Contraindications to the Small Hole Stapedectomy

1981 ◽  
Vol 90 (6) ◽  
pp. 636-639 ◽  
Author(s):  
Brown Farrior

A small hole stapedectomy with an unprotected piston is contraindicated in an ear subjected to excessive pressure changes whether these are excessive fluid pressure changes which occur in the inner ear or excessive air pressure changes in the middle ear. Excessive fluid pressure changes in the inner ear may be the result of an overly patent aqueduct of the cochlea or a permeable internal auditory canal. These excessive fluid pressure changes may produce fistulas or a dilated blister around the piston called a tented piston. Excessive air pressure changes in the middle ear will produce excessive excursions of the tympanic membrane which may result in vertigo or a dislocated piston.

2018 ◽  
Vol 69 (11) ◽  
pp. 3199-3202
Author(s):  
Ruxandra Oana Iana ◽  
Dragos Cristian Stefanescu ◽  
Viorel Zainea ◽  
Razvan Hainarosie

Otalgia during airplane flights is a common complaint among patients. This occurs due to the changes in air pressure during take-off and landing that affect middle ear and inner ear. The eustachian tube is responsible with equalizing pressure but in many cases, it happens insufficiently leading to mild to severe pain, hearing loss, tympanic membrane rupture and even inner ear lesions. The aim of this paper is to asses the efficacy of two decongestants, oral pseudoephedrine versus topical xylometazoline in preventing otic barotrauma.


1979 ◽  
Vol 88 (3) ◽  
pp. 368-376 ◽  
Author(s):  
A. Axelsson ◽  
J. Miller ◽  
M. Silverman

Acute middle ear (ME) and inner ear changes following brief unilateral phasic ME pressure changes (up to ± 6000/mm H2O) were studied in the guinea pig. Middle ear findings included perforation of the tympanic membrane, serous and serosanguinous exudate and hemorrhage of tympanic membrane and periosteal vessels. Changes were related to magnitude of applied pressure. Perforation and hemorrhage were more commonly seen with negative rather than positive pressure. Air bubbles behind the round window were seen with positive pressures. Occasional distortion, but never perforation of the round window, was noted. Hemorrhage of the scala tympani was observed with both positive and negative pressures; scala vestibuli hemorrhage was found with negative ME pressure. In some instances pressure direction and magnitude related changes were seen in the contralateral ear.


Author(s):  
Rogan Corbridge ◽  
Nicholas Steventon

Drugs used in the ear 348 Drugs used in the nose 349 Drugs used in the treatment of acid reflux 350 This group of drugs is widely used for the treatment of otitis externa. Otitis externa 2 drops tds for 10 days Presence of grommet or tympanic membrane perforation due to aminoglycoside ototoxicity in the inner ear. Risk thought to be low in the presence of active infection where the middle-ear mucosa is swollen and the antibiotic is unlikely to reach the inner ear via the round window...


2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Wu Ren ◽  
Huijuan Yan ◽  
Yi Yu ◽  
Jinghong Ren ◽  
Jinlong Chang ◽  
...  

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.


1982 ◽  
Vol 91 (2) ◽  
pp. 209-215 ◽  
Author(s):  
Björn Carlborg ◽  
Barbara Densert ◽  
Ove Densert

The perilymphatic (P P) and cerebrospinal fluid (P CSF) pressures were investigated in relation to pressure variations in the ear canal, middle ear and intracranial compartment before and after occlusion of the cochlear aqueduct (CA). Experiments using intracranial infusion showed that the CA was responsible for a perfect hydrodynamic balance between the CSF and the perilymph. There are indications of additional pressure release factors but their capacities were not sufficient to prevent the appearance of a longstanding and substantial pressure gradient following occlusion of the CA. A gradual P P build-up, from zero to its original level after the CA was opened and occluded, indicated perilymph production within the labyrinth. Investigation of pressure transfer from the ear canal and middle ear to the perilymph showed that the CA was the major pressure release route from the cochlea. Occlusion of the CA reduced the compliance of the inner ear and severely reduced the pressure release capacity. In such a situation the inner ear is almost incapable of equilibrating ambient pressure changes.


