Double-Layer Tympanic Membrane Graft in Type I Tympanoplasty

2019 ◽  
Vol 128 (9) ◽  
pp. 795-801 ◽  
Author(s):  
Es-hak Bedri ◽  
Bilen Korra ◽  
Miriam Redleaf ◽  
Alemayehu Worku
Keyword(s):  
Tympanic Membrane ◽  
Double Layer ◽  
Medical Records ◽  
Single Layer ◽  
Layer Versus ◽  
Type I ◽  
Hearing Improvement ◽  
Significant Difference ◽  
The Difference ◽  
Hearing Outcomes

Background: Some discussion remains among otologists regarding the best grafts for tympanic membrane closure. It is unclear whether double-layer grafts are superior to single-layer and whether single-layer cartilage is superior to fascia or perichondrium alone. The objective of the current study was to examine the relative efficacy of single-layer versus double-layer tympanic membrane grafting techniques. Materials and Methods: A retrospective review of the medical records was used to address the objective of the study. Patients operated on in an over/under technique by the same surgeon underwent single-layer perichondrium or single-layer perichondrium with a cartilage island, or a double-layer of perichondrium combined with periochondrium with a cartilage island. The outcomes assessed were tympanic membrane reperforation and hearing improvement. Results: A total of 135/177 (76%) perichondrium grafts had no reperforation, and 43/55 (78%) perichondrium with cartilage island grafts had no reperforation; 352/390 (90%) of the double-layer closures had no reperforation. There was no statistically significant difference in reperforation rates between the 2 single-layer techniques ( P = .926). The difference in reperforation rates after the double-layer closure versus the perichondrium single-layer closure was statistically significant ( P = .001), as was the difference in reperforation rates after the double-layer closure versus the cartilage island single-layer closure ( P = .02). All 3 groups showed statistically significant hearing improvement postoperatively ( P < .0001). Preoperative hearing levels ( P = .179), postoperative hearing ( P = .857), and decibels of hearing improvement ( P = .356) were the same for all 3 groups. Conclusion: Double-layer closure gives lower tympanic membrane reperforation rates than does single-layer closure, as well as similar hearing outcomes.

scholarly journals Study of clinical outcome of patients undergoing intestinal anastomoses with single layer extramucosal technique and double layer anastomoses

2021 ◽  
Author(s):  
Arvind Rai ◽  
Sukantth R. J.
Keyword(s):  
Anastomotic Leak ◽  
Double Layer ◽  
Statistical Tests ◽  
Intestinal Anastomosis ◽  
Single Layer ◽  
Layer Versus ◽  
Intestinal Anastomoses ◽  
Significant Difference ◽  
Group A ◽  
Group B

 Background: Intestinal anastomosis is one of the common surgeries for cases like bowel obstruction, incarcerated hernias, benign and malignant tumours of small and large bowel. The ideal intestinal anastomosis does not leak and allow normal function of the gastrointestinal tract. This study compared single layer versus double layer  intestinal anastomosis in terms of duration, postoperative complications like anastomotic leak.Methods: A total of 100 patients admitted in Hamidia hospital, based on history and clinical examinations and radiological examinations, placed in two groups, group A (single layer anastomosis) and group B (double layer anastomosis) and were operated by a qualified surgical specialist. Data analysis of anastomotic time, anastomotic leak was done and statistical tests of significance were applied. A p value less than 0.05 is considered as significant.Results: In group A (single layer) the time required to perform in 30 (60%) patients is between 16-20 minutes. In double layer, maximum were done in between 26 to 30 minutes, 32 (64%). In our study of 100 patients, there were 6 anastomotic leaks, of which four of them were in group A (single layer) and 2 of them in group B (double layer).Conclusions: In our study, the duration required to perform a single layer intestinal anastomosis is significantly lesser when compared to double layer. There is no significant difference in anastomotic leak between two groups. Less time with no difference in complications, a move towards single layer anastomosis should be preferred.

scholarly journals Single layer versus double layer intestinal anastomoses: a comparative study

2020 ◽  
Vol 7 (9) ◽  
pp. 2991
Author(s):  
Ajit Kumar ◽  
Vinod Kumar
Keyword(s):  
Comparative Study ◽  
Anastomotic Leak ◽  
Double Layer ◽  
Intestinal Anastomosis ◽  
Single Layer ◽  
Anastomosis Group ◽  
Layer Versus ◽  
Intestinal Anastomoses ◽  
Significant Difference ◽  
End To End

