Ossicular Chain Reconstruction in a Developing Country

2018 ◽  
Vol 127 (5) ◽  
pp. 306-311 ◽  
Author(s):  
Es-Hak Bedri ◽  
Miriam Redleaf
Keyword(s):  
Tympanic Membrane ◽  
Developing Country ◽  
Middle Ear ◽  
Granulation Tissue ◽  
Ossicular Chain ◽  
Single Stage ◽  
Limited Resources ◽  
Closure Rate ◽  
Average Improvement ◽  
Ossicular Chain Reconstruction

Objectives: In Ethiopia, 2-stage operations with middle ear prostheses are economically unfavorable. We hypothesized that single-stage autologous ossiculoplasty results in acceptable tympanic membrane (TM) and hearing improvements in a setting of limited resources. Methods: One hundred eighty-eight patients (197 ears) who underwent 1-stage autologous ossiculoplasty for ossicular dysfunction are presented. All but 14 of these ears also had perforations of the TM. Conditions of the middle ear were granulation tissue, ossicular disruption only, tympanosclerosis, and cholesteatoma. Reconstructions of the ossicular chain were performed with autologous ossicles only. Results: The closure rate of TM perforations was 95%. Preoperative air bone gaps were 27 to 60 dB (mean [SD] = 44 [7] dB); postoperative air bone gaps were 0 to 50 dB (average [SD] = 23 [10] dB), for an average improvement of 21 dB across all reconstruction types ( P < .001). The largest favorable changes in air bone gaps were with incus and malleus columellas from the footplate to the TM (33 and 23 dB, respectively) ( P < .001). No patient had worsening of sensorineural hearing levels or extrusion of the reconstructed ossicles. Conclusion: Autologous ossiculoplasty performed well in this setting. Acceptable TM closure rates and improvement of air bone gaps were seen in 1-stage operations without the use of prostheses.

scholarly journals A comparative study of tragal cartilage and autologous incus for ossicular chain reconstruction in type IIB tympanoplasty at Dr. Hedgewar Hospital, Aurangabad

2019 ◽  
Vol 6 (1) ◽  
pp. 78
Author(s):  
Bharat G. Deshmukh ◽  
Deepak Bhisegaonkar ◽  
Akanksha Bakre
Keyword(s):  
Tympanic Membrane ◽  
Otitis Media ◽  
Middle Ear ◽  
Chronic Otitis Media ◽  
Ossicular Chain ◽  
Suppurative Otitis Media ◽  
High Incidence ◽  
Ossicular Chain Reconstruction ◽  
Small Bones ◽  
Set Up

<p class="abstract"><strong>Background:</strong> Tympanoplasty is the surgical operation performed for the reconstruction of the eardrum (tympanic membrane) and/or the small bones of the middle ear. Chronic otitis media is a very common condition of middle ear which not only has a high incidence in the world but also in our set up. So, in view of this, we decided to conduct a study on the surgical management of CSOM-tubotympanic type.</p><p class="abstract"><strong>Methods:</strong> We conducted this study at ENT department of Dr. Hedgewar Rugnalaya, Aurangabad to compare air bone gap closure by using tragal cartilage and autologous incus in type IIB tympanoplasty in patients with chronic suppurative otitis media, (tubotympanic). 66 patients with central perforation of tympanic membrane, necrosed incus and mobile stapes requiring type IIB tympanoplasty, were included as a part of the study.</p><p class="abstract"><strong>Results:</strong> We performed type IIB tympanoplasty with a routine post-aural incision in 66 patients. According to our observation, both incus and cartilage are good materials for ossiculoplasty, tragal cartilage being better.</p><p class="abstract"><strong>Conclusions:</strong> After conducting this study we concluded that incus and tragal cartilage both are excellent materials for ossiculoplasty.</p>

Ossicular chain reconstruction: endoscopic or microscopic?

