scholarly journals Type 1 tympanoplasty in patients with large perforations: Comparison of temporalis fascia, partial-thickness cartilage, and full-thickness cartilage

2020 ◽  
Vol 48 (8) ◽  
pp. 030006052094514
Author(s):  
Caixia Xing ◽  
Hong Liu ◽  
Guodong Li ◽  
Jianfeng Li ◽  
Xin Li
Keyword(s):  
Type I ◽  
Full Thickness ◽  
Temporalis Fascia ◽  
Hearing Gain ◽  
Partial Thickness ◽  
Significant Difference ◽  
Large Perforation ◽  
Type I Tympanoplasty ◽  
Graft Success ◽  
Materials Used

Objective This study aimed to compare the results of different graft materials in type I tympanoplasty for patients with a large perforation of the tympanic membrane. Methods We performed a retrospective study on 180 patients with type I tympanoplasty. The patients were divided into three groups according to the repair materials used. Age, sex, pre- and postoperative hearing levels, mean air–bone gap, rate of graft success, hearing gain, and the postoperative graft failure rate were evaluated. We continued to follow-up the patients to 1 year after surgery. Results The air conduction threshold was significantly higher before the operation than after the operation in the temporalis fascia, partial-thickness cartilage, and full-thickness cartilage groups. Although the hearing gain in the temporalis fascia group and the partial-thickness cartilage group was higher than that in the full-thickness cartilage group, there was no significant difference in the graft success rate among the groups. Conclusions Temporalis fascia, partial-thickness cartilage, and full-thickness cartilage can be used as appropriate transplantation materials for tympanoplasty type I in patients with a large perforation. Temporalis fascia and partial-thickness cartilage may be best for improvement of hearing.

scholarly journals Effect of Preoperative Mastoid Ventilation on Tympanoplasty Success

2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
Mehmet Metin ◽  
Zeynep Kizilkaya Kaptan ◽  
Sedat Dogan ◽  
Hasmet Yazici ◽  
Cem Bayraktar ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cell Volume ◽  
Type I ◽  
Computed Tomography Images ◽  
Significant Difference ◽  
Computer Environment ◽  
Type I Tympanoplasty ◽  
Graft Success ◽  
The Relationship ◽  
Cell Volumes

Purpose. This study was conducted with the aim of investigating the relationship between mastoid air cell volumes and graft success after tympanoplasty.Material and Methods. This study was performed retrospectively with patients undergoing type I tympanoplasty and antrostomy. A total of 57 patients (20–35.09% female and 37–64.91% male) with a mean age of29.69±SD(range 12–56 years) were included in the study. The patients were invited for a control at the 1st, 3rd, and 12th months, and otoscopic examinations and audiometric tests were performed. The temporal bone computed tomography images were screened with the 4800 Dpi optic resolution scanner and transferred to the computer environment in JPG format in order to calculate the mastoid air cell volume, and the volumes were calculated using the Autocad 2007 program.Results. Although, the graft success was determined to be better in the well-ventilated group, no significant difference could be found between the groups in terms of graft success at the 1st, 3rd, and 12th months(P>0.05). No statistically significant difference could be found between the three groups in terms of the preoperative and postoperative hearing gains(P>0.05).

scholarly journals Can ultrasound suffice for triaging patients requiring surgical correction of rotator cuff tears—a comparative evaluation of ultrasound and magnetic resonance imaging

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Aniket Agarwal ◽  
Kavita Vani ◽  
Anurag Batta ◽  
Kavita Verma ◽  
Shishir Chumber
Keyword(s):  
Rotator Cuff ◽  
Biceps Tendon ◽  
Surgical Correction ◽  
Statistical Testing ◽  
Rotator Cuff Tears ◽  
Full Thickness ◽  
Partial Thickness ◽  
Linear Probe ◽  
Significant Difference ◽  
Sensitivity Specificity

