Comparison of Temporalis Fascia and Transcanal Composite Chondroperichondrial Tympanoplasty Techniques

The purpose of this study was to compare the success rates and hearing outcomes of transcanal composite chondroperichondrial cartilage graft with that of underlay temporal muscle fascia (TMF) graft for myringoplasty. In this retrospective study, the medical records of patients who underwent type 1 myringoplasty between September 2015 and February 2018 at Otorhinolaryngology Department of Erzurum Ataturk University were reviewed. Demographic properties, preoperative otological findings, preoperative pure ton audiogram findings, postoperative pure ton audiogram findings, and duration of surgeries were reviewed from medical records. The patients with lack of one or more of these information at medical records or lost to at least 3 months of follow-up were excluded from the study. According to the graft material used in the operation, the patients were divided into 2 groups. The patients operated with cartilage graft by transcanal composite chondropericondrial cartilage graft myringoplasty (TCM) technique was regarded as first group, while patients operated with temporal fascia was regarded as the second group (TMF). Both groups were compared according to preoperative and postoperative air–bone gap (ABG), graft acceptance rate, and duration of operation using SPSS version 20.0 software. A total of 113 patients whose medical records met the inclusion criteria were included in the study. Of these, 59 underwent TCM and 54 underwent TMF myringoplasty. Tympanic membrane perforation closure success rate was higher in the cartilage group (94.9%) than in the fascia group (83.3%; P = .046). In the former, preoperative and postoperative ABG was 19.5 ± 5 and 10.8 ± 4.8 dB, respectively. In the latter, the corresponding values were 20.7 ± 5.4 and 11.5 ± 5.4 dB, respectively ( P < .05). Duration of surgery was 29.5 ± 3.4 minutes in the TCM group and 61.5 ± 6.0 minutes in the TMF group ( P < .05). Transcanal cartilage myringoplasty could be considered as an appropriate surgical option because of its simplicity, shorter operation time, and rapid patient recovery, with no significant difference in terms of hearing outcomes compared to temporal fascia.

Download Full-text

A comparative study of using temporalis fascia autograft and dehydrated temporal fascia homograft in tympanoplasty

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20194947 ◽

2019 ◽

Vol 5 (6) ◽

pp. 1669

Author(s):

Hemendra Bamaniya ◽

Padam Chand Ajmera

Keyword(s):

Graft Material ◽

Age Group ◽

Temporalis Fascia ◽

Suppurative Otitis Media ◽

Medical College ◽

Temporal Fascia ◽

Significant Difference ◽

Duration Of Surgery ◽

Group A ◽

Group B

Background: The objective of the present study was to compare the results of tympanoplasty operations performed using autograft temporalis fascia with those of dehydrated temporalis fascia homograft.Methods: This prospective study was conducted in the department of ENT of Pacific Medical College and Hospital, Udaipur in duration from February 2014 to January 2015. The study included 90 patients of chronic suppurative otitis media with dry, central perforation of tympanic membrane. The patients were divided into two groups with 45 members in each group. In group A, temporalis fascia autograft was used and in group B, dehydrated temporalis fascia homograft was used for tympanoplasty. Results were evaluated in terms of graft uptake rate and hearing improvement. Results: There were 50 male and 40 female patients in the study. Most of the patients (43.33%) were of the age group 21-30 years, followed by age group 31-40 years (24.44%). Post-operatively, 95.55% patients in group A and 91.11% patients in group B showed successful graft uptake. Mean preoperative AB gap in group A patients was 31.46±6.78 dB which was reduced to 13.01±5.61 dB postoperatively. Similarly, in group B patients, AB gap was reduced from 29.81±5.99 to 12.92±6.01 dB postoperatively. No statistically significant difference was observed between groups while comparing pre and postoperative AB gap.Conclusions: The results of tympanoplasty done by using either homograft or autograft were the same so dehydrated temporalis fascia homograft can be used as an alternative graft material with the same success rate wherever possible with the advantage of reduction in duration of surgery.

Download Full-text

Comparative study between fat plug and inlay butterfly cartilage grafts for myringoplasty in adults

The Egyptian Journal of Otolaryngology ◽

10.1186/s43163-021-00076-y ◽

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.

Download Full-text

Comparison of Two Types of Staged Laparoscopic Orchiopexy for High Intra-Abdominal Testes in Children: A Retrospective Study From a Single Center

Frontiers in Pediatrics ◽

10.3389/fped.2021.677955 ◽

2021 ◽

Vol 9 ◽

Author(s):

Jie Liu ◽

Rui Tang ◽

Xiao Wang ◽

Bangzhi Sui ◽

Zhiyuan Jin ◽

...

