Tympanoplasty: Long-Term Results

1973 ◽  
Vol 82 (4) ◽  
pp. 538-546 ◽  
Author(s):  
D. Thane R. Cody ◽  
William F. Taylor
Keyword(s):  
Tympanic Membrane ◽  
Long Term Results ◽  
Hearing Improvement ◽  
Hearing Results ◽  
Adequate Level ◽  
Gap Closure ◽  
Revision Operations ◽  
Active Disease

Long-term results after 878 tympanoplasties using five different methods of repair were analyzed. The five groups were as follows: canal skin and fascia, single fascia, double fascia, canal skin, and canal skin and homograft tympanic membrane. Ten percent of the graft failures occurred 18 months or longer after operation. The highest percentage of graft takes (88%) and satisfactory hearing improvement (socially adequate level 87%, air-bone gap closure to within 15 dB 76%) and the lowest incidence of depression in cochlear reserve (0.7%) was in the double fascia group. Overall hearing results achieved in the 878 tympanoplasties were poorer than anticipated. Differences in results in the five groups, although occasionally large, were not statistically significant. Differences in the percentage of successful graft takes in ears that had no active disease as compared with ears that had active disease and in primary operations as compared with revision operations were not statistically significant. Complications encountered were common and varied.

Effect of aerobic bacteriology on the clinical presentation and treatment results of chronic suppurative otitis media

1996 ◽  
Vol 110 (4) ◽  
pp. 315-318 ◽  
Author(s):  
Eero Vartiainen ◽  
Jukka Vartiainen
Keyword(s):  
Surgical Treatment ◽  
Otitis Media ◽  
Clinical Presentation ◽  
Chronic Suppurative Otitis Media ◽  
Long Term Results ◽  
Treatment Results ◽  
Suppurative Otitis Media ◽  
Hearing Results ◽  
Significant Difference

AbstractThe effect of aerobic bacteriology on the clinical presentation, complications of the disease and long-term results of surgical treatment was assessed in a cohort of 368 patients with chronic suppurative otitis media. Bacteriological findings showed no significant difference between child and adult patients. Staphylococcus aureus was isolated in cholesteatoma ears more frequently than Pseudomonas aeruginosa, in chronic ears without cholesteatoma the situation was reversed. Bacteriological findings had no significant effect on the incidence of complications caused by the disease. Failures after surgical treatment were most common in Pseudomonas ears. The bacteriology had no significant effect on pre-operative hearing levels nor postoperative hearing results. It was concluded that, in order to improve results of chronic ear sugery, more attention should be paid to pre-operative conservative treatment of chronically discharging ears, especially those infected by P. aeruginosa.

S232 – Hearing Gain Following Stapes Surgery Maintained Long-term?

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P153-P153
Author(s):  
Purushotam Sen ◽  
Abir K Bhattacharyya
Keyword(s):  
Observational Studies ◽  
Quality Evaluation ◽  
Data Extraction ◽  
Bone Conduction ◽  
Stapes Surgery ◽  
Long Term Results ◽  
Hearing Results ◽  
Hearing Gain ◽  
Air Conduction

Objectives To analyse whether the hearing gain following stapes surgery is maintained long-term. Methods Databases (PubMed, EMBASE and MEDLINE) were searched systematically, with no limits on the year or language of publications, for observational studies on the long-term hearing results of stapedectomy (>10 years). References identified from pertinent reviews and articles were also retrieved. 2 reviewers independently searched the databases and selected the studies using pre-specified standardized criteria. These criteria included appropriate adjustments for confounding factors in the analyses. The terms used in the search included stapes surgery, stapedectomy, stapedotomy, long-term results, hearing gain. Data extraction and study quality evaluation were performed independently and results were pooled quantitatively. Results Early studies noted that both air conduction (AC) and bone conduction (BC) deteriorated with time, resulting in a return to baseline pre-operative hearing in the long-term. More recent studies showed that in the long term, the hearing gain was maintained by 75% of patients despite the advent of presbycusis. Surgeons' experience may play a more important role than the type of stapes surgery. On average, studies have shown that the air bone gap tended to increase at a rate of 0.9 dB per year. Conclusions Though some earlier studies were equivocal, recent studies indicate that most stapes surgery patients maintain good hearing long-term, even though there is a gradual decline in the air conduction and bone conduction thresholds. Longitudinal studies are required to better understand this subject.

scholarly journals Inlay butterfly versus underlay cartilage tympanoplasty

2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Osama Hassan ◽  
Mena Esmat ◽  
Mohamed Salah ◽  
Mohamed El Shazly
Keyword(s):  
Tympanic Membrane ◽  
Patient Comfort ◽  
Middle Ear Surgery ◽  
Graft Material ◽  
Hearing Improvement ◽  
Gap Closure ◽  
Graft Take ◽  
Significant Difference ◽  
Cartilage Tympanoplasty ◽  
Group A

