and the mean VER. On the other hand, there seemed to be a difference of VER for the stability of embolized aneurysms between ruptured aneurysms and unruptured ones. In small aneurysms with small necks, the stability of embolized aneurysms in ruptured ones was obtained only when the VER was greater than 30%, whereas it was found in unruptured ones even though the VER was less than 20%. In conclusion, the long-term stability of embolized aneurysms was obtained in small-sized aneurysms, especially small neck aneurysms, and unruptured ones. The VER is a good, objective index to predict the long-term stability of embolized aneurysms.

Long-term stability of Onyx: is there any indication for repeated angiography after dural arteriovenous fistula embolization?

2021 ◽  
pp. 1-10
Author(s):  
Richard Voldřich ◽  
David Netuka ◽  
František Charvát ◽  
Vladimír Beneš
Keyword(s):  
Transarterial Embolization ◽  
Diagnostic Methods ◽  
Term Stability ◽  
Long Term Stability ◽  
Prospective Group ◽  
Significant Difference ◽  
Long Term Follow Up ◽  
The Mean

OBJECTIVE The natural course of dural arteriovenous fistulas (DAVFs) is unfavorable. Transarterial embolization with Onyx is currently the therapeutic method of choice, although the long-term stability of Onyx has been questioned. The literature reports a significant difference in the recurrence rate after complete DAVF occlusion and lacks larger series with long-term follow-up. The authors present the largest series to date with a long-term follow-up to determine the stability of Onyx, prospectively comparing magnetic resonance angiography (MRA) and digital subtraction angiography (DSA) as follow-up diagnostic methods. METHODS Demographics, clinical symptomatology, length of follow-up, diagnostic methods, and angiographic findings of DAVFs were recorded and retrospectively evaluated in 112 patients. A prospective group of 15 patients with more than 5 years of follow-up after complete DAVF occlusion was established. All 15 patients in the prospective group underwent a clinical examination and MRA; 10 of these patients also underwent DSA. The recurrences and the correlation between the two diagnostic methods were evaluated. RESULTS Among the 112 patients, 71 were men and 41 were women, with an average age of 60 years. Intracranial hemorrhage (40%) was the most common clinical presentation of DAVF. At the last follow-up, 73% of the patients experienced clinical improvement, 21% remained unchanged, and 6% worsened. Overall, 87.5% of the DAVFs were occluded entirely with endovascular treatment, and 93% of the DAVFs were classified as cured at the last follow-up (i.e., completely embolized DAVFs and DAVFs that thrombosed spontaneously or after Gamma Knife surgery). Two recurrences of DAVFs were recorded in the entire series. Both were first diagnosed by MRA and confirmed with DSA. The mean follow-up was 27.7 months. In the prospective group, a small asymptomatic recurrence was diagnosed. The mean follow-up of the prospective group was 96 months. CONCLUSIONS Onyx is a stable embolic material, although recurrence of seemingly completely occluded DAVFs may develop because of postembolization hemodynamic changes that accentuate primarily graphically absent residual fistula. These residuals can be diagnosed with MRA at follow-up. The authors’ data suggest that MRA could be sufficient as the follow-up diagnostic method after complete DAVF occlusion with Onyx. However, larger prospective studies on this topic are needed.

scholarly journals Comparative study between fat plug and inlay butterfly cartilage grafts for myringoplasty in adults

2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Ahmed Gamal Khafagy ◽  
Mohamed El-Begermy ◽  
Marwa Mohamed El-Begermy ◽  
Pretty O. Afifi
Keyword(s):  
Tympanic Membrane ◽  
Chronic Otitis Media ◽  
Fat Graft ◽  
Cartilage Graft ◽  
Tympanic Membrane Perforations ◽  
Number Of Patients ◽  
Significant Difference ◽  
Hearing Outcomes ◽  
Age Range

Abstract Background This study aims to compare the graft uptake rate and hearing improvement of fat graft versus inlay butterfly tragal cartilage in the repair of perforations in chronic otitis media mucosal in adults. In this retrospective study, twenty-eight patients were included with small dry anteroinferior tympanic membrane perforations (less than 1/3 of the tympanic membrane). The age range was 18 to 44 years old. Myringoplasty was done under general anesthesia for 8 patients with a fat graft (FG) and 20 patients with inlay butterfly cartilage graft (IBCG). Six months postoperatively, a follow-up evaluation was done for successful graft uptake and hearing outcomes. Results The success rate of graft uptake in the first group (fat graft) was 6/8 cases (75%) while in the second group (IBCG) was 19/20 (95%) with no statistically significant difference (P = 0.0148). Also, there was no statistical difference between the two groups as regards postoperative ABG, improvement changes in ABG, and number of patients with improved hearing. Conclusions Inlay butterfly cartilage graft is a useful graft in repairing small tympanic membrane perforations as regard graft take and hearing outcomes.

