scholarly journals Blood clots affect the response of tympanic membrane perforations to gelfoam grafting after ventilation tube insertion

2021 ◽  
Vol 50 (1) ◽  
Author(s):  
Zhengcai Lou
Keyword(s):  
Tympanic Membrane ◽  
Otitis Media With Effusion ◽  
Chronic Otitis Media ◽  
Tympanic Membrane Perforation ◽  
Ventilation Tube ◽  
Tube Insertion ◽  
Closure Rate ◽  
Surgical Closure ◽  
Tympanic Membrane Perforations ◽  
Temporal Fascia

AbstractChronic tympanic membrane (TM) perforation associated with ventilation tube (VT) insertion was commonly encountered in pediatric patients with chronic otitis media with effusion (COME) treatment and eustachian tube dysfunction. The persistent perforation require surgical closure by myringoplasty. Song JS et al. recently a paper entitled: “Evaluating short and long term outcomes following pediatric myringoplasty with gelfoam graft for tympanic membrane perforation following ventilation tube insertion.” In their study, the authors performed gelfoam myringoplasty to repair the perforations following VT insertion in children and compare the successful TM closure rate among different graft materials. The authors believed that gelfoam alone was superior to hyaluronic acid (HA), tragal cartilage (TC), and gelfoam-plus-temporal fascia (TF). The sample size is unbalanced and incommensurable between gelfoam and other graft materials. In addition, a confounding factor was added in the gelfoam group, thereby affected the assessment of TM closure. Thus, the conclusion is not rigorous and scientific.

Myringotomy and ventilation tube insertion: a ten-year follow-up

1997 ◽  
Vol 111 (3) ◽  
pp. 257-261 ◽  
Author(s):  
D. N. Riley ◽  
S. Herberger ◽  
G. McBride ◽  
K. Law
Keyword(s):  
Hearing Loss ◽  
Tympanic Membrane ◽  
Otitis Media With Effusion ◽  
Recurrent Infection ◽  
Tympanic Membrane Perforation ◽  
Significant Loss ◽  
Type I ◽  
Ventilation Tube ◽  
Tube Insertion ◽  
Ventilation Tubes

AbstractEighty children who had myringotomy performed for otitis media with effusion in 1984 were reviewed in 1994. This had involved surgery on 158 ears. Three aspects of ear condition were studied: hearing loss, tympanic membrane perforation, and tympanosclerosis. Hearing losses were present in 13 ears (8.2 per cent), involving 10 children (12.5 per cent), although losses were under 20 dB in seven of these ears (five patients).Of the six ears with losses more than 20 dB (3.8 per cent), in five patients bilateral losses of 30 dB were due to a recurrence of effusions, a large dry posterior perforation was the cause of a 30 dB loss, an infected anterior perforation had caused a 30 dB loss, an ear which had a cholesteatoma, and had a mastoidectomy and ossiculoplasty in 1987, had a 30–40 dB loss, and one ear which had a Type I tympanoplasty in 1994 had a 50 dB loss. Therefore in only three ears (1.9 per cent) could hearing loss be associated directly with myringotomy and ventilation tube insertion.Perforations had persisted unilaterally in seven patients, three having had tympanoplasties. Of the remaining perforated tympanic membranes, two were free of symptoms, one had only a slight hearing loss, and one had a more significant loss with recurrent infection.Tympanosclerosis was only found in those ears which had ventilation tubes inserted (and not those which had myringotomy only), occurring in 48 ears (31 per cent, or 39 per cent of those which had a ventilation tube inserted).There was no link between tympanosclerosis and hearing loss. The site of tympanosclerosis was not restricted to the site of myringotomy, and in many cases was present only in other areas of the tympanic membrane. There was a tendency for more extensive tympanosclerosis to occur in those ears which had more ventilation tube insertions. The risk of perforation in particular lends support to a policy of ‘watchful waiting’.

Fat graft myringoplasty in children – a safe and successful day-stay procedure

1997 ◽  
Vol 111 (2) ◽  
pp. 106-108 ◽  
Author(s):  
R. B. Mitchell ◽  
Kevin D. Pereira ◽  
Rande H. Lazar
Keyword(s):  
Tympanic Membrane ◽  
Otitis Media With Effusion ◽  
Tympanic Membrane Perforation ◽  
Successful Outcome ◽  
Fat Graft ◽  
Graft Material ◽  
Surgical Closure ◽  
Tympanic Membrane Perforations ◽  
Membrane Perforation ◽  
Ventilation Tubes

AbstractThe surgical closure of dry tympanic membrane perforations in children remains a controversial issue due to conflicting opinions on the appropriate technique, graft material and success rate. We present a review of 342 children who underwent fat graft myringoplasty as a day-stay procedure over a six-year period. Successful closure of the tympanic membrane perforation was achieved in 92 per cent of ears. Subsequent recurrent otitis media with effusion required insertion of ventilation tubes in 12 per cent. No relationship was observed between the age of the child and a successful outcome. We conclude that day-stay fat graft myringoplasty is a safe and successful procedure which results in a dry and safe ear in the majority of children.

