Tympanoplasty following Blast Injury

2017 ◽  
Vol 157 (6) ◽  
pp. 1025-1033 ◽  
Author(s):  
Matthew Keller ◽  
Ryan Sload ◽  
Justin Wilson ◽  
Howard Greene ◽  
Peggy Han ◽  
...  
Keyword(s):  
Tympanic Membrane ◽  
Significant Relationship ◽  
Tertiary Care ◽  
Case Series ◽  
Success Rates ◽  
Military Population ◽  
Tympanic Membrane Perforations ◽  
Primary Surgery ◽  
Clinical Surveillance ◽  
Surgery Rates

Objectives To assess outcomes following tympanoplasty for blast-induced tympanic membrane perforations in a military population. Study Design Case series with chart review. Setting Tertiary care medical centers. Subjects and Methods Military personnel (N = 254) undergoing tympanoplasty for blast-related tympanic membrane perforations sustained between April 2005 and July 2014 were identified from the Expeditionary Medical Encounter Database. Descriptive statistics were obtained regarding demographics, primary and revision surgery success rates, hearing status pre- and postsurgery, and frequency of ossicular reconstruction. Rates of successful perforation closure were assessed against perforation size and character (central vs marginal) and time to surgery. Rates and types of complications were additionally explored. Results There were a total of 352 operations among 254 subjects, with an 82.1% rate of successful closure following primary surgery. For successful primary tympanoplasty, the mean improvement in pure tone average was 11.7 ± 12.1 dB. Ossiculoplasty was performed in 9.1% (32 of 352) of cases. There was no significant relationship between successful perforation closure and perforation size, perforation character, or time between injury and surgery. Cholesteatoma complicated 4.3% (15 of 352) of cases. A significant relationship was identified between risk of cholesteatoma development and increasing perforation size and marginal perforations. Conclusion Tympanoplasty success rates for blast-induced tympanic membrane perforations are lower than for other common injury mechanisms. Due to appreciable rates of postoperative cholesteatoma development, close clinical surveillance is recommended.

Endoscopic Lateral Cartilage Graft Tympanoplasty

2017 ◽  
Vol 157 (4) ◽  
pp. 683-689 ◽  
Author(s):  
Cameron C. Wick ◽  
Demetri Arnaoutakis ◽  
Vivian F. Kaul ◽  
Brandon Isaacson
Keyword(s):  
Tympanic Membrane ◽  
Tertiary Care ◽  
Case Series ◽  
University Hospital ◽  
Long Term Results ◽  
Lateral Cartilage ◽  
Cartilage Graft ◽  
Closure Rate ◽  
Tympanic Membrane Perforations ◽  
The Mean

Objective To describe a novel technique for lateral graft tympanoplasty. Study Design Case series with chart review. Setting Tertiary care university hospital. Subjects and Methods Pediatric and adult patients with tympanic membrane perforations deemed unfavorable for a medial graft technique due to the perforation characteristics or myringitis. Results Between 2014 and 2016, 34 ears from 31 patients underwent a transcanal endoscopic lateral cartilage graft tympanoplasty. The mean age was 24.4 years (range, 6-71 years), and 22 patients (65%) were younger than 18 years. All patients had tympanic membrane perforations. Eighteen patients (53%) had total or near-total perforations, leaving a minimal anterior remnant, and 16 patients (47%) had extensive myringitis. A bisected tragal cartilage-perichondrium shield graft was used in 33 patients (97%). The mean (SD) follow-up length was 9.8 (5.7) months. Initial perforation closure rate was 88.2% (30/34). Three of the persistent perforations underwent a revision endoscopic medial graft tympanoplasty with successful closure, leaving a final closure rate of 97.1% (33/34). Five patients (15%) required topical therapy for postoperative myringitis. Mean (SD) pure-tone average and air-bone gap significantly improved by 11.5 (10.7) dB ( P < .001) and 11.4 (10.6) dB ( P < .001), respectively. Twenty-seven patients (79%) closed their air-bone gap within 20 dB. Conclusion Transcanal endoscopic lateral cartilage graft tympanoplasty is feasible, and initial data support favorable outcomes. Further data are necessary for evaluation of long-term results and efficacy comparisons.

