scholarly journals Use of Endoscopic Cartilage Graft Myringoplasty Without Tympanomeatal Flap Elevation to Repair Posterior Marginal Perforations

2020 ◽  
pp. 014556132093122
Author(s):  
Zhengcai Lou
Keyword(s):  
Success Rate ◽  
Case Series ◽  
Composite Graft ◽  
Mastoid Cavity ◽  
Cartilage Graft ◽  
Significant Difference ◽  
Graft Extrusion ◽  
The Mean ◽  
Graft Success ◽  
Flap Elevation

Objective: We evaluated the graft success rate and hearing outcomes of endoscopic cartilage graft myringoplasty without tympanomeatal flap elevation used to repair posterior marginal perforations. Study Design: A prospective case series. Materials and Methods: A total of 31 patients with posterior marginal perforations who underwent endoscopic cartilage graft myringoplasty were included. The outcomes were the hearing gain and graft success rate at 6 and 24 months. Results: The graft success rate was 96.7% (30/31) at 6 months and 90.3% (28/31) at 24 months; 1 patient exhibited composite graft extrusion and lateralization in the region of the anterior annulus; a residual perforation was apparent. Reperforation occurred in 2 patients. The mean preoperative air-bone gap (ABG; 28.61 ± 3.14 dB) was significantly greater than the mean postoperative ABG (12.15 ± 3.98 dB; P < .05) at 6 months; however, there was no statistically significant difference between the post-6 months and post-24 months with regard to ABG values ( P = .871), ABG gain ( P = 0.648), or functional success rate ( P = .472). No significant graft blunting or atelectasis was noted during follow-up. The free perichondrium became fully integrated with the skin of the external auditory canal; the perichondrium could not be clearly distinguished endoscopically 4 to 8 weeks postoperatively. Computed tomography revealed well-pneumatized middle ear and mastoid cavity at postoperative 24 months. Conclusion: Endoscopic cartilage graft myringoplasty without tympanomeatal flap elevation reliably repairs posterior marginal perforations. The short- and long-term graft success rate is high, and the hearing results are satisfactory; the technique is minimally invasive.

scholarly journals COMPARATIVE STUDY OF TYMPANOPLASTY WITH CONVENTIONAL TEMPORALIS FASCIA GRAFT VERSUS TRAGAL CARTILAGE PERICHONDRIUM GRAFT

2020 ◽  
pp. 1-4
Author(s):  
Apurba Sarkar ◽  
Debabrata Das ◽  
Anurag Pradhan ◽  
Sk Nawazur Rahaman ◽  
arjuman Parveen
Keyword(s):  
Success Rate ◽  
Failure Rate ◽  
Surgical Outcome ◽  
Pure Tone ◽  
Pure Tone Audiometry ◽  
Composite Graft ◽  
Cartilage Graft ◽  
Temporalis Fascia ◽  
Fascia Graft ◽  
The Mean

The study was carried out on 50 patients with central perforation in tympanic membrane ( dry & inactive stage ). The study was done in the department of OTORHINOLARYNGOLOGYof BURDWAN MEDICALCOLLEGE AND HOSPITALover a period of one year. The study was done on comparison between tympanoplasty procedure using temporalis fascia as graft versus cartilage composite graft. Precise history was taken from respective patients in detail and were examined clinically. Patients with dry perforation with good cochlear reserve, intact and mobile ossicular chain, functioning Eustachian tube were selected randomly for the operation. Tympanoplasty procedure using temporalis fascia as graft was done in 50% (n=25) patients and tympanoplasty procedure using cartilage composite graft was done in 50% (n=25) patients. In this study the age range of patients were from 13 to 50 years, the mean age was 26.62 years, the number of male and female was equal. Right sided disease was predominant in our study and the mean duration of symptom was 11.24 months. The mean pre-operative hearing loss (pure tone average by pure tone audiometry) was 37.84 ± 4.65 dB and mean pre operative airbone gap was 22.84 ± 4.65 dB . Post operative Mean air conduction was 23.48 ± 5.54 dB among them 24.2 ± 6.26 dB in the fascial group and 22.76 ± 4.73 dB in the cartilage group. This result is not statistically signicant. Post operative mean air-bone gap was 13.84 ± 5.94 dB among them 14.76 ± 5.6 dB in fascial group and 12.92 ± 6.23 dB in the cartilage group which is not signicant stastistically. Successful graft take-up rate of 88.00% (n=44). The overall success rate among tympanoplasty using temporalis fascia graft( GROUP A ) and tympanoplasty using composite cartilage graft ( GROUP B ) technique were 84.00% (n=21) and 92.00% (n=23) respectively. 12.00% (n=6) patients were marked as failure cases during postoperative follow up period. The overall failure rate among tympanoplasty using temporalis fascia graft( GROUPA) and tympanoplasty using composite cartilage graft ( GROUPB ) technique were 16.00% (n=4) and 8.00% (n=2) respectively. So the distribution of surgical outcome in terms of success rate or failure rate was statistically insignicant in the two study groups (p= 0.384). So the distribution of surgical outcome in terms of success rate or failure rate cartilage composite graft gives a denitely better result than temporalis fascia graft. However, the two method did not differ signicantly in terms of hearing improvement.