2021 ◽  
pp. 1-7
Author(s):  
E A Guneri ◽  
A Cakir Cetin
Keyword(s):  
Word Recognition ◽  
Middle Ear ◽  
Risk Index ◽  
Ossicular Chain ◽  
Recognition Score ◽  
Reconstruction Surgery ◽  
Ossicular Chain Reconstruction ◽  
Operation Duration ◽  
Air Conduction

Abstract Objective To compare the results of endoscopic and microscopic ossicular chain reconstruction surgery. Methods Patients undergoing ossicular chain reconstruction surgery via an endoscopic (n = 31) or microscopic (n = 34) technique were analysed for age, gender, Middle Ear Risk Index, ossicular chain defect, incision type, ossicular chain reconstruction surgery material, mean air conduction threshold, air–bone gap, air–bone gap gain, word recognition score, mean operation duration and mean post-operative follow up. Results Post-operative air conduction, air–bone gap and word recognition score improved significantly in both groups (within-subject p < 0.001 for air conduction and air–bone gap, and 0.026 for word recognition score); differences between groups were not significant (between-subject p = 0.192 for air conduction, 0.102 for air–bone gap, and 0.709 for word recognition score). Other parameters were similar between groups, except for incision type. However, endoscopic ossicular chain reconstruction surgery was associated with a significantly shorter operation duration (p < 0.001). Conclusion Endoscopic ossicular chain reconstruction surgery can achieve comparable surgical and audiological outcomes to those of microscopic ossicular chain reconstruction surgery in a shorter time.

A new device for real-time peroperative monitoring of ossicular chain reconstruction during middle ear surgery

2019 ◽  
Vol 34 (4) ◽  
pp. 827-832
Author(s):  
Van Son Nguyen ◽  
Didier Rouxel ◽  
Brice Vincent ◽  
Joël Ducourneau ◽  
Cécile Parietti-Winkler
Keyword(s):  
Real Time ◽  
Middle Ear ◽  
Ossicular Chain ◽  
Middle Ear Surgery ◽  
Ear Surgery ◽  
New Device ◽  
Ossicular Chain Reconstruction

scholarly journals Study on the Prosthesis Structural Design and Vibration Characteristics Based on the Conduction Effect of Human Middle Ear

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Wu Ren ◽  
Huijuan Yan ◽  
Yi Yu ◽  
Jinghong Ren ◽  
Jinlong Chang ◽  
...  
Keyword(s):  
Frequency Response ◽  
Inner Ear ◽  
Tympanic Membrane ◽  
Middle Ear ◽  
Transmission Function ◽  
Ossicular Chain ◽  
Sound Signal ◽  
Sound Perception ◽  
Response Characteristics ◽  
Middle Ear Prosthesis

As a bridge from the sound signal in the air to the sound perception of the inner ear auditory receptor, the tympanic membrane and ossicular chain of the middle ear transform the sound signal in the outer ear through two gas-solid and solid-liquid conversions. In addition, through the lever principle formed by three auditory ossicle structure, the sound was concentrated and amplified to the inner ear. However, the sound transmission function of the middle ear will be decreased by disease, genetic, or trauma. Hence, using middle ear prosthesis to replace the damaged ossicles can restore the conduction function. The function realization of middle ear prosthesis depends on the vibration response of the prosthesis from the tympanic membrane to the stapes plate on the human auditory perception frequency, which is affected by the way the prosthesis combined with the tympanic membrane, the material, and the geometric shape. In this study, reasonable prosthetic structures had been designed for different types of ossicular chain injuries, and the frequency response characteristics were analyzed by the finite element method then. Moreover, in order to achieve better vibration frequency response, a ball structure was designed in the prosthesis to simulate its amplification function. The results showed that the middle ear prostheses constructed by different injury types can effectively transfer vibration energy. In particular, the first- and second-order resonant frequencies and response amplitudes are close to each other when ball structure models of different materials are added. Instead, the resonance frequency of the third stage formed by aluminum alloy ball materials is larger than that of the other two, which showed good response features.

Is it the Middle Ear Disease or the Reconstruction Material That Determines the Functional Outcome in Ossicular Chain Reconstruction?