Background: There are still conflicting views regarding suitability of single layer and double layer anastomotic technique. This prospective single blinded randomized comparative study conducted at Rajendra Institute of Medical Sciences to assess various aspects viz. safety, efficacy, duration of hospital stays and chances of perforation in single- and double-layer anastomotic surgery.Methods: 26 patients each in single layer and double layer anastomosis group were included in the study.  Single layer intestinal anastomosis was carried using extramucosal technique with 2-0 vicryl suture (round body). Double layer anastomosis was carried out using interrupted 3-0 silk lembert sutures for the outer layer and a continuous 2-0 vicryl for the inner layer. End to end colocolic, end to end ileocolic, end to side ileocolic, end to end ileoileal, side to side ileoileal, end to end jejunoileal and end to end jejunojejunal anastomosis were performed. Each group was compared for anastomotic leak, time required to construct the anastomosis, cost incurred, and length of hospital stay.Results: Findings of the study indicated that single layer is economical in comparison to double layer anastomosis and took significant less time to operate. There was no significant difference in hospital stay of the patients in two groups. There was no anastomotic leak in group-S (single layer) while one (3.8%) patient in group-D (double layer) suffered from anastomotic leak.Conclusions: It was concluded that single layer anastomosis method is beneficial and safe as it required less operative time, suturing material and no leak took place after surgery.

scholarly journals A COMPARATIVE STUDY BETWEEN SINGLE LAYER VERSUS DOUBLE LAYER INTESTINAL ANASTOMOSIS

2021 ◽  
pp. 64-66
Author(s):  
Sudhansu Sarkar ◽  
Sourav Das
Keyword(s):  
Comparative Study ◽  
Double Layer ◽  
Intestinal Anastomosis ◽  
Single Layer ◽  
Layer Versus ◽  
Medical College ◽  
Number Of Patients ◽  
Significant Difference ◽  
Group A ◽  
Group B

A comparative study between Single Layer versus Double Layer Intestinal Anastomosis,was undertaken at Department of Surgery,Bankura Sammilani Medical College & Hospital,Bankura from April 2019 – September 2020,which included 74 patients, comprising 2 groups: Group A-Single layer and Group B- Double layer with equal number of patients randomly allotted in each group. More number of patients had anastomotic leak in Group B than Group A, though not statistically significant. Difference of Mean Duration of Anastomosis with both groups is statistically significant.Mean Duration of Hospital Stay with both groups is statistically insignificant. Although more number of patients had anastomotic leaks in Group B than Group A,it was statistically insignificant.

scholarly journals Impact of type of graft material on outcome of tympanoplasty: a comparison between temporalis fascia and cartilage with perichondrium

2018 ◽  
Vol 4 (5) ◽  
pp. 1301
Author(s):  
Kanchan Tadke ◽  
Randhir Ghorpade ◽  
Vaibhav Lahane ◽  
P. S. Mundada
Keyword(s):  
Tympanic Membrane ◽  
Controlled Trial ◽  
Tertiary Care ◽  
Type I ◽  
Graft Material ◽  
Hearing Improvement ◽  
Temporalis Fascia ◽  
Graft Take ◽  
Significant Difference ◽  
And Cartilage

<p class="abstract"><strong>Background:</strong> Various graft materials have been used to repair tympanic membrane perforations. Temporalis fascia and cartilage with or without perichondrium are the most commonly used materials. The objective of the study was to compare the anatomical and functional success in type I tympanoplasty by using cartilage- perichondrium graft with that of temporalis fascia in a homogenous group of population.</p><p class="abstract"><strong>Methods:</strong> 64 patients with chronic otitis media - mucosal type were included in the study. This prospective, randomized controlled trial was conducted at a tertiary care centre between December 2012 to October 2014. Patients were grouped randomly between temporalis fascia (34/64) and cartilage group (30/64). In the fascia group, the graft was placed by underlay technique. In the cartilage group, tragal cartilage was thinned by cartilage thinner keeping the perichondrium attached on one side. The graft was placed by underlay or over-underlay technique. Postoperative results i.e. graft take up (anatomical success) and hearing improvement (functional success) were evaluated at 6 months.  </p><p class="abstract"><strong>Results:</strong> Graft take up rate was 94.11% for fascia group and 96.66% for cartilage group. The mean pure tone air bone gaps pre and postoperatively in the fascia group were 26.4±6.55 dB and 11.47±6.5 dB respectively, whereas for cartilage-perichondrium group, the values were 28.3±5.86 dB and 13.2±6.48 dB respectively. There was no statistically significant difference in the graft take up rate and postoperative hearing improvement between the two groups (p≥0.05).</p><p class="abstract"><strong>Conclusions:</strong> Cartilage with perichondrium can be considered as an alternative to more traditional grafting material for tympanic membrane reconstruction.</p>