Abstract Background Objectives: To comparatively evaluate the role of ultrasound and MRI in rotator cuff and biceps tendon pathologies and to establish ultrasound as a consistently reproducible, quick and accurate primary investigation modality sufficient to triage patients requiring surgical correction of full thickness rotator cuff tears. Methods: Fifty patients, clinically suspected to have rotator cuff and/or biceps tendon pathologies, with no contraindications to MRI, were evaluated by US and MRI, in a prospective cross-sectional observational study. US was done with high-frequency linear probe, and MRI was done on a 1.5-T scanner using T1 oblique sagittal, proton density (PD)/T2 fat-suppressed (FS) oblique sagittal, T1 axial, PD/T2 FS axial, T1 oblique coronal, T2 oblique coronal and PD FS oblique coronal sequences. Statistical testing was conducted with the statistical package for the social science system version SPSS 17.0. The sensitivity, specificity, PPV, NPV and accuracy were also calculated to analyze the diagnostic accuracy of US findings correlating with MRI findings. A p value less than 0.05 was taken to indicate a significant difference. Results Mean age was 45 years; 74% patients were males; 77% females and 60% males had tears. Majority of patients with rotator cuff tears were in the sixth decade of life. The frequency of tears was higher among older patients. Fourteen percent of patients had full thickness tears while 64% had partial thickness tears. US was comparable to MRI for detection of full thickness tears with overall sensitivity, specificity, PPV and accuracy of 93.8%, 100%, 100% and 98.2%, respectively (p value < 0.001). For partial thickness tears, US had overall sensitivity, specificity, PPV and accuracy of 75.6%, 82.6%, 89.5% and 78%, respectively (p value < 0.001), as compared to MRI. Subacromial-subdeltoid bursal effusion and long head of biceps tendon sheath effusion were common associated, though, non-specific findings. Conclusion Ultrasound findings in our study were found to be in significant correlation with findings on MRI in detection of rotator cuff tears. US was equivalent to MRI in detection of full thickness tears and fairly accurate for partial thickness tears. Therefore, US should be considered as the first line of investigation for rotator cuff pathologies.

scholarly journals Factors affecting surgical outcome of myringoplasty

1970 ◽  
Vol 17 (2) ◽  
pp. 82-87 ◽  
Author(s):  
Md Zakaria Sarker ◽  
Mesbauddin Ahmed ◽  
Khabiruddin Patwary ◽  
Rabiul Islam ◽  
Abul Hasnat Joarder
Keyword(s):  
Middle Ear ◽  
Surgical Outcome ◽  
Tympanic Membrane Perforation ◽  
Hearing Improvement ◽  
Factors Affecting ◽  
Hearing Gain ◽  
Graft Take ◽  
Significant Difference ◽  
Large Perforation ◽  
Small Perforation

Introduction: This prospective study was carried out to evaluate the factors that affect the graft take rate as well as hearing improvement after myringoplasty. Method: In this study 60 patients were divided into several groups based on 4 factors like size of perforation (small, medium and large), site of perforation (anterior central, posterior central and central malleolar), Condition of the middle ear (dry & wet) and surgical approach (post auricular and transcanal). Surgical outcome of myringoplasty was measured on the basis of graft take rate and post operative hearing improvement. Results: Size of the perforation affects the graft take rate and post operative hearing gain. Post operative closure of air-bone gap was 10.45 dB, 19.21 dB and 18.86 dB in small, medium and large perforation respectively. Hearing gain was greater after closure of large perforation than the smaller one. Graft take rate was 100%, 82% and 72.73% in small, medium and large perforation respectively. Graft take rate was greater in small perforation than other. Site of perforation also affects surgical outcome after myringoplasty. Graft take rate in anterior central, posterior central and central malleolar perforation was 66.67%, 82.25% and 83.79% respectively. Graft take rate was higher in central malleolar perforation than anterior central perforation. Post operative air-bone gap closure after myringoplasty was 15.31 dB, 12.38 dB and 20.89 dB in anterior central, posterior central and central malleolar perforation respectively. Post operative improvement of hearing was greater in central malleolar perforation. Condition of middle ear at the time of operation also affects the surgical outcome. Graft take rate was 89.36% in dry perforation and 53.85% in wet perforation. Graft take rate was greater in dry perforation. Closure of air-bone gap was 18.23 dB and 7.8 dB in dry and wet perforation respectively. Hearing improvement was greater in dry perforation. No significant difference was found in post-aural and transcanal approach. Conclusion: From this study we concluded that site and size of tympanic membrane perforation and condition of middle ear effects surgical outcome after myringoplasty. Key words: Myringoplasty; hearing improvement; graft take rate. DOI: http://dx.doi.org/10.3329/bjo.v17i2.8846 BJO 2011; 17(2): 82-87

scholarly journals A Comparative Study of Endoscopic versus Microscopic Cartilage Type I Tympanoplasty