scholarly journals Endoscopic Tympanoplasty: Inlay Cartilage Versus Underlay Cartilage Graft

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.

scholarly journals Is Allergic Rhinitis a Factor That Affects Success of Tympanoplasty?

2016 ◽  
Vol 59 (1) ◽  
pp. 10-13
Author(s):  
Elif Ersoy Callioglu ◽  
A. Sami Bercin ◽  
Hayati Kale ◽  
Togay Muderris ◽  
Sule Demirci ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Success Rate ◽  
Middle Ear ◽  
Success Rates ◽  
Type 1 Tympanoplasty ◽  
Significant Difference ◽  
Patient Groups ◽  
The Difference ◽  
Graft Success

Objective: The aim of the present study was to investigate the effect of allergic rhinitis on the success of the operation in chronic otitis surgery by using score for allergic rhinitis (SFAR). Materials and Methods: In the present study; 121 patients, who underwent type 1 tympanoplasty were examined retrospectively. SFAR of all patients were recorded. The graft success rates of 26 patients with allergic rhinitis (AR) and 95 patients with no allergic rhinitis group (NAR) were compared. Results: While the graft success rate in NAR group was 89.5%, this rate was 80.8% in the AR group. However, the difference between groups was not statistically significant (p = 0.311). Conclusion: These findings suggest that allergic rhinitis decreases the graft success rate of the pathologies occurring in eustachian tube, middle ear and mastoid although statistically significant difference wasn’t found. Prospective studies with larger patient groups are required in order to evaluate this pathology.

scholarly journals Anatomical and Visual Effects of Implantable Phakic Contact Lens on Correction of Myopia

2022 ◽  
Author(s):  
Mahmoud Ekram ◽  
Ahmed Mohamed Kamal Elshafei ◽  
Asmaa Anwar Mohamed ◽  
Mohamed Farouk Sayed Othman Abdelkader
Keyword(s):  
Visual Acuity ◽  
Anterior Chamber ◽  
Contact Lens ◽  
Anterior Segment ◽  
Anterior Chamber Depth ◽  
Case Series ◽  
Care Group ◽  
Case Series Study ◽  
Significant Difference ◽  
The Mean

Abstract Purpose: To evaluate the anatomical effects of implantable phakic contact lens (IPCL) (Care Group, India) on anterior segment and its visual outcomes .Patients and methods: In a prospective interventional case series study, 60 highly myopic eyes of 32 patients were subjected to IPCL implantation in the Ophthalmology Department of Minia University Hospital, Egypt from January 2019 to June 2021. All patients had complete ophthalmic examination and were followed up for 1 year. Pentacam was used for preoperative and postoperative estimation of anterior chamber depth (ACD), anterior chamber angle (ACA), anterior chamber volume (ACV) and IPCL vault in the 1st, 3rd, and 12th months. Assessment of corneal endothelium was done using specular microscope preoperatively and after 12 months. Preoperative and postoperative refraction and visual acuity were measured. Results: There was a statistically significant decrease in ACD, ACA, and ACV. There was no significant difference between preoperative and postoperative mean intraocular pressure (IOP) by the 12th month (P=0.163). The mean preoperative endothelial cell count (ECD) was significantly reduced from 2929.3±248 cells/mm2 to 2737.9±303 cells/mm2 at the 12th month (P<0.001). with a statistically highly significant improvement of mean Log Mar uncorrected visual acuity (UCVA) from 1.48±0.19 preoperatively to 0.46±0.11 by the end of follow up (P<0.001) with insignificant difference between preoperative best corrected visual acuity (BCVA) and postoperative UCVA (P=0.209). In the 12th month, the mean vault was 240±540 μm. No sight threatening complications occurred.Conclusion: Although IPCL induced anatomical changes, it was safe and effective for correction of high myopia.