Effect of tympanic membrane perforation on middle-ear sound transmission

2009 ◽  
Vol 123 (S31) ◽  
pp. 81-89 ◽  
Author(s):  
Y Matsuda ◽  
T Kurita ◽  
Y Ueda ◽  
S Ito ◽  
T Nakashima
Keyword(s):  
Image Analysis ◽  
Tympanic Membrane ◽  
Chronic Otitis Media ◽  
Tympanic Membrane Perforation ◽  
Conduction Disturbance ◽  
Low Frequencies ◽  
Tympanic Membrane Perforations ◽  
Precise Evaluation ◽  
Membrane Perforation ◽  
Sound Conduction

AbstractTympanic membrane perforation causes a sound conduction disturbance, and the size of this conduction disturbance is proportional to the perforation area. However, precise evaluation of perforation size is difficult, and there are few detailed reports addressing this issue. Furthermore, such evaluation becomes more difficult for irregularly shaped perforations. This study conducted a quantitative evaluation of tympanic membrane perforations, using image analysis equipment.A significant correlation was found between the degree of sound conduction disturbance and the perforation area; this correlation was greater at low frequencies following a traumatic perforation. The conductive disturbance associated with chronic otitis media was significantly greater at low frequencies. Circular perforations caused only minor conduction disturbance. Perforations in the anteroinferior quadrant were associated with greater conduction disturbance. Traumatic spindle-shaped perforations and malleolar perforations were associated with greater conduction disturbance.

EVALUATING THE RESULTS OF TREATMENT FOR OTITIS MEDIA WITH EFFUSION BY VENTILATION TUBE INSERTION

2016 ◽  
pp. 81-86
Author(s):  
Phuoc Minh Hoang ◽  
Thanh Thai Le
Keyword(s):  
Hearing Loss ◽  
Tympanic Membrane ◽  
Otitis Media ◽  
Otitis Media With Effusion ◽  
Clinical Intervention ◽  
Normal Function ◽  
Common Disease ◽  
Age Group ◽  
Ventilation Tube ◽  
Tube Insertion

Background: Otitis media with effusion (OME) is a common disease especially in children. Objective: To study clinical, tympanometry, audiometry and the results of ventilation tube insertion. Materials and methods: Prospective study with clinical intervention in 114 ears of 76 patients with OME. Results: The most common age group was ≤ 6 years of age (39.5%). Common symptoms in ≤6 years of age group are nasal obstruction (73.3%), rhinorrhea (66.7%); in > 6 years of age group are tinnitus (78.3%), hearing loss (76.1%). Tympanic membrane findings: completed opaque (40.4%), air-fluid level (64.1%), retraction (44.7%), losing cone of light (87.7%). Tympanograme type B was 78.1%. Audiograme was conductive hearing loss with PTA > 20 db (100%). Ventilation tube insertion one or both side associated with or without adenoidectomy. After 6 months of follow-up, postoperative average PTA was 28.4±1.6 dB. Most of cases have dry ear, hearing improvement, tubes on the tympanic membrane. Common complications were otorrhea and extrusion. Conclusion: OME is asymptomatic especially in children. Tympanograme plays a key role in diagnosis. Ventilation tube insertion improves the hearing and restores the normal function of the middle ear.

Myringoplasty for the anterior perforation: experience with the Kerr flap

1992 ◽  
Vol 106 (1) ◽  
pp. 14-16 ◽  
Author(s):  
J. F. Sharp ◽  
T. F. Terzis ◽  
J. Robinson
Keyword(s):  
Tympanic Membrane ◽  
Graft Failure ◽  
Tympanic Membrane Perforation ◽  
Confidence Limits ◽  
Closure Rate ◽  
Surgical Closure ◽  
Membrane Perforation ◽  
Anterior Support ◽  
Threshold Gain ◽  
Anterior Perforation

AbstractSurgical closure of the anteriorly located tympanic membrane perforation can present a problem. The lack of anterior support for the graft frequently leads to graft failure if an underlay method is used whereas anterior blunting is a complication of onlay techniques in this situation. The experience with the Kerr flap, an underlay graft fashioned to include a tab of fascia which is placed laterally under the annulus and the anterior meatal skin, is presented. This method gave a 97.5 per cent closure rate with no cases of anterior marginal blunting and a mean auditory threshold gain of 8.5 dB (95 per cent confidence limits 5 to 11.9 dB, P<O.O1) was achieved at the frequencies tested. The use of the Kerr flap is recommended when repairing the anteriorly placed tympanic membrane perforation

scholarly journals A STUDY ON CORRELATION OF SIZE AND SITE OF TYMPANIC MEMBRANE PERFORATION WITH DEGREE OF CONDUCTIVE HEARING LOSS IN CHRONIC OTITIS MEDIA