2012 ◽  
Vol 33 (4) ◽  
pp. 580-585 ◽  
Author(s):  
Uygar Levent Demir ◽  
Sait Karaca ◽  
Omer Afsn Ozmen ◽  
Fikret Kasapoglu ◽  
Hamdi Hakan Coskun ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Middle Ear ◽  
Ossicular Chain ◽  
Ossicular Chain Reconstruction ◽  
Middle Ear Disease

scholarly journals Factors that have an influence on bone conduction thresholds changes after otosurgery in the patients operated on due to the perforation of the tympanic membrane with the preserved ossicular chain

2017 ◽  
Vol 71 (4) ◽  
pp. 26-33
Author(s):  
Maciej Wiatr ◽  
Agnieszka Wiatr ◽  
Sebastian Kocoń ◽  
Jacek Składzień
Keyword(s):  
Tympanic Membrane ◽  
Middle Ear ◽  
Negative Impact ◽  
Positive Impact ◽  
Round Window ◽  
Bone Conduction ◽  
Ossicular Chain ◽  
Middle Ear Surgery ◽  
Ear Surgery ◽  
Study Objective

Introduction: The aim of the middle ear surgery is to eliminate abnormalities from the mucous, ensure the due airing of the postoperative cavity and reconstruct the sound-conducting system in the middle ear. Numerous reports can be found in literature on the changes to bone conduction as a consequence of middle ear surgery. Study objective: The aim of the work is to define the factors that affect bone conduction in the patients operated on due to the perforation of the tympanic membrane with the preserved and normal mobile ossicular chain. Material and method: A prospective analysis of patients operated on due to diseases of the middle ear in 2009–2012 was carried out. The cases of patients operated on for the first time due to chronic otitis media were taken into consideration. The analysis encompassed the patients who had undergone myringoplasty. The patients were divided into several groups taking into account the abnormalities of the mucous observed during otosurgery. Results: A significant improvement of bone conduction was observed in the patients with dry perforation, without other lesions in the middle ear. The appropriate pharmacological treatment before otosurgery in patients with permanent discharge from the ear resulted in significant bone conduction improvement. The elimination of granulation lesions turned out to be a positive factor for the future improvement of the function of the inner ear. Conclusions: The lack of abnormalities on the mucous of the middle ear (e.g. granulation,) and discharge has a positive impact on improvement of bone conduction after myringoplasty. Adhesions in the tympanic cavity, especially in the niche of the round window, have a negative impact on improvement of bone conduction in patients after myringoplasty.

2D Modeling of the Human Ear Using the Equivalent Mechanical Impedance

2020 ◽  
Author(s):  
Chahbi Aziz ◽  
Assif Safaa ◽  
Faiz Adil ◽  
Hajjaji Abdelowahed.
Keyword(s):  
Tympanic Membrane ◽  
Middle Ear ◽  
Sound Pressure ◽  
Mechanical Impedance ◽  
Ossicular Chain ◽  
Body Parts ◽  
Frequency Range ◽  
Ear Canal ◽  
Finite Elements Analysis ◽  
Human Tympanic Membrane

Several mass–spring–damper models have been developed to study the response of the human body parts. In such models, the lumped elements represent the mass of different body parts, and stiffness and damping properties of various tissues. The aim of this research is to develop a 2D axisymmetric model to simulate the motion of the human tympanic membrane. In this contribution we develop our model using a Comsol Multiphysics software to construct a 2D axisymmetric objects, the acoustic structure interaction between the ear canal (field of propagation of the acoustic wave) and the structure of ear (skin, cartilage, bone, tympanic membrane) was solved using finite elements analysis (FEA). A number of studies have investigated the motion of the human tympanic membrane attached to the ossicular chain and the middle ear cavity. While, in our model the tympanic annular is assumed to be fixed and the loading of what comes behind the tympanic membrane as the ossicular chain, middle ear cavity and cochlea were replaced by the equivalent mechanical impedance of a spring mass damper system. The obtained results demonstrate that the maximum displacements of the umbo are obtained at the frequency range of [0.9 - 2.6] kHz, the sound pressure gain had the shape of peak with a maximum at [2 – 3] kHz frequency range. The umbo displacement depends on the damping coefficient d, and the sound pressure at the tympanic membrane was enhanced compared to that at the ear canal entrance.

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