scholarly journals Radiological Outcomes of Third Generation Minimally Invasive Chevron Akin Osteotomies (MICA) for Hallux Valgus

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0032
Author(s):  
Thomas L. Lewis ◽  
Robbie Ray; David Gordon
Keyword(s):  
Minimally Invasive ◽  
Hallux Valgus ◽  
Weight Bearing ◽  
Case Series ◽  
Deformity Correction ◽  
Third Generation ◽  
Radiographic Measurements ◽  
Significant Difference ◽  
Patient Reported ◽  
The Mean

Category: Bunion Introduction/Purpose: Minimally invasive surgery for hallux valgus has significantly increased in popularity recently due to smaller incisions, reduced soft tissue trauma, and the ability to achieve large deformity corrections compared to traditional treatments. This study aimed to investigate the radiological outcomes and degree of deformity correction of the intermetatarsal angle (IMA) and the hallux valgus angle (HVA) following third generation (using screw fixation) Minimally Invasive Chevron and Akin Osteotomies (MICA) for hallux valgus. Methods: A single surgeon case series of patients with hallux valgus underwent primary, third generation MICA for hallux valgus. Pre- and post-operative (6 weeks after surgery) radiological assessments of the IMA and HVA were based on weight-bearing dorso-plantar radiographs. Radiographic measurements were conducted by two foot & ankle fellowship trained consultant surgeons (RR, DG). Paired t-tests were used to determine the statistically significant difference between pre- and post-operative measurements. Results: Between January 2017 and December 2019, 401 MICAs were performed in 274 patients. Pre- and post-operative radiograph measurements were collected for 348 feet in 232 patients (219 female; 13 male). The mean age was 54.4 years (range 16.3-84.9, standard deviation (s.d.) 13.2). Mean pre-operative IMA was 15.3° (range 6.5°-27.0°, s.d. 3.4°) and HVA was 33.8° (range 9.3°-63.9°, s.d. 9.7°). Post-operatively, there was a statistically significant improvement in radiological deformity correction; mean IMA was 5.3° (range -1.2°-16.5°, s.d. 2.7°, p<0.001) and mean HVA was 8.8° (range -5.2°-24.0°, s.d. 4.5°, p<0.001). The mean post-operative reduction in IMA and HVA was 10.0° and 25.0° respectively. Conclusion: This is the largest case series demonstrating radiological outcomes following third generation Minimally Invasive Chevron and Akin Osteotomies (MICA) for hallux valgus to date. These data show that this is an effective approach at correcting both mild and severe hallux valgus deformities. Longer term radiological outcome studies are needed to investigate whether there is any change in radiological outcomes. Correlation with patient reported outcomes is planned.

Corneal biomechanical outcome of collagen cross-linking in keratoconic patients evaluated by Corvis ST

2020 ◽  
pp. 112067212094479
Author(s):  
Mahmoud Jabbarvand ◽  
Zahra Moravvej ◽  
Kianoush Shahraki ◽  
Hessam Hashemian ◽  
Hamed Ghasemi ◽  
...  
Keyword(s):  
Amplitude Ratio ◽  
Corneal Thickness ◽  
Case Series ◽  
Cross Linking ◽  
Corvis St ◽  
Significant Difference ◽  
Biomechanical Changes ◽  
The Mean ◽  
Prospective Case Series ◽  
Collagen Cross Linking