2021 ◽  
Vol VOLUME 9 (ISSUE 1) ◽  
pp. 19-23
Author(s):  
M Lavanya
Keyword(s):  
Hearing Loss ◽  
Tympanic Membrane ◽  
Conductive Hearing Loss ◽  
Chronic Otitis Media ◽  
Tympanic Membrane Perforation ◽  
Tympanic Membrane Perforations ◽  
Posterior Quadrant ◽  
Membrane Perforation ◽  
Duration Of Disease ◽  
Conductive Hearing

Background: Tympanic membrane perforations are common cause of hearing loss. This study was designed to analyze the relation between tympanic membrane perforation and conductive hearing loss. Materials and Methods: In this prospective study, patients with dry tympanic membrane perforations of safe type were included. The patients were divided into groups in according to size, site and duration of perforation. Based on the inclusion and exclusion criteria a total of 100 patients were included in this study. All the patients clinical data was analyzed statistically using paired t-test. Results:Hearing loss increased as the size of perforation increased. Posterior quadrant perforations were associated with more hearing loss as compared to anterior quadrant perforations. Also duration of disease was in linear relation with mean hearingloss. Conclusions: The degree of conductive hearing loss as a result of tympanic membrane perforation would be expected with the size, site and duration of perforation. Keywords: Tympanic membrane, Conductive hearing loss, Perforation, hearing loss, posterior quadrant, ear.

scholarly journals Long-term Outcome of the Management of Otitis Media with Effusion in Children with and Without Cleft Palate Using the House-brand Polyethylene Ventilation Tube Insertion

2021 ◽  
Vol 73 ◽  
pp. 245-251
Author(s):  
Kitirat Ungkanont ◽  
Alisa Tabthong ◽  
Chulaluk Komoltri ◽  
Amornrut Leelaporn ◽  
Vannipa Vathanophas ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Tympanic Membrane ◽  
Otitis Media ◽  
Otitis Media With Effusion ◽  
Ventilation Tube ◽  
Tube Insertion ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Hearing Outcome

Objective: To study the long-term outcome of otitis media with effusion in children with and without cleft palate treated with the same protocol of ventilation tube insertion. Materials and Methods: A retrospective cohort study was conducted in eighty-five children with cleft palate and 80 children without cleft palate who had otitis media with effusion and had follow-up between 2001 and 2019. Both groups were treated with ventilation tube insertion for longstanding middle ear effusion more than 90 days. The main outcome was the cumulative incidence of surgical management, time of the indwelling ventilation tubes, conditions of the tympanic membrane, and the hearing outcome. Results: At 24 months old, 63.5% of children with cleft palate and 11.3% of children without cleft palate had their first ventilation tube insertion. Repeated surgery was done in 81.2% of children with cleft palate and 50% of children without cleft palate (p < 0.001). The median duration of the indwelling tube was 11.3 months in the children with cleft palate and 12.4 months in the non-cleft children (p = 0.82). At the end of the study, 63.7% of children without cleft palate and 43.5% of children with cleft palate had normal tympanic membrane (p = 0.009). The hearing outcomes of children with and without cleft palate were 20.7 dB and 19.3 dB, respectively. Conclusion: Children with and without cleft palate were managed under the same guideline and the hearing outcome was favorable in both groups.

Tympanic Membrane Perforations and Tympanostomy Tubes

1994 ◽  
Vol 103 (5_suppl) ◽  
pp. 27-30 ◽  
Author(s):  
Sam Levine ◽  
Kathleen Daly ◽  
G. Scott Giebink
Keyword(s):  
Tympanic Membrane ◽  
Otitis Media ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Chronic Otitis Media ◽  
Tympanic Membrane Perforations ◽  
Tympanostomy Tubes ◽  
Preoperative Factor ◽  
Middle Ear Disease

Tympanoplasty and tympanostomy tubes were developed at the same time and have dramatically changed the treatment of chronic middle ear disease. One hundred forty-nine children who had tubes inserted between ages 6 months and 8 years for chronic otitis media with effusion have been prospectively followed up for an average of 4 years. Fourteen percent developed tympanic membrane perforations. No preoperative factor completely predicted the development of perforation. a majority of the perforations closed spontaneously. Three ears had noncontiguous observations of perforations during follow-up. The implications of these findings are discussed with respect to tympanoplasty.

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