Keyword(s):

Medical Records ◽

Vas Deferens ◽

Operation Time ◽

Testicular Atrophy ◽

High Survival ◽

Laparoscopic Treatment ◽

Atrophy Rate ◽

Medical College ◽

Significant Difference ◽

Surgery Center

Background: To evaluate the efficacy and safety of 2nd-stage laparoscopic traction orchiopexy (Shehata technique) compared to Fowler-Stephens (F-S technique) for high intra-abdominal testes (IATs) in children.Patients and Methods: We performed a retrospective review of all children (<14 years old) who underwent laparoscopic treatment of high IAT in the pediatric surgery center of Yijishan Hospital of Wannan Medical College from April 2016 to April 2020. Participants were divided into the Fowler-Stephens (F-S) group and Shehata group according to the surgical method. We collected the medical records of all children and analyzed them statistically.Results: In this study, 43 patients in our center received 2nd-stage laparoscopic surgical treatment. The results showed that there were 23 high IATs in 22 patients in the F-S group and 22 IATs in 21 patients in the Shehata group. All patients completed the operation successfully. No significant difference in operation time was noted between the two groups. There was no significant difference in the testicular atrophy rate between the two groups (P = 0.323). The testicular retraction rate of the F-S group was greater than that of the Shehata group (P = 0.04).Conclusion:The results of this study indicate that the application of assisted laparoscopic testicular traction technology can effectively retain the main blood supply of the testis and vas deferens with a high survival rate and clear advantages. The preliminary results show that the Shehata technique is safe, reliable and effective in the treatment of high IAT in children.

Download Full-text

Comparison of the anatomical and functional success of fascia and perichondrium grafts in transcanal endoscopic type 1 tympanoplasty

Journal of Otolaryngology - Head and Neck Surgery ◽

10.1186/s40463-019-0386-z ◽

2019 ◽

Vol 48 (1) ◽

Cited By ~ 2

Author(s):

Kadir Özdamar ◽

Alper Sen

Keyword(s):

Retention Rates ◽

Success Rates ◽

Temporal Muscle ◽

Type 1 Tympanoplasty ◽

Significant Difference ◽

The Status ◽

Group A ◽

Group B ◽

Age Range

Abstract Background There are no studies in the literature, comparing the functional and anatomical successes of the use of fascial and perichondrial grafts in endoscopic type 1 tympanoplasties. Objectives To compare the anatomical and functional outcomes of grafting with the fascia of the temporalis muscle and with the perichondrium of the tragal cartilage in patients undergoing primary transcanal type 1 tympanoplasty with endoscopy. Methods We enrolled a total of 151 patients (80 females and 71 males with a mean age of 26.0 ± 9.3 years in the age range between 18-57) with MERI scores ranging from 1 to 3 and who underwent a transcanal endoscopic type 1 tympanoplasty without tympanomeatal flap elevation. The patients were assigned to two groups according to the type of the graft used. The patients were assigned to either the tragal cartilage perichondrium group (Group A) or the fascia of the temporal muscle (Group B). The groups were compared according to the pre- and postoperative air-bone gaps and to the status of the tympanic membrane. Results There were no statistically significant differences in the distribution of the age, gender, localization, MERI scores, the duration of the operation, and the size of the perforation (all p values> 0.05). The pre-operative air-bone gap values of Group A and B did not show a statistically significant difference (p = 0.073). The postoperative improvement in the air-bone gap value did not demonstrate a significant difference between Group A and B (p = 0.202). The graft retention rates were 94.9 and 97.2% in Group A and in Group B respectively. There were no statistically significant differences between the two groups in terms of the graft retention success rates (p = 0.743). Conclusion Perichondrium and fascia were suitable for use in endoscopic tympanoplasties.

Download Full-text

Assessment of incidence of post-operative wound infection in women undergoing caesarean section: a retrospective study

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20182344 ◽

2018 ◽

Vol 7 (6) ◽

pp. 2328

Author(s):

Radha Sangavi ◽

Rajkumari K. S.