2019 ◽  
Vol 24 (01) ◽  
pp. e80-e85 ◽  
Author(s):  
Dipesh Shakya ◽  
Arun KC ◽  
Ajit Nepal
Keyword(s):  
Comparative Study ◽  
Success Rate ◽  
Demographic Data ◽  
Operation Time ◽  
Type I ◽  
Success Rates ◽  
Type I Tympanoplasty ◽  
Graft Success ◽  
Retrospective Comparative Study ◽  
Endoscopic Tympanoplasty

Abstract Introduction The use of endoscope is rapidly increasing in otological and neuro-otological surgery in the last 2 decades. Middle ear surgeries, including tympanoplasty, have increasingly utilized endoscopes as an adjunct to or as a replacement for the operative microscope. Superior visualization and transcanal access to diseases normally managed with a transmastoid approach are touted as advantages with the endoscope. Objectives The present study aimed to compare the outcomes of endoscopic and microscopic cartilage tympanoplasty (Type I) Methods This was a retrospective comparative study of 70 patients (25 males and 45 females) who underwent type I tympanoplasty between March 2015 and April 2016. The subjects were classified into 2 groups: endoscopic tympanoplasty (ET, n = 35), and microscopic tympanoplasty (MT, n = 35). Tragal cartilage was used as a graft and technique used was cartilage shield tympanoplasty in both groups. Demographic data, perforation size of the tympanic membrane at the preoperative state, operation time, hearing outcome, and graft success rate were evaluated. Results The epidemiological profiles, the preoperative hearing status, and the perforation size were similar in both groups. The mean operation time of the MT group (52.63 ± 8.68 minutes) was longer than that of the ET group (48.20 ± 10.37 minutes), but the difference was not statistically significant. The graft success rates 12 weeks postoperatively were 91.42% both in the ET and MT groups, that is, 32/35; and these values were not statistically significantly different. There was a statistically significant improvement in hearing within the groups, both pre- and postoperatively, but there was no difference between the groups. Conclusion Endoscopic tympanoplasty is a minimally invasive surgery with similar graft success rate, comparable hearing outcomes and shorter operative time period as compared to microscopic use.

Clinical advantages of cartilage palisades over temporalis fascia in type I tympanoplasty

2014 ◽  
Vol 41 (5) ◽  
pp. 422-427 ◽  
Author(s):  
Ashish Vashishth ◽  
Neeraj Narayan Mathur ◽  
Santosha Ram Choudhary ◽  
Abhishek Bhardwaj
Keyword(s):  
Type I ◽  
Temporalis Fascia ◽  
Type I Tympanoplasty

Functional results of temporalis fascia versus cartilage tympanoplasty in patients with bilateral chronic otitis media

2011 ◽  
Vol 126 (1) ◽  
pp. 22-25 ◽  
Author(s):  
K Onal ◽  
S Arslanoglu ◽  
M Songu ◽  
U Demiray ◽  
I A Demirpehlivan
Keyword(s):  
Standard Deviation ◽  
Otitis Media ◽  
Chronic Otitis Media ◽  
Functional Results ◽  
Type I ◽  
Temporalis Fascia ◽  
Cartilage Tympanoplasty ◽  
The Mean ◽  
Graft Success ◽  
And Cartilage