Author(s):  
V.I. Fedoseev ◽  
◽  
N.A. Mileshina ◽  
E.V. Kurbatova ◽  
S.S. Osipenkov ◽  
...  

The use of navigation system during the coclear implantation (CI) in patients with congenital and acquired malformation of the inner ear is necessary because of surgical difficulties. The purpose of our work is to evaluate the effectiveness of the navigation system in congenital and acquired anomalies of the middle and inner ear. Materials and methods The authors followed-up 27 children with bilateral congenital malformation of the inner ear and 58 patients with acquired cochlea obliteration (12 adults and 46 children with the acquired obliteration were included in the group). 55 patients have the acquired obliteration of the inner ear, 3 patients – the total obliteration of the inner ear. Audiological, CT and MRI were performed. All our patients the CI was performed. Conclusion.The use of navigation system during CI in patients with a combination of malformation of the inner and middle ear to increase the efficiency of surgical treatment. The duration of anesthesia and surgery in children with congenital malformation increases when navigation is applied All patients after meningitis or with the fracture of the temporal bone should be performed MRI The patients with an extension of the internal auditory canal, anomaly of Mondini dysplasia of the cochlear, the partial obliteration of the cochlea have good rehabilitation results after CI. The patients with the total obliteration of the inner ear have unsatisfactory results of rehabilitation.


1980 ◽  
Vol 89 (3_suppl) ◽  
pp. 65-66 ◽  
Author(s):  
Jörgen Holmquist ◽  
Ulf Renvall ◽  
Pål Svendsen

The medial displacement of the tympanic membrane or the retracted tympanic membrane is a common clinical finding. Also, retractions are looked upon as the precursor of middle ear cholesteatoma. In current otologic literature there seems to be some dispute whether the retractions of the tympanic membrane are caused by negative intratympanic air pressure or by shrinkage of middle ear adhesions pulling the tympanic membrane or part of it medially. In this study only ears with posterior/superior retractions of the tympanic membrane were investigated. Tympanometry revealed that only 33% of the ears did have middle ear pressure within ± 100 mm H2O. After insertion of a polyethylene tube through the tympanic membrane, the eustachian tube function was tested using the air pressure equalization technique. None of the ears could change the negative air pressure upon swallowing. Planometric measurements on the x-ray of the mastoid air cell system of the present material deviate from those of a normal material, indicating a significantly smaller air volume in the present material. It may be concluded that dysfunction of the eustachian tube and a small air volume of the mastoid are characteristic features of an ear with posterior/superior retraction of the tympanic membrane.


2011 ◽  
Vol 125 (5) ◽  
pp. 467-473 ◽  
Author(s):  
T Just ◽  
T Zehlicke ◽  
O Specht ◽  
W Sass ◽  
C Punke ◽  
...  

AbstractObjective:We report an ex vivo and in vivo experimental study of a device designed to measure tympanic membrane movement under normal and pathological conditions, assessed using optical coherence tomography.Materials and methods:We designed two types of flexible, round film patch with integrated strain gauge, to be attached to the tympanic membrane in order to measure tympanic membrane movement. Tympanic membrane attachment was assessed using optical coherence tomography. The devices were tested experimentally using an ex vivo model with varying middle-ear pressure.Results:Optical coherence tomography reliably assessed attachment of the film patch to the tympanic membrane, before and after middle-ear pressure changes. Strain gauge voltage changes were directly proportional to middle-ear pressure recordings, for low pressure changes. Tympanic membrane perforations smaller than 2 mm could be sealed off with the film patch.Conclusion:Attachment of the film patch with integrated strain gauge to the tympanic membrane was not ideal. Nevertheless, the strain gauge was able to precisely detect small pressure changes within the middle ear, in this experimental model.


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