Keyword(s):

Risk Factors ◽

Retrospective Study ◽

Caesarean Section ◽

Wound Infection ◽

Demographic Data ◽

Operation Time ◽

Healthcare Systems ◽

Prolonged Labour ◽

Significant Difference ◽

Duration Of Surgery

Background: The surgical site infection is the second most common infectious complication occurring after caesarean section. Infections occurring after caesarean section represent a considerable burden to the healthcare systems and preventing these complications is a priority of healthcare systems especially in developing countries. The aim of this study was to determine the incidence of SSI in patients undergoing a LSCS at a RIMS teaching hospital, Raichur, and to identify risk factors, common bacterial pathogens and antibiotic sensitivity.Methods: The present retrospective study was conducted in RIMS Institute, during a period of 3 years i.e. from 2013-2016. In this study a total of 50 cases were collected from MRD department. They were divided into two groups- cases and controls, each having 50 subjects each. Wound infection was defined as inflammation or sepsis with or without positive bacterial cultures. With SSI, there may be fever, redness, swelling and/or pain in the area around the incision site. Complete information regarding demographic data, the type and indication for caesarean section, duration of labour, duration of surgery and rupture of membrane were recorded. Wound infections occuring after 30 days of LSCS & other gynaecological surgeries were excluded. All the results were analyzed by SPSS software 16.0. Chi-square test and student t test were used for the assessment of level of significance. Probability value of less than 0.05 was considered significant.Results: A total of 100 subjects were included in the present study, out of which, 50 were cases and the remaining 50 were controls. The mean age of the subjects was 37.45 years. There were 7 cases and 13 controls who were aged between 20-24 years. There was no significant difference amongst cases and controls regarding age. There was a significant difference in the haemoglobin levels amongst cases and controls. The third criterion that was assessed was duration of labour. Majority of the cases had prolonged labour whereas in majority of the controls, the duration of labour of labour was less than 6 hours. There was a significant difference in duration of labour amongst cases and controls (p<0.05). Elective c section was done in 2 cases and 6 controls. C section was performed in an emergency in 48 cases and 44 controls. There was a significant difference in the operation time between cases and controls (p<0.05). E.coli infection occurred in 15 cases in the present study followed by Actinobacter species which occurred in 13 cases. Absence of growth was seen in 5 cases.Conclusions: The risk factors associated with SSI in our study were, haemoglobin levels, prolonged labour, duration of operation. The most common organisms isolated were E. coli and Actinobacter species.

Download Full-text

Endoscopic Tympanoplasty: Inlay Cartilage Versus Underlay Cartilage Graft

Northwestern Medical Journal ◽

10.5222/nwmj.2021.08208 ◽

2021 ◽

Author(s):

Ahmet Doblan ◽

Ergun Sevil

Keyword(s):

Success Rate ◽

Chronic Otitis Media ◽

Pure Tone Audiometry ◽

Operation Time ◽

Cartilage Graft ◽

Significant Difference ◽

Graft Success ◽

Small Perforation ◽

Endoscopic Tympanoplasty

INTRODUCTION: Several graft placement methods have been described in tympanoplasty. The aim of this study is to assess the surgical effects of the endoscopic tympanoplasty utilizing inlay cartilage or underlay cartilage graft. METHODS: We reviewed medical records of 123 patients who experienced endoscopic tympanoplasty for chronic otitis media with a minimum twelve-month follow-up period. Perforations were divided into central, posterior, and anterior ones based on the place of the perforation to malleus handle. Graft success rate, air conduction pure tone audiometry (PTA) before surgery and after surgery, hearing gain and air bone gap (ABG) reduction were calculated following surgery. RESULTS: No significant difference was found between the groups in terms of the distribution of the follow-up period, age, perforation location, and gender (p>0.05). The average air conductions (AC) before surgery and after surgery for the inlay group were 36.3 ± 13.7 dB and 25.4 ± 12.3 dB 6 months after surgery and 22.5 ± 10.5 dB 12 months after surgery. They were 35.6 ± 13.3 dB and 24.8 ± 12.4 dB 6 months after surgery and 22.7 ± 9.7 12 months after surgery for the underlay group. A significant difference was found between the two groups in terms of ABG (P=0.037). There was no significant difference in the mean ABG in each group (small perforation P =0.473, medium perforation P=0.876 and large perforation P=0.341). DISCUSSION AND CONCLUSION: The inlay method can be used with high graft success rate, low risk of complications among the appropriate patients, and shorter operation time as a reliable surgical option for treatment.