Abstract Background Tympanic membrane grafting is one of the most common otological procedures. Underlay technique of tympanoplasty was described by Shea in 1960. Utech in 1959 introduce the cartilage in middle ear surgery. The search for an ideal graft material and technique for tympanoplasty was adopted by numerous contributions from surgeons all over the world. Professor Roland Eavey in 1998 introduced a transcanal inlay technique which offers advantages of surgical ease and speed as well as patient comfort. Results This study included 46 patients; 23 patients had inlay butterfly myringoplasty (group A), and 23 patients had underlay cartilage tympanoplasty. In group A, 65 % of the patients had a completely healed tympanic membrane postoperatively. Mean AB gap closure was 3.94 db. In underlay group B, 82.6% of the patients had a completely healed tympanic membrane postoperatively. Mean AB gap closure was 4.7 db. These outcomes show no statistically significant difference between both groups in terms of graft take and hearing improvement (p > 0.1). Conclusions Inlay butterfly myringoplasty is an easy, reliable, and time saving procedure that should be possible as a choice to underlay procedure. Results are comparable with underlay technique in terms of graft take rate and hearing improvement. Procedure is better regarding diminishing operative time, postoperative pain, and duration before resuming usual activities.

Does cartilage thickness affect hearing results in real life? Long‐term results of cartilage and fascia graft in type 1 tympanoplasty

2019 ◽  
Vol 44 (5) ◽  
pp. 842-846 ◽  
Author(s):  
Mahmut Tayyar Kalcioglu ◽  
Ozan Tuysuz ◽  
Muhammed Zeki Yalcin ◽  
Erkan Karatas
Keyword(s):  
Real Life ◽  
Cartilage Thickness ◽  
Long Term Results ◽  
Hearing Results ◽  
Type 1 Tympanoplasty ◽  
Fascia Graft

Acquired Atresia of the External Auditory Canal: Recurrence and Long-Term Results

2009 ◽  
Vol 118 (5) ◽  
pp. 345-349 ◽  
Author(s):  
Giuseppe Magliulo
Keyword(s):  
External Auditory Canal ◽  
Clinical Symptoms ◽  
Pure Tone Audiometry ◽  
Long Term Results ◽  
Hearing Results ◽  
Weighted Magnetic Resonance Imaging ◽  
Echo Planar ◽  
Acquired Atresia

Objectives: I describe the clinical symptoms and signs of acquired atresia of the external auditory canal (EAC) and the technique used to manage it. Methods: Forty-one consecutive patients affected by acquired atresia of the EAC were assessed by otoscopy, pure tone audiometry, computed tomography, and traditional and echo-planar diffusion-weighted magnetic resonance imaging. The anatomic and functional hearing results were evaluated. Results: At surgery for acquired atresia of the EAC, an EAC cholesteatoma was found in 3 of the 41 patients. Twenty-three of the 41 patients were followed for at least 5 years. Recurrence was seen in 9 of the 25 ears (36%) over the entire period of observation. Twenty-one, 23, and 22 of the patients had a normal or nearly normal contour and size of the ear canal at 6 months, 1 year, and 5 years, respectively. The results were similar for the air-bone gap. Conclusions: The main complication following surgery was recurrence. There was recurrence at 6 months in 4 patients (16%). Recurrence was seen in 12% of the cases at the 5-year follow-up. Similar findings were clear on evaluation of the hearing results. This result demonstrates that the surgical procedure, even when performed correctly, did not afford a stable, long-lasting outcome in a cohort of patients.

Long-term results with hydroxylapatite middle ear implants

2000 ◽  
Vol 122 (5) ◽  
pp. 635-642
Author(s):  
Robert A. Goldenberg ◽  
Mark Driver
Keyword(s):  
Long Term Results ◽  
Hearing Results ◽  
Factors Associated ◽  
Hearing Result ◽  
Middle Ear Implants ◽  
Long Term Follow Up ◽  
The Mean ◽  
Canal Wall Up

PURPOSE: This study evaluated long-term results in patients who had ossicular reconstruction with a Goldenberg hydroxylapatite implant. METHODS: A total of 233 patients underwent implantation; of these, 77 had 5-year or longer follow-up and are the subjects of this study of long-term hearing results. All 233 patients were included for analysis of extrusion rate and postoperative otorrhea. RESULTS: The hearing success rate at long-term follow-up was 56.8%; the mean air-bone gap was 21.1 dB. Prosthesis extrusion occurred in 5.29% of the 233 patients, and visible slippage occurred in 7.7%. Overall, 50.6% of patients met the criteria for successful hearing, which included no extrusion and a dry ear. Better hearing before surgery and presence of the malleus long process were factors associated with a successful hearing result, as was tympanoplasty alone and canal wall up tympanomastoidectomy. CONCLUSION: Hydroxylapatite hybrid prostheses provide stable hearing results over time with low extrusion and a dry ear overall.

