Clinical Assessment of Ossicular Mobility by a Ceramic Vibrator Designed for Implantable Hearing AIDS

1986 ◽  
Vol 95 (4) ◽  
pp. 323-326 ◽  
Author(s):  
Kiyofumi Gyo ◽  
Naoaki Yanagihara
Keyword(s):  
Hearing Aids ◽  
Piezoelectric Ceramic ◽  
Bone Conduction ◽  
Hearing Threshold ◽  
Middle Ear Surgery ◽  
Ear Surgery ◽  
Hydroxyapatite Ceramic ◽  
Bone Conduction Threshold ◽  
Implantable Hearing Aids ◽  
Vibration Threshold

Ossicular mobility was assessed by direct coupling of a piezoelectric ceramic vibrator to the ossicles during middle ear surgery. The sites excited were 1) body of the incus, 2) head of the stapes, and 3) footplate of the stapes through a hydroxyapatite ceramic strut. The threshold of the vibratory hearing was determined by the patient's response as a minimum audition, and the vibration threshold was obtained by subtracting the preoperative bone conduction threshold from the vibratory hearing threshold. The results were analyzed by the state of hearing after the operation, which revealed that a patient with a good vibration threshold during the operation had a tendency to get good postoperative hearing. This may mean that postoperative hearing can be predicted to some extent during the operation by the measurement of ossicular mobility.

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.

scholarly journals Hearing and hearing rehabilitation after obliteration of troublesome mastoid cavities

2020 ◽  
Vol 277 (12) ◽  
pp. 3307-3313
Author(s):  
Simon Geerse ◽  
Tim J. M. Bost ◽  
Samira Allagul ◽  
Maarten J. F. de Wolf ◽  
Fenna A. Ebbens ◽  
...  
Keyword(s):  
Hearing Aids ◽  
Revision Surgery ◽  
Residual Disease ◽  
Bone Conduction ◽  
Hearing Threshold ◽  
Patient Characteristics ◽  
Ossicular Chain ◽  
Mastoid Cavity ◽  
Hearing Thresholds ◽  
Ossicular Chain Reconstruction

Abstract Purpose The purpose of this study is the evaluation of post-operative hearing threshold after revision surgery and obliteration of troublesome canal wall down mastoidectomy cavities (CWDMCs). The ability to use and tolerate conventional hearing aids (CHAs) was also evaluated. Methods A retrospective chart analysis of 249 patients with chronically draining CWDMCs who underwent revision surgery including obliteration of the mastoid cavity between 2007 and 2017 at the AMC location of the Amsterdam University Medical Centers (Amsterdam UMC) was performed. Patient characteristics, pre- and post-operative Merchant grade, surgical outcomes, pre- and post-operative hearing thresholds, and the ability/necessity to use a CHA or the ability/necessity to use a Bone Conduction Device (BCD) were recorded. Results Dry ears were found in 95% of the total cohort. Residual disease was detected in 1.6% during MRI follow-up with no residual cholesteatoma in the obliterated area. In 3.2% of the patients, recurrent disease was found. A significant improvement in mean air conduction level, mean bone conduction level, and mean air-bone gap (ABG) was found post-operatively (p < 0.05). For all types of ossicular chain reconstruction, a significant improvement in mean Pure Tone Average was observed (p < 0.05). The percentage of patients with an indication for CHA was similar pre- and post-operatively (67% both pre- and post-operatively). The ability to use a CHA improved from 3% pre-operatively to 57% post-operatively (p < 0.001). Conclusion This study shows that revision surgery and obliteration of CWDMCs enable successful CHA rehabilitation post-operatively. Upon this type of surgery, hearing thresholds improve significantly, but the need for rehabilitation with a CHA remains necessary in most cases.

The Bone-Anchored Hearing Aid (BAHA) in Children with Auricular Malformations

1997 ◽  
Vol 76 (4) ◽  
pp. 238-247 ◽  
Author(s):  
Gösta Granström ◽  
Anders Tjellström
Keyword(s):  
Middle Ear ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Adult Population ◽  
Bone Conduction ◽  
Middle Ear Surgery ◽  
Ear Reconstruction ◽  
Skin Reactions ◽  
Bone Anchored Hearing Aid ◽  
Middle Ear Reconstruction

A retrospective study was undertaken to evaluate the outcome of the use of the bone-anchored hearing aid (BAHA) in children. All patients included in the study had bilateral auricular malformations. Previous alternatives had been conventional hearing aids or surgical middle ear reconstruction. Thirty-seven patients under 16 years of age were studied. The most common syndrome in the group was Treacher Collins. Sixteen of the patients had earlier middle ear reconstruction, the results of which did not produce social hearing. Of 40 inserted fixtures to anchor the BAHA, three were lost during the follow-up period because of failed osseointegration. Skin reactions were graded according to a clinical scoring system and were determined to be comparable in number and severity to those of an adult population. All patients in the study considered the BAHA to be superior to earlier bone-conduction devices. It is concluded that the BAHA is an excellent alternative to bone-conduction devices in children with auricular malformations. Middle ear surgery can be postponed until adulthood or abandoned, especially in syndromic patients in whom it is known to be difficult and unpredictable.