Class II treatment in early mixed dentition with the eruption guidance appliance: effects and long-term stability

2019 ◽  
Vol 42 (2) ◽  
pp. 151-156 ◽  
Author(s):  
Katri Keski-Nisula ◽  
Leo Keski-Nisula ◽  
Juha Varrela
Keyword(s):  
Treatment Group ◽  
Class Ii ◽  
Post Treatment ◽  
Mixed Dentition ◽  
Term Stability ◽  
Long Term Stability ◽  
Class Ii Treatment ◽  
Significant Correction ◽  
The Mean

Summary Objectives Our aim was to analyse dentoskeletal effects and long-term stability of Class II treatment carried out with an eruption guidance appliance (EGA) in early mixed dentition. Materials and methods Sixty-five Class II patients (38 females and 27 males), treated with an EGA in early mixed dentition, were compared with 58 children (26 females and 32 males) with untreated Class II malocclusion. The mean age in the treatment group at the start (T1) and end of treatment (T2) was 5.4 years (±0.4) and 8.5 years (±0.9), respectively, and at the final examination in the early permanent dentition (T3) 16.7 years (±0.4). In the control group, the mean age at T1 and T2 were 5.1 years (±0.5) and 8.4 years (±0.5), respectively. The independent and dependent sample t-tests, Chi-square test, and Fisher’s test were used in the statistical evaluation. Results In the treatment group, the frequency of Class II decreased from 100 to 14% during the treatment (T1–T2) and a significant correction took place in all occlusal variables. At T2, the treatment and control groups showed statistically significant differences (P &lt; 0.05) in all occlusal variables. In the treated children, mandibular length increased 5 mm more (P &lt; 0.001) from T1 to T2 compared to the control children, and the ANB angle became significantly smaller (P = 0.006). During the post-treatment period (T2–T3), the frequency of Class II in the treatment group decreased from 14 to 2% (P &lt; 0.05), overbite increased from 2.2 to 3.1 mm (P &lt; 0.05), and lower crowding increased from 2to 14% (P &lt; 0.05). Post-treatment changes in overjet and upper crowding were not statistically significant. At T3, the mean values of the SNA, SNB, and ANB angles were 83.0° (SD 3.9°), 81.3° (SD 3.8°), and 2.4° (SD 1.5°), respectively. Conclusions A clinically significant correction of the molar relationship, overjet, overbite, incisor alignment, and growth enhancement of the mandible were observed after treatment in early mixed dentition. The treatment results remained largely stable in the early permanent dentition. However, an increase was observed in overbite and lower crowding. None of the children treated in early mixed dentition needed a second treatment phase.

scholarly journals Middle Ear Transducer: Long Term Stability of the Latest Generation T2

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Nils Kristian Prenzler ◽  
Eugen Kludt ◽  
Thomas Giere ◽  
Rolf Salcher ◽  
Thomas Lenarz ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Middle Ear ◽  
Observation Time ◽  
Term Stability ◽  
Long Term Stability ◽  
Average Observation ◽  
Technical Failures

Objectives/Hypothesis. Comparing long term stability of the Middle Ear Transducers (MET) of the 1st generation T1 (Otologics LLC) with the current generation T2 (Cochlear Ltd.) in all our clinical cases with standard incus coupling. Study Design. Retrospective chart review. Methods. 52 ears implanted with a MET device between 2008 and 2016 were analyzed retrospectively. All patients suffered from sensorineural hearing loss and the actuator was coupled to the body of the incus (standard coupling). 23 ears were implanted with the transducer T1 (Otologics LLC) between 2008 and 2011 and 29 ears were implanted with the current transducer T2 since 2011 (Otologics LLC/Cochlear Ltd.). Latest available in situ and bone conduction (BC) thresholds were exploited for a follow-up period of up to 7 years after first fitting. Long term stability of coupling and actuator performance was evaluated by tracking differences between in situ and BC thresholds. Results. In the T1 group, 9 out of 23 implants were still used by the patients at their last follow-up visit (average observation time 3.7 yrs.; min 1.0 yrs., max 7.4 yrs.). In 9 patients a technical failure identified by a decrease of in situ threshold of more than 15 dB compared to BC thresholds [Δ (in situ – BC)] lead to non-usage of the implant and 7 explantations. Five other explantations occurred due to medical reasons such as BC threshold decrease, infection, or insufficient speech intelligibility with the device. In the T2 group, 23 out of 29 implants were still used at the most current follow-up visit (average observation time 3.3 yrs.; min 1.0 yrs., max 4.8 yrs.). No technical failures were observed up to more than 4 years after implantation. Five T2 patients discontinued using the device due to insufficient benefit; two of these patients were explanted. One patient had to be explanted before the activation of the device due to disorders of wound healing. Nevertheless, a small but significant decrease of hearing loss corrected coupling efficiency [Δ (in situ – BC)] was seen in the T2 group. Conclusions. In contrast to the T1 transducers of the earlier generation of MET systems where technical failures occurred frequently, no technical failures were detected after 29 implantations with the current T2 transducers. However, a small but significant decline of transmission efficiency was observable even in the T2 implanted group.