Purpose: A 6-month evaluation of the topographic and biomechanical changes induced by corneal collagen cross-linking (CXL) in keratoconic eyes using Pentacam and Corvis ST. Design: Longitudinal prospective case series. Methods: In this study, 67 eyes of 67 patients with progressive keratoconus (KCN) treated with “Epithelium-off” CXL were evaluated. Patients with stages 1 or 2 of KCN and a corneal thickness of at least 400 μm at the thinnest point were included. Standard ophthalmologic examinations were carried out for all patients. The topographic and biomechanical measurements of the cornea were obtained by Pentacam (Oculus Optikgeräte GmbH, Wetzlar, Germany) and Corvis ST (Oculus Optikgeräte GmbH, Wetzlar, Germany) preoperatively and 6-month postoperatively. Results: The mean age of the participants was 21.68 ± 4.23 years. There was significant difference in mean spherical equivalent (SE) before and 6 months after CXL. Uncorrected and best corrected visual acuity improved postoperatively, although not statistically significant. The mean and maximum keratometry showed a significant decrease 6 months after CXL (0.93 ± 0.38 D and 1.43 ± 0.62 D, respectively p < 0.001). Among Corvis ST parameters, first applanation length and velocity (AL1 and AV1) showed statistically significant changes. The radius at highest concavity changed significantly (0.13 ± 0.37 mm mean increase after CXL; p < 0.001). A significant increase was observed in stiffness parameter A1 (SP-A1; p < 0.001) and significant decreases were noted in integrated radius (IR) and deformation amplitude ratio (DAR; p < 0.001). Conclusion: Analyzing biomechanical changes after corneal cross-linking can provide basis for efficient KCN treatment. Corvis ST parameters demonstrated changes in corneal biomechanical characteristics indicative of stiffing after CXL.

scholarly journals Osteochondral allograft transplantation for large Hill-Sachs lesions: a retrospective case series with a minimum 2-year follow-up

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Hongwu Zhuo ◽  
Yangkai Xu ◽  
Fugui Zhu ◽  
Ling Pan ◽  
Jian Li
Keyword(s):  
Clinical Outcomes ◽  
Case Series ◽  
Osteochondral Allograft ◽  
Satisfaction Rate ◽  
Allograft Transplantation ◽  
Constant Murley Score ◽  
Significant Difference ◽  
The Mean ◽  
Graft Resorption

Abstract Purpose To investigate the clinical outcomes after osteochondral allograft transplantation for large Hill-Sachs lesions. Methods Patients who underwent osteochondral allograft transplantation for large Hill-Sachs lesions were identified. Clinical assessment consisted of active range of motion (ROM), American Shoulder and Elbow Surgeons score (ASES), Constant-Murley score, Rowe score, and patient satisfaction rate. Radiographic assessment was performed with CT scan. Results Nineteen patients met the inclusion criteria. The mean age was 21.7 years. The mean preoperative size of the Hill-Sachs lesion was 35.70 ± 3.02%. The mean follow-up was 27.8 months. All grafts achieved union at an average of 3.47 months after surgery. At the final follow-up, graft resorption was observed in 43.1% of patients. The average size of residual humeral head articular arc loss was 12.31 ± 2.79%. Significant improvements (P < .001) were observed for the active ROM, ASES score, Constant-Murley score, and Rowe score. The overall satisfaction rate was 94.7%. No significant difference was found between the resorption group and the nonresorption group in postoperative clinical outcomes. Conclusion Osteochondral allograft transplantation is a useful treatment option for patients with large Hill-Sachs lesions. Although the incidence of graft resorption may be relatively high, the clinical outcomes at a minimum 2-year follow-up are favorable. Level of evidence Level IV, case series

scholarly journals Outcome of Myringoplasty with Temporalis Fascia and Perichondrial-Cartilage Composite Graft in High Risk Perforations

2019 ◽  
Vol 21 (1) ◽  
pp. 60-64
Author(s):  
Anup Dhungana ◽  
RR Joshi ◽  
AS Rijal ◽  
KK Shrestha ◽  
S Maharjan
Keyword(s):  
High Risk ◽  
Tympanic Membrane ◽  
Uptake Rate ◽  
Pure Tone Audiometry ◽  
Composite Graft ◽  
Temporalis Fascia ◽  
Fascia Graft ◽  
Significant Difference ◽  
The Mean ◽  
And Cartilage