The Joint Facial and Invasive Neck Trauma (J-FAINT) Project, Iraq and Afghanistan: 2011-2016

2017 ◽  
Vol 157 (4) ◽  
pp. 602-607 ◽  
Author(s):  
Alexander Lanigan ◽  
Brentley Lindsey ◽  
Stephen Maturo ◽  
Joseph Brennan ◽  
Adrienne Laury
Keyword(s):  
Soft Tissue ◽  
Tertiary Care ◽  
Case Series ◽  
Soft Tissue Injuries ◽  
Published Data ◽  
Care Hospital ◽  
Neck Injuries ◽  
Facial Fractures ◽  
Tympanic Membrane Perforations ◽  
Tissue Injuries

Objective Define the number and type of facial and penetrating neck injuries sustained in combat operations in Iraq and Afghanistan from 2011 to 2016. Compare recent injury trends to prior years of modern conflict. Study Design Case series with chart review. Setting Tertiary care hospital. Methods The Joint Theater Trauma Registry (JTTR) was queried for facial and neck injuries from Iraq and Afghanistan from June 2011 to May 2016. Injury patterns, severity, and patient demographics were analyzed and compared to previously published data from combat operations during January 2003 to May 2011. Results A total of 5312 discrete facial and neck injuries among 922 service members were identified. There were 3842 soft tissue injuries (72.3%) of the head/neck and 1469 (27.7%) facial fractures. Soft tissue injuries of the face/cheek (31.4%) and neck/larynx/trachea (18.8%) were most common. The most common facial fractures were of the orbit (26.3%) and maxilla/zygoma (25.1%). Injuries per month were highest in 2011 to 2012 and steadily declined through 2016. The percentage of nonbattle injuries trended up over time, ranging from 14.7% to 65%. Concurrent facial/neck soft tissue trauma or fracture was associated with an overall mortality rate of 2.44%. Comparison of our data to that previously published revealed no statistical difference in concurrent mortality (3.5%-2.2%, P = .053); an increase in orbital fractures ( P < .005), facial nerve injury ( P < .0005), and ear/tympanic membrane perforations ( P < .0005); and a decrease in mandible fractures ( P < .005). Conclusion Penetrating neck and facial injuries remain common in modern warfare. Assessing injury characteristics and trends supports continued improvements in battlefield protection and identifies areas requiring further intervention.

scholarly journals Intrauterine condom catheter tamponade in the management of atonic postpartum haemorrhage: a case series from a tertiary care centre in Central India

2017 ◽  
Vol 6 (8) ◽  
pp. 3468 ◽  
Author(s):  
Moushmi B. Parpillewar ◽  
Shalini S. Fusey
Keyword(s):  
Postpartum Haemorrhage ◽  
Tertiary Care ◽  
Balloon Catheter ◽  
Case Series ◽  
Central India ◽  
Success Rates ◽  
Tertiary Care Centre ◽  
Non Invasive ◽  
Surgical Methods ◽  
Condom Catheter

Background: Postpartum haemorrhage (PPH) is the leading cause of maternal mortality worldwide with a prevalence rate of approximately 6% and 50% is due to atonic PPH. According to WHO 2014-  in India 45,000 maternal deaths take place annually and 20-60% are due to postpartum hemorrhage. Various medical and surgical methods are available. Uterine balloon tamponade is one of the methods reported increasingly with good success rates avoiding surgical morbidity.Methods: Prospective data of all women who went into atonic primary PPH after 28 weeks of gestation was collected over a period of one year.Results: Out of the 252 women who had atonic PPH, 23 were inserted with condom balloon catheter after medical management. Success rate was 18/23 (78.2%).Conclusions: Condom catheter is a non-invasive, effective, conservative method of PPH management.  In cases of failure it provides a temporary tamponade effect and time to prepare for other interventions.

Laser Therapy for Refractory Myringitis in Children

2002 ◽  
Vol 127 (3) ◽  
pp. 163-168 ◽  
Author(s):  
Frank P. Fechner ◽  
Michael J. Cunningham ◽  
Roland D. Eavey
Keyword(s):  
Laser Treatment ◽  
Tertiary Care ◽  
Case Series ◽  
Laser Technique ◽  
Retrospective Case ◽  
Tympanic Membrane Perforations ◽  
Specialty Hospital ◽  
Associated Symptoms ◽  
Initial Results

OBJECTIVE: We present the application and initial results of a CO2 laser technique for the treatment of medically refractory chronic granular myringitis (CGM). STUDY DESIGN AND SETTING: Retrospective case series of 15 treated ears in 13 consecutive patients between the ages of 6 and 14 years (median age, 9.0 years) cared for in a tertiary care specialty hospital. RESULTS: Eleven of 15 treated ears had total resolution of CGM and associated symptoms; median follow-up time was 10 months. Three ears were improved, and 1 ear remained unchanged. Three of 5 preoperative tympanic membrane perforations healed after laser treatment; 1 patient developed a postoperative, dry perforation. Hearing was not impaired in any patient tested. CONCLUSION: Preliminary results suggest that CGM, when refractory to medical treatment, can often be treated effectively by a single laser treatment.