Download Full-text

White-Eyed Orbital Blowout Fracture: A Retrospective Study of 22 Patients

Korean Journal of Otorhinolaryngology - Head and Neck Surgery ◽

10.3342/kjorl-hns.2021.00304 ◽

2021 ◽

Vol 64 (12) ◽

pp. 896-900

Author(s):

Gyo Han Bae ◽

Geun Woo Park ◽

Tai Jung Park ◽

Woong Jae Noh ◽

Tae Young Jung

Keyword(s):

Retrospective Study ◽

Medical Records ◽

Demographic Data ◽

Operation Time ◽

Graft Material ◽

Successful Result ◽

Blowout Fracture ◽

Ocular Symptoms ◽

Study Population ◽

Early Reconstruction

Background and Objectives The study reports on the clinical experience of repairing white-eyed orbital blow out fracture through a retrospective study of various incidences of white-eyed orbital blow out fracture that resulted in different treatment methods and outcomes.Subjects and Method A retrospective study was performed on 22 patients with white-eyed blowout fracture who underwent operation between March 2009 and June 2019 at our clinic. Patients were divided into 2 groups by age: 6 to 12 and 13 to 18. A review of medical records included demographic data, cause of injury, preoperative symptoms, trauma to operation time and surgical outcomes including improvement of postoperative ocular symptoms and complications.Results The study population included 20 males and 2 female patients ranging from 6 to 18 years (mean, 14.2 years) of age. Fifteen of 21 patients with diplopia or limitation of eyeball movement showed a complete improvement of symptoms after surgery and 6 (28.5%) had remaining symptoms. One patient had no ocular symptom, but had oculocardiac reflex including nausea and vomiting. Two cases were re-operated due to adhesion of graft material. There was one sinus infection related to the implant.Conclusion This study shows that early reconstruction and release of incarcerated muscle within 5 days after trauma for white-eyed blowout fracture gives successful result that does not accompany major complications. All of the 22 patients who were operated for white-eyed blowout fractures had successful results.

Download Full-text

Feasibility of mesentericoportal vein reconstruction by autologous falciform ligament during pancreaticoduodenectomy—cohort study

BMC Surgery ◽

10.1186/s12893-020-01019-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Yi Shao ◽

Jiaojiao Feng ◽

Yuancong Jiang ◽

Zhenhua Hu ◽

Jian Wu ◽

...

Keyword(s):

Medical Records ◽

Patency Rate ◽

Operation Time ◽

Postoperative Hospital Stay ◽

Ductal Adenocarcinoma ◽

Falciform Ligament ◽

Common Procedure ◽

Term Survival ◽

Significant Difference

Abstract Background Mesentericoportal vein (MPV) resection in pancreatic ductal adenocarcinoma (PDAC) surgery has become a common procedure. A few studies had described the use of falciform ligament (FL) for MPV reconstruction and received encouraging preliminary effects. Aims This study was designed to explore the feasibility and efficacy of this technique compared with others. Methods Patients who underwent pancreaticoduodenectomy (PD) with MPV resection for PDAC from 2009 to 2018 were enrolled. Medical records were retrospectively reviewed, MPV reconstructions using FL were distinguished and compared with other techniques. Results 146 patients underwent MPV reconstruction, and 13 received FL venoplasty. Other reconstruction techniques included primary end-to-end anastomosis (primary, n = 30), lateral venorrhaphy (LV, n = 19), polytetrafluoroethylene conduit interposition (PTFE, n = 24), iliac artery (IA) allografts interposition (n = 47), and portal vein (PV) allografts interposition (n = 13). FL group holds the advantages of shortest operation time (p = 0.023), lowest blood loss (p = 0.109), and shortest postoperative hospital stay (p = 0.125). The grouped patency rates of FL, primary, LV, PTFE, IA, and PV were 100%, 90%, 68%, 54%, 68%, and 85% respectively. Comparison displayed that FL had the highest patency rate (p = 0.008) and lowest antiplatelet/anticoagulation proportion (p = 0.000). Complications and long-term survival were similar among different techniques. The median survival time of patent group (24.0 months, 95% CI: 22.0–26.0) was much longer than that of the thrombosed (17.0 months, 95% CI: 13.7–20.3), though without significant difference (P = 0.148). Conclusions PD with MPV resection and reconstruction by FL is safe, feasible, and efficacious, it might provide a potential benefit for patients.

Download Full-text

Tympanoplasty Type I using Tragal Cartilage as graft: Our experience.