 The objective of this study was to compare the graft uptake results and postoperative hearing of myringoplasty with temporalis fascia and cartilage-perichondrial composite graft in high risk perforations. Patients of age 13 years and above with diagnosis of chronic otitis media – mucosal type with high risk perforation that is >50% perforation of tympanic membrane, revision cases, absent/ eroded handle of malleus, oedematous/unhealthy middle ear mucosa and marginal involvement cases were included for myringoplasty. Pure Tone Audiometry was done within 1 week before surgery. 80 cases were included for myringoplasty which were randomly allocated by lottery method with 40 cases each in temporalis fascia group and cartilage perichondrial composite graft group. Graft uptake results were assessed after 6 weeks and postoperative hearing was evaluated and compared within and between the groups. Graft uptake rate in temporalis fascia group and cartilage perichondrial composite graft group was 90% and 92.5%, respectively with no significance difference in the graft uptake rate (p = 0.692) between the groups. The mean pre and post-operative air bone gap in temporalis fascia group and cartilage perichondrial composite group were 30.69dB±10.19,16.36±8.37dB and 33.73±8.07dB, 20.76±9.47dB, respectively with highly significant difference in both groups (p < 0.001) showing improvement in the hearing after surgery in both groups. The mean air bone gain were 14.33dB and 12.97dB in temporalis fascia and cartilage perichondrial composite group respectively with no significant difference between the groups (p=0.469). The graft uptake rate and hearing results after cartilage perichondrial composite graft are comparable to those of temporalis fascia graft. Furthermore, the cartilage perichondrial composite graft is more rigid and thick so it is more resistant than fascia to anatomic deformation and necrosis. Therefore, we recommend the use of cartilage perichondrial composite graft for tympanic membrane reconstruction in high risk perforation without concern about affecting audiometric results.

Systematic Functional Assessment of Nasal Dyspnea

2011 ◽  
Vol 145 (5) ◽  
pp. 845-850 ◽  
Author(s):  
Daniel A. Larson ◽  
Benjamin W. Cilento
Keyword(s):  
Success Rate ◽  
Preoperative Evaluation ◽  
Tertiary Care ◽  
Case Series ◽  
Predictive Ability ◽  
Preoperative Assessment ◽  
Military Hospital ◽  
Significant Difference ◽  
Vas Scores ◽  
Outcome Of Surgery

Objective. Evaluate the ability of a systematic preoperative evaluation to determine the most appropriate procedures for patients undergoing functional septorhinoplasty and to accurately predict postoperative outcomes. Study Design. Case series with chart review. Setting. Tertiary care military hospital. Subjects and Methods. Fifty-nine consecutive patients from a quality control database who underwent functional rhinoplasties for nasal dyspnea were evaluated. All patients underwent a full preoperative assessment using intranasal manipulation to determine the area(s) contributing to their nasal dyspnea. Rates of success for the predictive ability and for the functional outcome were determined for each side of the nose by comparing preoperative visual analog scale (VAS) scores (1-10) to postoperative scores. Results. Overall there was a 91% success rate in predicting the outcome of surgery and a 95% success rate in improving nasal dyspnea at 1 year. There was no statistically significant difference in improvement between different surgical groups (septoplasty ± alar strut grafts ± spreader grafts) or between primary surgeries and revisions. Conclusion. Using a systematic approach to evaluate patients for nasal dyspnea, it is possible to predict and improve outcomes by choosing the most appropriate surgery for each individual.

scholarly journals A Comparative Study between Vitrectomy with Internal Tamponade and a New Modified Fiber Optic Illuminated Ando Plombe for Cases of Macular Hole Retinal Detachment in Myopic Eyes

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Ahmed M. Bedda ◽  
Ahmed M. Abdel Hadi ◽  
Muhammad S. Abd Al Shafy
Keyword(s):  
Retinal Detachment ◽  
Success Rate ◽  
Macular Hole ◽  
Fiber Optic ◽  
Case Series ◽  
Successful Outcome ◽  
Significant Difference ◽  
Macular Hole Retinal Detachment ◽  
Pars Plana ◽  
Light Group

Aim.To compare pars plana vitrectomy (PPV) with silicone tamponade or gas (Groups Ia and Ib) and a new modified Ando plombe equipped with a fiber optic light (Group II) for cases with macular hole retinal detachment (MHRD) in high myopic eyes (axial length > 26 mm).Methods.A prospective interventional randomized case series included 60 eyes (20 in each group). Successful outcome was considered if the retina was completely attached at the end of the follow-up period. Complications were identified for each group.Results.Visual acuity improved by 37.31%, 40.67%, and 49.40% in Groups Ia, Ib, and II, respectively. The success rate was 55%, 60%, and 100% in Groups Ia , Ib, and II, respectively, with a statistically significant difference between Groups Ia, Ib, and II (p< 0.001 in Ia,p: 0.002 in Ib). Complications rates were 60%, 45%, and 20% in Groups Ia, Ib, and II, respectively, with a statistically significant difference between Groups Ia and II (p: 0.01).Conclusion.Fiber optic illuminated Ando plombe allows better positioning under the macula and consequently improves the success rate of epimacular buckling in comparison to PPV with internal tamponade in MMHRD.

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