scholarly journals Mastoid Reconstruction With Platelet-Rich Plasma and Bone Pate After Canal Wall Down Mastoidectomy: A Preliminary Report

2019 ◽  
pp. 014556131987978 ◽  
Author(s):  
Sherif M. Askar ◽  
Ibrahim M. Saber ◽  
Mohammad Omar
Keyword(s):  
Tympanic Membrane ◽  
Cortical Bone ◽  
Platelet Rich Plasma ◽  
Case Series ◽  
Stressful Events ◽  
Mastoid Cavity ◽  
Canal Wall ◽  
Tympanic Membrane Perforations ◽  
Canal Wall Down ◽  
Canal Wall Down Mastoidectomy

Objectives: Mastoid reconstruction principle had been described to overcome problems of chronic discharging cavity. Different materials were used; nonbiologic materials seem to be less preferred. Platelet-rich plasma (PRP) could promote the regeneration of mineralized tissues. In this work, the authors present a simple and easy technique for mastoid reconstruction with PRP and cortical bone pate. Methods: The study design is a case series. Patients had mastoid reconstruction after canal wall down mastoidectomy using PRP and cortical bone pate. Results: This study included 21 patients: 9 males, and 12 females. Sixteen patients had left side disease. All surgical procedures were conducted smoothly within 90 to 135 minutes with no stressful events had been reported. At 12 to 16 months of follow-up, external canal stenosis and mastoid fistulas were not reported. Good healing of the tympanic membrane was seen in 18 patients. No radiological signs suggestive of recurrence were detected and the reconstructed mastoid cavity was smooth and well aerated. Residual tympanic membrane perforations were detected in 3 patients. Conclusion: Autologous materials (PRP and bone pate pate) after canal wall down mastoidectomy appear to be a reliable and effective choice for mastoid reconstruction.

A comparative study of endoscopic cartilage myringoplasty used to treat wet and dry ears with mucosal-type chronic otitis media

2020 ◽  
Vol 134 (9) ◽  
pp. 773-778
Author(s):  
Z Lou ◽  
X Li
Keyword(s):  
Comparative Study ◽  
Success Rate ◽  
Tympanic Membrane ◽  
Otitis Media ◽  
Chronic Otitis Media ◽  
Success Rates ◽  
Hearing Gain ◽  
Tympanic Membrane Perforations ◽  
The Difference ◽  
Graft Success

AbstractObjectiveThe outcomes of dry and wet ears were compared following endoscopic cartilage myringoplasty performed to treat chronic tympanic membrane perforations in patients with mucosal chronic otitis media.MethodsPatients with chronic perforations, and with mucosal chronic otitis media with or without discharge, were recruited; all underwent endoscopic cartilage myringoplasty. The graft success rate and hearing gain were evaluated at six months post-operatively.ResultsThe graft success rates were 85.9 per cent (67 out of 78) in dry ears and 86.2 per cent (25 out of 29) in wet ears; the difference was not significant (p = 0.583). Among the 29 wet ears, the graft success rates were 100 per cent in 11 ears with mucoid discharge and 77.8 per cent in the 18 patients with mucopurulent otorrhoea.ConclusionThe wet or dry status of ears in patients with chronic perforations with mucosal chronic otitis media did not affect graft success rate or hearing gain after endoscopic cartilage myringoplasty. However, ears with mucopurulent discharge were associated with increased failure rates and graft collapse, whereas ears with mucoid discharge were associated with higher graft success rates.