AbstractObjectives:To compare the functional results of type I tympanoplasty performed with either temporalis fascia or a perichondrium and cartilage island flap, in patients with bilateral chronic otitis media.Method:The study included primary tympanoplasty cases with a subtotal perforation, an intact ossicular chain, a dry ear for at least one month and normal middle-ear mucosa, together with contralateral tympanic membrane perforation. Temporalis fascia tympanoplasty was undertaken in 41 patients, and cartilage tympanoplasty in 39 patients.Results:The graft success rate was 65.9 per cent for the fascia group and 92.3 per cent for the cartilage group. Post-operatively, the mean ± standard deviation air conduction threshold was 28.54 ± 14.20 dB for the fascia group and 22.97 ± 8.37 dB for the cartilage group, while the mean ± standard deviation bone conduction threshold was 11.71 ± 8.50 dB for the fascia group and 7.15 ± 5.56 dB for the cartilage group.Conclusion:In patients with bilateral chronic otitis media, cartilage tympanoplasty seems to provide better hearing results and graft success rates.

scholarly journals A comparative study of preoperative and postoperative hearing after type I tympanoplasty using temporalis fascia graft at Dr. B. R. Ambedkar Medical College, Bengaluru

2020 ◽  
Vol 6 (7) ◽  
pp. 1258
Author(s):  
Muniraju M. ◽  
Smita Hegde
Keyword(s):  
Disease Duration ◽  
Type I ◽  
Temporalis Fascia ◽  
Hearing Gain ◽  
Medical College ◽  
Type 1 Tympanoplasty ◽  
Fascia Graft ◽  
Cortical Mastoidectomy ◽  
A Prospective Study

<p class="abstract"><strong>Background:</strong> The objective of the study was to identify the factors which significantly influence type 1 tympanoplasty success.</p><p class="abstract"><strong>Methods:</strong> A prospective study was performed on 30 patients who underwent type 1 tympanoplasty via underlay technique using temporalis fascia graft from December 2017 to September 2019 in a teaching hospital. Outcome measures were graft uptake rate and hearing gain. The factors assessed were the age and sex, preoperative condition of the ipsilateral and contralateral ears, perforation size, presence of tympanosclerosis, and whether simultaneous cortical mastoidectomy was performed.  </p><p class="abstract"><strong>Results:</strong> None of the factors proved to have a significant influence on tympanic membrane closure or hearing gain.</p><p class="abstract"><strong>Conclusions:</strong> The success rate of a type 1 tympanoplasty is dependent on the skills of the surgeon and the type of graft used. Age, sex, laterality of the disease, duration of dry ear, size of the perforation, presence of tympanosclerosis and simultaneous cortical mastoidectomy have no bearing on hearing gain.</p>

Evaluation and comparison of type I tympanoplasty efficacy and histopathological changes to the tympanic membrane in dry and wet ear: a prospective study

2015 ◽  
Vol 129 (10) ◽  
pp. 945-949 ◽  
Author(s):  
R Shankar ◽  
R S Virk ◽  
K Gupta ◽  
A K Gupta ◽  
A Bal ◽  
...  
Keyword(s):  
Prospective Study ◽  
Success Rate ◽  
Tympanic Membrane ◽  
Histopathological Examination ◽  
Chronic Otitis Media ◽  
Type I ◽  
Significant Difference ◽  
Type I Tympanoplasty ◽  
One Year ◽  
A Prospective Study

AbstractObjective:This study aimed to compare the success rate of type I tympanoplasty in active (wet) and inactive (dry) mucosal chronic otitis media.Methods:A prospective study was performed of 35 patients each with dry ear and wet ear undergoing type I tympanoplasty in the Otolaryngology Department, Postgraduate Institute of Medical Education and Research, India. All patients underwent type I tympanoplasty between January 2010 and June 2011 by the post-auricular approach. Samples of the remnant tympanic membrane were sent for histopathological examination.Results:After a minimum follow up of one year, the success rate was 88.6 per cent for dry ears and 80 per cent for wet ears. Neither the type (p = 0.526) nor the presence (p = 0.324) of discharge influenced the success rate. Histopathological examination of the tympanic membrane margins was performed for 46 patients: of these, 19 showed evidence of vascularity and 27 did not. There was no significant difference in success rate between groups (p = 0.115).Conclusion:The success rate was not influenced by the presence of ear discharge at the time of surgery, and tympanic membrane vascularity did not influence graft uptake.

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