Early complications of surgery for chronic otitis media

1999 ◽  
Vol 113 (9) ◽  
pp. 803-810 ◽  
Author(s):  
P. J. D. Dawes
Keyword(s):  
Otitis Media ◽  
Bone Conduction ◽  
Chronic Otitis Media ◽  
Chorda Tympani ◽  
Threshold Elevation ◽  
Early Complications ◽  
Ear Surgery ◽  
Bone Conduction Threshold ◽  
Operative Complications ◽  
Complications Of Surgery

AbstractThis audit report details early post-operative complications following surgery for chronic otitis media. One hundred and forty-five cases were assessed. There were no facial nerve palsies, a bone conduction threshold elevation occurred in 4.6 per cent of cases. A wound infection occurred in six per cent of cases as did BIPP allergy. Twenty-six per cent of patients reported symptoms consistent with chorda tympani trauma. Short-lived symptoms of jaw discomfort were reported by 46 per cent of patients and imbalance or vertigo by 10 per cent of patients. The findings are compared with other published reports of complications following ear surgery.

scholarly journals Robot-Assisted Middle Ear Endoscopic Surgery: Preliminary Results on 37 Patients

2021 ◽  
Vol 8 ◽  
Author(s):  
Marine Veleur ◽  
Ghizlene Lahlou ◽  
Renato Torres ◽  
Hannah Daoudi ◽  
Isabelle Mosnier ◽  
...  
Keyword(s):  
Middle Ear ◽  
Bone Conduction ◽  
Case Series ◽  
Petrous Apex ◽  
Middle Ear Surgery ◽  
Type I ◽  
Type Ii ◽  
Robot Assisted ◽  
Ear Surgery ◽  
Type Iii

Background: Endoscopy during middle ear surgery is advantageous for better exploration of middle ear structures. However, using an endoscope has some weaknesses as surgical gestures are performed with one hand. This may trouble surgeons accustomed to using two-handed surgery, and may affect accuracy. A robot-based holder may combine the benefits from endoscopic exposure with a two-handed technique. The purpose of this study was to assess the safety and value of an endoscope held by a teleoperated system.Patients and Methods: A case series of 37 consecutive patients operated using endoscopic exposure with robot-based assistance was analyzed retrospectively. The RobOtol® system (Collin, France) was teleoperated as an endoscope holder in combination with a microscope. The following data were collected: patient characteristics, etiology, procedure type, complications, mean air and bone conduction thresholds, and speech performance at 3 months postoperatively. Patients had type I (myringoplasty), II (partial ossiculoplasty), and III (total ossiculoplasty) tympanoplasties in 15, 14, and 4 cases, respectively. Three patients had partial petrosectomies for cholesteatomas extending to the petrous apex. Finally, one case underwent resection of a tympanic paraganglioma. Ambulatory procedures were performed in 25 of the 37 patients (68%).Results: Complete healing with no perforation of the tympanic membrane was noted postoperatively in all patients. No complications relating to robotic manipulation occurred during surgery or postoperatively. The mean air conduction gain was 3.8 ± 12.6 dB for type I (n = 15), 7.9 ± 11.4 dB for type II (n = 14), and −0.9 ± 10.8 for type III tympanoplasties (n = 4), and the postoperative air-bone conduction gap was 13.8 ± 13.3 dB for type I, 19.7 ± 11.7 dB for type II and 31.6 ± 13.0 dB for type III tympanoplasty. They was no relapse of cholesteatoma or paraganglioma during the short follow-up period (&lt;1 year).Conclusion: This study indicates that robot-assisted endoscopy is a safe and trustworthy tool for several categories of middle ear procedures. It combines the benefits of endoscopic exposure with a two-handed technique in middle ear surgery. It can be used as a standalone tool for pathology limited to the middle ear cleft or in combination with a microscope in lesions extending to the mastoid or petrous apex.

scholarly journals Experimental middle ear surgery in rabbits: a new approach for reconstructing the ossicular chain

2009 ◽  
Vol 43 (2) ◽  
pp. 198-204 ◽  
Author(s):  
M Stieve ◽  
H J Hedrich ◽  
R D Battmer ◽  
P Behrens ◽  
P Müller ◽  
...  
Keyword(s):  
Middle Ear ◽  
Bone Conduction ◽  
Hearing Threshold ◽  
Ossicular Chain ◽  
Ceramic Materials ◽  
Middle Ear Surgery ◽  
Electric Response ◽  
Hearing Level ◽  
Erbium:Yag Laser ◽  
Significant Difference