Long- and short-term in vitro D-dimer stability measured with INNOVANCE D-Dimer

2010 ◽  
Vol 103 (02) ◽  
pp. 461-465 ◽  
Author(s):  
Martina Böhm-Weigert ◽  
Thomas Wissel ◽  
Heidrun Muth ◽  
Bettina Kemkes-Matthes ◽  
Dirk Peetz
Keyword(s):  
Frozen Storage ◽  
Percentage Change ◽  
Short Term ◽  
Term Stability ◽  
Long Term Stability ◽  
Repeated Freezing ◽  
The Mean ◽  
D Dimer

Summary In vitro D-dimer stability in plasma is widely assumed, but has not yet been documented by systematic studies using samples covering a wide range of D-dimer. We investigated the short- and long-term stability of D-dimer in clinical citrated plasma samples with normal and pathological levels. The short-term stability was analysed by measuring D-dimer fresh, after storage of plasma for 4 hours at room temperature (RT) and after an additional 24 h storage at +2 to +8°C (n=40). Long-term stability samples (n=40) were measured fresh and after storage for 19, 25 and 36 months at ≤-60°C. The effect of repeated freezing was analysed by measuring samples (n=50) fresh and after four consecutive freeze-thaw cycles. D-dimer was measured on the BCS System using the INNOVANCE D-Dimer assay (Siemens Healthcare Diagnostics Products GmbH, Marburg, Germany). D-dimer values at baseline ranged from 0.23–22.2 mg/l FEU. The mean percentage change after storage for 4 hours at RT and additional 24 hours at +2 to +8°C was +3.8% and +2.7%, respectively. The mean percentage change after frozen storage for 19, 25 and 36 months at ≤-60°C was –11.7%, –4.8% and –9.3%, respectively. The small decrease of D-dimer values after frozen storage was not time-dependent. Repeated freezing did not significantly alter D-dimer values (mean change ≤5%). The data demonstrate stability of D-dimer in plasma prior to freezing for up to 4 hours at RT and for up to 24 hours at +2 to +8°C as well as in plasma stored for up to three years at ≤-60°C.

scholarly journals Combining Techniques to Treat Isolated Deep Recession-Type Defects: A Case Report with Long-Term Stability

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
João Carnio ◽  
Anna Tereza Carnio
Keyword(s):  
Case Report ◽  
Root Coverage ◽  
Case Presentation ◽  
Term Stability ◽  
Long Term Stability ◽  
Dental Procedures ◽  
Donor Area ◽  
Deep Recession

Introduction. The purpose of this case report was to show the clinical long-term stability of a successful two-step root coverage procedure. A combination of two single techniques was used to treat an isolated deep-wide defect. Case Presentation. A 28-year-old female patient was referred in order to treat a single recession defect at #22. Due to her fear of dental procedures and a poor economic situation, the team developed an alternative solution. They used a modified apically repositioned flap (MARF) to increase the donor area and then a laterally positioned flap (LPF) to treat the root defect. Clinical evaluation at the three-year follow-up revealed complete resolution of the defect, a gain in clinical attachment, excellent esthetic results, and minor morbidity to the patient. Conclusion. The combination of the MARF and the LPF procedures was able to successfully treat a single deep recession defect with some advantages over traditional techniques such as simplicity, ideal color match of tissues, and the absence of palatal donor tissue.

scholarly journals Middle Ear Packing and External Ear Packing with Fibrin Glue Enhances the Success of Fat Myringoplasty without Hyaluronic Acid Disc

2021 ◽  
Author(s):  
Jongmin Kim ◽  
Chul Ho Jang
Keyword(s):  
Success Rate ◽  
Fibrin Glue ◽  
Middle Ear ◽  
Fat Graft ◽  
External Ear ◽  
Tertiary Referral ◽  
Closure Rate ◽  
Tertiary Referral Center ◽  
Significant Difference ◽  
The Mean

Background: To date, FM using middle ear packing has rarely reported. In this study, we hypothesized that middle ear packing with dexamethasone soaked gelfoam and fibrin glue over the fat graft could promote the success rate of TMP closure regardless of perforation size. Methods: Between January 2005 and July 2020, a total of 209 patients who underwent fat myringoplasty due to chronic TMP at tertiary referral center were encountered and analyzed. The success rate and audiologic outcome was analyzed. Results: The mean successful TM closure rate was 88.0 %. The success rate by different age generation was not significant difference. The size of the perforation grade showed no significant difference. The perforation site by anterior or posterior was not significant. The preoperative mean threshold of AC, BC and ABG were 55.71, 12.98 and 42.73 dB respectively. The postoperative mean threshold of AC, BC and ABG were 23.67, 12.98 and 10.69 dB. The change of preoperative and postoperative hearing showed statistically significant. Conclusion: From our results, the simple trimming of the perforation edge and middle ear packing with external ear canal packing using fibrin glue induced the stable adhesion between the remnant TM and the fat graft.

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