scholarly journals A comparative study of superiorly based circumferential tympanomeatal flap tympanoplasty with anteriorly anchoring flap tympanoplasty in large, subtotal, and anterior tympanic membrane central perforations in chronic suppurative otitis media of mucosal type

2018 ◽  
Vol 4 (2) ◽  
pp. 432
Author(s):  
Amitkumar Rathi ◽  
Vinod Gite ◽  
Sameer Bhargava ◽  
Neeraj Shetty
Keyword(s):  
Comparative Study ◽  
Tympanic Membrane ◽  
Otitis Media ◽  
Statistical Difference ◽  
Chronic Suppurative Otitis Media ◽  
Age Group ◽  
Hearing Improvement ◽  
Suppurative Otitis Media ◽  
Gap Closure ◽  
The Mean

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">The main objective of the study was to assess and compare the graft uptake, hearing improvement, complications in large, subtotal, and anterior moderate perforations by each technique viz; superiorly based circumferential tympanomeatal flap tympanoplasty (STT)/full cuff and anterior anchoring flap tympanoplasty (AAT)/anterior tucking. </span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">In our study of 30 cases age group in the range of 10 years to 60 years. The mean air bone gap for the 8 patients with anterior moderate perforation was 31.75 db, for 17 patients with large central perforations was 38.75 db and for 5 patients with subtotal perforations was 41.4 db.  </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">Mean air bone gap closure after 3 months of surgery in the STT group was 21.4 db while that after 6months of the surgery for the same group was 22.06 db. Mean air bone gap closure after 3 months of surgery in the AAT group was 18.2 db while that after 6months of the surgery for the same group was 18.73 db. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Comparing the air bone gap closure in patients who underwent surgery by AAT and STT technique we found that there is no statistical difference. Both techniques (viz: superiorly based circumferential tympanomeatal flap tympanoplasty and anteriorly anchoring flap tympanoplasty) can be used for the repair of large, subtotal, and anterior tympanic membrane central perforations in chronic suppurative otitis media of mucosal type.</span></p>

Long-term Results with Hydroxylapatite Middle Ear Implants

2000 ◽  
Vol 122 (5) ◽  
pp. 635-642 ◽  
Author(s):  
Robert A. Goldenberg ◽  
Mark Driver
Keyword(s):  
Long Term Results ◽  
Hearing Results ◽  
Factors Associated ◽  
Hearing Result ◽  
Middle Ear Implants ◽  
Long Term Follow Up ◽  
The Mean ◽  
Canal Wall Up

PURPOSE: This study evaluated long-term results in patients who had ossicular reconstruction with a Goldenberg hydroxylapatite implant. METHODS: A total of 233 patients underwent implantation; of these, 77 had 5-year or longer follow-up and are the subjects of this study of long-term hearing results. All 233 patients were included for analysis of extrusion rate and postoperative otorrhea. RESULTS: The hearing success rate at long-term follow-up was 56.8%; the mean air-bone gap was 21.1 dB. Prosthesis extrusion occurred in 5.29% of the 233 patients, and visible slippage occurred in 7.7%. Overall, 50.6% of patients met the criteria for successful hearing, which included no extrusion and a dry ear. Better hearing before surgery and presence of the malleus long process were factors associated with a successful hearing result, as was tympanoplasty alone and canal wall up tympa-nomastoidectomy. CONCLUSION: Hydroxylapatite hybrid prostheses provide stable hearing results over time with low extrusion and a dry ear overall.

Persistent and recurrent conductive deafness following stapedotomy

2010 ◽  
Vol 125 (5) ◽  
pp. 460-466 ◽  
Author(s):  
G Thiel ◽  
R Mills
Keyword(s):  
Hearing Loss ◽  
Success Rate ◽  
Revision Surgery ◽  
Conductive Hearing Loss ◽  
Successful Outcome ◽  
Hearing Results ◽  
Gap Closure ◽  
Primary Procedure ◽  
Conductive Hearing

AbstractBackground:Stapedotomy produces the best hearing results of any otological operation. However, in a small number of cases the air–bone gap is not successfully closed, or conductive hearing loss recurs.Objective:To investigate the proportion of cases in the senior author's series which required revision surgery and to determine the medium to long term success rate of surgery, taking into account the results of revision surgery.Methods:Review of a series of 233 primary stapedotomy operations and 100 revision procedures carried out by one surgeon over a 20-year period.Results:Closure of the air–bone gap to within 10 dB was achieved in 80 per cent of cases following the primary procedure. Fifteen per cent of patients developed a recurrence of conductive hearing loss. When the results of revision surgery were taken into account, the proportion of ears with a mean air–bone gap of less than 10 dB was 86 per cent. However, of the patients undergoing revision surgery, air–bone gap closure to within 10 dB was only achieved in 52 per cent of cases.Conclusion:The best chance of obtaining a successful outcome in stapedotomy is to achieve this for the first procedure. However, revision surgery does increase the medium to long term success rate.

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