This experimental animal study aimed at evaluating a new prosthesis to replace the ossicular chain; we developed a new technique for surgical implantation into the middle ear of rabbits. The rabbit middle ear is, owing to the relative anatomical dimensions involved, an ideal environment for implantation procedures involving the ossicles, as the surgical conditions are similar to those of the human middle ear. This study included a total of 34 approximately six-month-old female white rabbits (New Zealand) weighing between 3.2 and 4.4 kg. The implants used were constructed of ceramic materials (titania, TiO2) of various pore sizes. Directly prior to implanting the total ossicular reconstruction prostheses (TORPs), as well as at 28, 84 and 300 days after implantation, electric response audiometry was used to determine the hearing thresholds of the animals (bone conduction; click stimulus nHL). An erbium:YAG laser was used to excise the original ossicular chain. Following implantation, we were unable to detect any stenosis of the outer ear canal or perforation of the tympanic membrane. The conductive hearing threshold was in the range of 4.21 ± 6.68 dB nHL ( n = 131). The hearing level showed no significant difference before and after surgery ( P < 0.05).

Assessment of Stapes Mobility by Use of a Newly Developed Piezoelectric Ceramic Device

2000 ◽  
Vol 109 (5) ◽  
pp. 473-477 ◽  
Author(s):  
Kiyofumi Gyo ◽  
Eiji Yumoto ◽  
Hidemitsu Sato ◽  
Naoaki Yanagihara
Keyword(s):  
Middle Ear ◽  
Piezoelectric Ceramic ◽  
Chronic Otitis Media ◽  
The Other ◽  
Middle Ear Surgery ◽  
Measuring Range ◽  
Ear Surgery ◽  
Dental Cement ◽  
Surgical Field ◽  
The Mean

A piezoelectric device was developed for assessment of stapes mobility during middle ear surgery. The device comprises a pair of ceramic bimorph elements: one for activation of the stapes and the other to pick up the vibration as an electric output, which varies in accordance with the stapes mobility, ie, the inverse of the cochlear input impedance (Zsc). The device is compact and easily manipulated even in the narrow surgical field of the ear. However, the measuring range is restricted to between 1 and 10 kHz. Measurement of Zsc was conducted with this device in 5 ears of 5 dogs. The mean magnitude of Zsc increased with frequency in the range from 1 to 10 kHz: 0.95 megohm at 1 kHz and 8.8 megohms at 10 kHz. After fixation of the stapes with dental cement, the magnitude increased to more than 10 megohms, except at 1 kHz. The results suggest that the device is useful in detecting decreases in stapes mobility in patients with chronic otitis media.

scholarly journals A study of occurrence of postoperative sensorineural hearing loss after middle ear surgeries

2017 ◽  
Vol 3 (3) ◽  
pp. 510
Author(s):  
Md. Shafiuddin Mazhar ◽  
Shrikrishna B. H.
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Middle Ear ◽  
Pure Tone ◽  
Bone Conduction ◽  
Hearing Threshold ◽  
Sensorineural Hearing ◽  
Middle Ear Surgery ◽  
Post Surgery ◽  
Duration Of Surgery

<p class="abstract"><strong>Background:</strong> Chronic otitis media is the most common middle ear disease that is encountered in our hospital. There are various surgical procedures that are performed in cases of COM and other similar conditions of the middle ear. Any type of otosurgical procedure involves the risk of inner ear damage. As middle ear surgery is also performed for functional reasons this risk should be taken into consideration. There have been some studies mentioning many insults to the cochlea during middle ear surgeries. Some studies claim that sensorineural hearing loss post-surgery is not significant at all. In view of these contradictory studies, further study is essential on this subject<span lang="EN-IN">. </span></p><p class="abstract"><strong>Methods:</strong> All patients undergoing middle ear surgeries are subjected to pure tone audiometry pre-operatively and tenth day, one month and three months postoperatively. Hearing assessment done with pure tone audiometer. The hearing threshold for pure tone audiometer was determined in a sound treated room at frequencies ranging from 125-8000 Hz for air conduction and 250-4000 Hz for bone conduction<span lang="EN-IN">.  </span></p><p class="abstract"><strong>Results:</strong> Sensorineural hearing loss was not found in any of the patients postoperatively on 10th day 1st month and 3rd month<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> There was no significant variation between preoperative and postoperative bone conduction levels.  Therefore middle ear surgeries have not resulted in any SNHL. Duration of ear discharge, duration of surgery, type of surgery had no bearing on postoperative sensory neural hearing levels<span lang="EN-IN">.</span></p>

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