Endoscopic triple-C tympanoplasty: an alternative approach to anteriorly located tympanic membrane repair

2018 ◽  
Vol 132 (11) ◽  
pp. 1007-1009 ◽  
Author(s):  
H Demirhan ◽  
Ö Yiğit ◽  
B Hamit ◽  
M Çakır
Keyword(s):  
Success Rate ◽  
Tympanic Membrane ◽  
Operating Time ◽  
Case Series ◽  
Membrane Repair ◽  
Anterior Portion ◽  
Tympanic Membrane Perforations ◽  
Alternative Method ◽  
Graft Success

AbstractObjectiveAnteriorly located tympanic membrane perforations can negatively affect surgical success rates. This study aimed to present, using our case series results, endoscopic triple-C (composite chondroperichondrial clip) tympanoplasty as an alternative method in the repair of tympanic membrane anterior quadrant perforations.MethodsThis study included patients with a perforation sized greater than 3 mm, who had an anterior quadrant dominant perforation where the anterior portion could not be seen during microscopic examination; all underwent endoscopic triple-C tympanoplasty.ResultsOperating time was 30–79 minutes (mean, 46.6 minutes). The post-operative graft success rate at six months was 92 per cent (23 out of 25). Mean post-operative follow-up duration was 21.5 ± 7.3 months (range, 11–40 months), and no intratympanic cholesteatoma was observed.ConclusionEndoscopic triple-C tympanoplasty is a comfortable, minimally invasive alternative method to repair anterior tympanic membrane perforations. The graft success rate and the degree of recovery from hearing loss were in accordance with the literature. However, more reliable results may be obtained in a larger series with longer follow-up times.

scholarly journals A comparative study of endoscopic and microscopic myringoplasty in a rural tertiary care teaching hospital

2020 ◽  
Vol 6 (2) ◽  
pp. 321
Author(s):  
Viswanathan Kavathur ◽  
Vineeth Abraham Anchery
Keyword(s):  
Tympanic Membrane ◽  
Statistical Significance ◽  
Tertiary Care ◽  
Routine Activity ◽  
P Value ◽  
Failure Rates ◽  
Success Rates ◽  
Fascia Graft ◽  
Significant Difference ◽  
Endoscopic Myringoplasty

<p class="abstract"><strong>Background:</strong> Myringoplasty is the procedure done to repair the tympanic membrane perforation. In this study we aimed to compare the results of endoscopic myringoplasty and microscopic tympanoplasty.</p><p class="abstract"><strong>Methods:</strong> A total of 50 patients with central perforation of tympanic membrane and dry ear of minimum 6 months were divided into two groups of 25 each. The even serial numbers were subjected to microscopic myringoplasty through post aural route and odd serial numbers were subjected to endoscopic myringoplasty done through endomeatal route. Both the procedures were done under general anaesthesia. Dried temporalis fascia graft was used and follow up till 1 year post op. Air-bone gap closure, average time taken for surgery, success and failure rates, scar evaluation by doctor and patient along with postoperative return to routine activity were compared. The p value was calculated to find out statistical significance.  </p><p class="abstract"><strong>Results:</strong> Post operatively the average air-bone gap reduced to 12.6 dB in endoscopic group and 14.28 dB in microscopic group. There was no statistical significant difference in the time taken for both the procedures. There was significant difference in the assessment of postoperative scar and number of days taken for return to routine activity. The success and failure rates of both the procedures were also found to be comparable.</p><p><strong>Conclusions:</strong> Our study showed that the success rates and average time taken for the procedures were the same for both the techniques but a better cosmetic appeal and considerably fewer days for return to routine activity by the patients who underwent endoscopic procedure.</p>

Role of mitomycin C in reducing keloid recurrence: patient series and literature review

2010 ◽  
Vol 125 (3) ◽  
pp. 297-300 ◽  
Author(s):  
M Gupta ◽  
T Narang
Keyword(s):  
Wound Healing ◽  
Mitomycin C ◽  
Controlled Trial ◽  
Tertiary Care ◽  
Case Series ◽  
Disease Process ◽  
Success Rates ◽  
Ear Piercing ◽  
Randomised Controlled

AbstractObjective:To study the role of mitomycin C in reducing keloid recurrence.Study design:Prospective, randomised, controlled trial.Setting:Tertiary care referral centre.Patients:Case series of 20 patients presenting with 26 pinna swellings, mostly following ear piercing.Interventions:We used the technique of surgical shave excision combined with topical application of mitomycin C and secondary wound healing, in all 26 pinnae.Results:Patients were followed up six to 24 months post-operatively. No recurrences were noted during this period.Conclusion:Keloids are fibrotic lesions resulting from abnormal wound healing. The uncontrolled proliferation of normal tissue healing processes results in scarring that enlarges well beyond the original wound margins. Successful treatment of keloids remains a challenge because this disease process has a high propensity for recurrence. Various therapies have previously been reported, and success rates are highly variable. We believe that shave excision followed by topical mitomycin C application is a promising treatment option for the management of pinna keloids.

Sign in / Sign up

Export Citation Format

Share Document