Single layer versus double layer suture for anastomosis of the gastrointestinal tract

2009 ◽  
Author(s):  
Alvaro Sanabria ◽  
Gabriel Gomez ◽  
Eduardo Valdivieso ◽  
C Bermudez
Keyword(s):  
Gastrointestinal Tract ◽  
Double Layer ◽  
Single Layer ◽  
Layer Versus

Single layer versus double layer suture for anastomosis of the gastrointestinal tract

2005 ◽  
Author(s):  
Alvaro Sanabria ◽  
Gabriel Gomez ◽  
Eduardo Valdivieso ◽  
C Bermudez
Keyword(s):  
Gastrointestinal Tract ◽  
Double Layer ◽  
Single Layer ◽  
Layer Versus

scholarly journals Ileo-colic intra-corporeal anastomosis during robotic right colectomy: a systematic literature review and meta-analysis of different techniques

2021 ◽  
Author(s):  
Simone Guadagni ◽  
Matteo Palmeri ◽  
Matteo Bianchini ◽  
Desirée Gianardi ◽  
Niccolò Furbetta ◽  
...  
Keyword(s):  
Double Layer ◽  
Meta Analysis ◽  
Single Layer ◽  
Right Colectomy ◽  
Layer Versus ◽  
Bleeding Rate ◽  
Common Technique ◽  
Technical Details ◽  
Robotic Right Colectomy ◽  
Mechanical Anastomosis

Abstract Purpose Robotic assistance could increase the rate of ileo-colic intra-corporeal anastomosis (ICA) during robotic right colectomy (RRC). However, although robotic ICA can be accomplished with several different technical variants, it is not clear whether some of these technical details should be preferred. An evaluation of the possible advantage of one respect to another would be useful. Methods We conducted a systematic review of literature on technical details of robotic ileo-colic ICA, from which we performed a meta-analysis of clinical outcomes. The extracted data allowed a comparative analysis regarding the outcome of overall complication (OC), bleeding rate (BR) and leakage rate (LR), between (1) mechanical anastomosis with robotic stapler, versus laparoscopic stapler, versus totally hand-sewn anastomosis and (2) closure of enterocolotomy with manual double layer, versus single layer, versus stapled. Results A total of 30 studies including 2066 patients were selected. Globally, the side-to-side, isoperistaltic anastomosis, realized with laparoscopic staplers, and double-layer closure for enterocolotomy, is the most common technique used. According to the meta-analysis, the use of robotic stapler was significantly associated with a reduction of the BR with respect to mechanical anastomosis with laparoscopic stapler or totally hand-sewn anastomosis. None of the other technical aspects significantly influenced the outcomes. Conclusions ICA fashioning during RRC can be accomplished with several technical variants without evidence of a clear superiority of anyone of these techniques. Although the use of robotic staplers could be associated with some benefits, further studies are necessary to draw conclusions.

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.

Characterization and Design of Honeycomb Absorbing Materials

2019 ◽  
Vol 294 ◽  
pp. 51-56
Author(s):  
Hui Min Sun ◽  
Le Chen ◽  
Zhao Zhan Gu
Keyword(s):  
Double Layer ◽  
Low Frequency ◽  
Single Layer ◽  
Electromagnetic Parameters ◽  
Honeycomb Sandwich ◽  
Absorbing Materials ◽  
Absorbing Material ◽  
The Difference ◽  
Free Space Method ◽  
Honeycomb Sandwich Structure

Honeycomb absorbing materials are anisotropic structural materials. Depending on the size of honeycomb lattices, the absorbent content of the impregnated layer is different, the thickness of the impregnated layer is different, and the absorbing function of the impregnated honeycomb absorbing materials is also different. For the characterization of electromagnetic parameters of honeycomb absorbing materials, this paper adopts free space method for testing, uses CST software for modeling, and inverts the electromagnetic parameters of honeycomb absorbing structures. The absorbing performance of single-layer and double-layer honeycomb sandwich structures was simulated by RAM Optimizer software. The research shows that the height of the single-layer honeycomb absorbing material is 22mm. When the absorber content is 65%, 75% and 85% respectively, the harmonic peak moves slightly to the low frequency electromagnetic wave with the increase of the absorber content, but the absorbing strength decreases with the increase of the absorber content. For the double-layer honeycomb sandwich structure, the difference of absorber content in the upper and lower honeycomb absorbing materials is smaller, and the absorbing performance is stronger. When the thickness of the wave-transparent panel is thinner, the harmonic peak of the absorbing curve moves slightly to the high frequency.

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