The Professional Medical Journal ◽

10.29309/tpmj/2019.26.12.3334 ◽

2019 ◽

Vol 26 (12) ◽

pp. 2135-2140

Author(s):

Fazal-I- Wahid ◽

Sajid Rashid Nagra

Keyword(s):

Pure Tone Audiometry ◽

Neck Surgery ◽

Acoustic Properties ◽

P Value ◽

Type I ◽

Graft Material ◽

Cartilage Graft ◽

Hearing Improvement ◽

Female Ratio ◽

Significant Difference

Objectives: To determine the efficacy of tragal cartilage graft in tympanoplasty type I. Study Design: Quasi-experimental study. Setting: Department of ENT, Head and Neck Surgery, Medical Teaching Institute (MTI), Lady Reading Hospital (LRH), Peshawar, Pakistan. Period: From Jan. 2017 to Dec. 2017 (One Year). Material & Methods: A total of forty four patient fulfilling inclusion criteria were included in this study. All the patients were assessed in terms of detail history, thorough examination focusing on ENT findings. Pure Tone Audiometry (PTA) was performed pre-operative and post-operative at 3 and 6 months interval for the frequencies of 0.5, 1, 2,4 Hz. Data were analyzed using SPSS (version 16). Paired sample t-test of significance was used. The confidence interval was set to 95% and P-value <0.05 was considered significant. Results: Out of 44 patients males were 24 (54.54%), female 20 (45.45%) with Male: Female ratio of 1.2:1. Mean age of the patients was 28. 47 + SD 7.26 Years. There was statistically significant difference between the pre and post-op air conduction (p<.001), and pre-op and post-op air bone gap (p<.001).There was subjectively significant hearing improvement in 31 patients (70.5%). Cartilage graft was taken in 43 patients with success rate of 97.7%. Conclusion: Tragal cartilage is an effective graft material, which yields good results in terms of graft take up, hearing improvement and minimum complication, postoperative healing and acoustic properties.

Download Full-text

Semi-extended Intramedullary Nailing of the Tibia Using an Infrapatellar Approach

10.21203/rs.3.rs-122487/v1 ◽

2020 ◽

Author(s):

Ke Lu ◽

Yi-jun Gao ◽

Hong-zhen Wang ◽

Zhi-qiang Wu ◽

Chong Li

Keyword(s):

Intramedullary Nailing ◽

Medical Records ◽

Functional Outcomes ◽

Operation Time ◽

Delayed Union ◽

Interquartile Range ◽

Tibial Shaft ◽

Shaft Fractures ◽

Significant Difference ◽

Tibial Shaft Fractures

Abstract Background The semi-extended tibial intramedullary nailing method would enable easier and improved reductions for tibial fractures as well as facilitate fluoroscopic imaging; however, its in-articular nature remains controversial. The aim of this study was to compare the clinical and functional outcomes of the semi-extended infrapatellar (SEIP) approach and hyper-flexed infrapatellar (HFIP) approach for intramedullary nailing to treat tibial shaft fractures.MethodsThis study involved the retrospective analysis of the medical records of patients with tibial shaft fractures that were fixed through either the SEIP approach or the HFIP approach of intramedullary nailing and who were admitted to a level 1 trauma center. The minimum patient follow-up period was 12 months and the clinical and functional outcomes were estimated at the 12-month visit. ResultsOf the 80 patients whose medical records were analyzed, 40 (50%) underwent SEIP nailing and the remaining 40 (50%) underwent the traditional HFIP nailing. Compared with the HFIP group, patients in the SEIP group had a higher Lysholm knee score (median, 92 [interquartile range, 88-95] vs median, 88 [interquartile range, 81-92]; p = .01), a shorter intraoperative fluoroscopy time (median, 93 [interquartile range, 78-105] s, vs median, 136 [interquartile range, 110-157] s; p < .001), and operation time (mean, 88.1 [SD, 17.8] min vs mean, 98.7 [SD, 19.3] min; p = .01). The VAS score was significantly lower in the SEIP group (median, 0; interquartile range, 0-0) than in the HFIP group (median, 0; interquartile range, 0-2) (p = .03). There were two cases (5%) in the SEIP group and 10 cases (25%) in the HFIP group of moderate AKP (p = .03). Meanwhile, there was no significant difference in malalignment, nonunion, delayed union, infection, and other complications, as well as SF-36 physical and mental scores.ConclusionWe found that the SEIP approach to tibia intramedullary nailing was superior to the HFIP approach based on the intraoperative and postoperative outcomes. Thus, this novel technique provides an infrapatellar option for semi-extended tibial nailing.

Download Full-text