scholarly journals Middle ear reconstruction with a flexible prosthesis

2017 ◽  
Vol 3 (2) ◽  
pp. 143-146 ◽  
Author(s):  
Thomas Stoppe ◽  
Matthias Bornitz ◽  
Nikoloz Lasurashvili ◽  
Kirsten Sauer ◽  
Thomas Zahnert ◽  
...  
Keyword(s):  
Middle Ear ◽  
Healing Process ◽  
Annular Ligament ◽  
Middle Ear Surgery ◽  
Ear Reconstruction ◽  
Ossicular Replacement ◽  
Transmission Quality ◽  
Temporal Bones ◽  
Middle Ear Reconstruction

AbstractThe middle ear plays a crucial role in the quality of hearing. This complex construct performs different tasks like the protection against large air pressure input, the transmission of sound and its adaption to the inner ear impedance. Traumas, erosion by chronic otitis media or cholesteatoma, as well as other degenerative or damaging diseases, are reasons for a necessary reconstruction of specific middle ear structures. The reconstruction of the ossicular chain is very often performed by using rigid ossicular replacement prostheses made out of titanium, ceramics or bone. Tilting and dislocation of these passive implants are some of the known complications after middle ear surgery. They are related to loads at the implant coupling points in response to a tension change in the middle ear. The healing process, scar tension and ventilation problems are possible causes.To increase the sound transmission quality of total reconstructions and safety in case of pressure dependent movement of the tympanic membrane, a novel flexible total ossicular replacement prosthesis (TORP) with a silicone coated ball joint prototype was developed and investigated. Besides measurements of first middle ear transfer functions of temporal bones, the mechanical properties of the flexible TORP were examined with stress relaxation investigations.The novel silicone coated ball and socket joint TORP provides a sound transfer equivalent to the intact human middle ear at normal pressure and negative pressure in the middle ear. Together with the low stiffness values at an anatomically typical deflection of about 500 μm the prevention of a stiffening of the stapes annular ligament could be approved. Thus, improved acoustic transmission quality and reconstruction stability in comparison to common rigid titanium TORP could be determined. Nevertheless, further design improvements should be accomplished. The demonstrated flexible TORP can solve some common problems in middle ear reconstruction.

Audiometric Results of Torp and Porp Middle Ear Reconstruction

1989 ◽  
Vol 98 (6) ◽  
pp. 429-433 ◽  
Author(s):  
I. W. S. Mair ◽  
S. Pedersen ◽  
E. Laukli
Keyword(s):  
Middle Ear ◽  
Hearing Aids ◽  
Functional Results ◽  
Middle Ear Surgery ◽  
Hearing Level ◽  
Ear Reconstruction ◽  
Ossicular Replacement ◽  
Middle Ear Reconstruction ◽  
Air Conduction ◽  
Observation Period

The results of 70 middle ear reconstructions using either total or partial ossicular replacement prostheses are presented, the mean observation period being 45 months. Twenty-seven of the prostheses (39%) were extruded, this occurring as late as 72 months after surgery, and four (6%) were removed at reoperation. The surgical results when assessed by the magnitude of the air-bone gap are comparable to those of other series in the literature. However, postoperative air conduction thresholds remained high, and 23 % of the patients are using hearing aids. The average air-bone gap for the frequencies 0.5, 1, and 2 kHz does not provide information on patients' everyday hearing level, and should no longer be employed as an index for assessing the functional results of middle ear surgery.

Optical coherence tomography of the oval window niche

2009 ◽  
Vol 123 (6) ◽  
pp. 603-608 ◽  
Author(s):  
T Just ◽  
E Lankenau ◽  
G Hüttmann ◽  
H W Pau
Keyword(s):  
Optical Coherence Tomography ◽  
Middle Ear ◽  
Imaging Modality ◽  
Oval Window ◽  
Annular Ligament ◽  
Middle Ear Surgery ◽  
Optical Coherence ◽  
Ear Surgery ◽  
Temporal Bones

AbstractObjective:Optical coherence tomography was used to study the stapes footplate, both in cadaveric temporal bones and during middle-ear surgery.Materials and methods:Optical coherence tomography was conducted on five temporal bone preparations (from two children and three adults) and in eight patients during middle-ear surgery. A specially equipped operating microscope with integrated spectral domain optical coherence tomography apparatus was used for standard middle-ear surgical procedures.Results:This optical coherence tomography investigation enabled in vivo visualisation and documentation of the annular ligament, the different layers of the footplate and the inner-ear structures, both in non-fixed and fixed stapes footplates. In cases of otosclerosis and tympanosclerosis, an inhomogeneous and irregularly thickened footplate was found, in contrast to the appearance of non-fixed footplates. In both fixed and non-fixed footplates, there was a lack of visualisation of the border between the footplate and the otic capsule.Conclusions:Investigation of the relatively new technology of optical coherence tomography indicated that this imaging modality may assist the ear surgeon to assess the oval window niche intra-operatively.

The Bone-Anchored Hearing Aid (BAHA) in Children with Auricular Malformations

1997 ◽  
Vol 76 (4) ◽  
pp. 238-247 ◽  
Author(s):  
Gösta Granström ◽  
Anders Tjellström
Keyword(s):  
Middle Ear ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Adult Population ◽  
Bone Conduction ◽  
Middle Ear Surgery ◽  
Ear Reconstruction ◽  
Skin Reactions ◽  
Bone Anchored Hearing Aid ◽  
Middle Ear Reconstruction

A retrospective study was undertaken to evaluate the outcome of the use of the bone-anchored hearing aid (BAHA) in children. All patients included in the study had bilateral auricular malformations. Previous alternatives had been conventional hearing aids or surgical middle ear reconstruction. Thirty-seven patients under 16 years of age were studied. The most common syndrome in the group was Treacher Collins. Sixteen of the patients had earlier middle ear reconstruction, the results of which did not produce social hearing. Of 40 inserted fixtures to anchor the BAHA, three were lost during the follow-up period because of failed osseointegration. Skin reactions were graded according to a clinical scoring system and were determined to be comparable in number and severity to those of an adult population. All patients in the study considered the BAHA to be superior to earlier bone-conduction devices. It is concluded that the BAHA is an excellent alternative to bone-conduction devices in children with auricular malformations. Middle ear surgery can be postponed until adulthood or abandoned, especially in syndromic patients in whom it is known to be difficult and unpredictable.

Problems in Alloplastic Middle Ear Reconstruction

1992 ◽  
Vol 112 (2) ◽  
pp. 322-327 ◽  
Author(s):  
A. W. Blayney ◽  
K. R. Williams ◽  
J.-P. Erre ◽  
T. H. J. Lesser ◽  
M. Portmann
Keyword(s):  
Middle Ear ◽  
Ear Reconstruction ◽  
Middle Ear Reconstruction

scholarly journals Impact of depressive disorders on quality of life after middle ear surgery in patients with chronic otitis media

2020 ◽  
Author(s):  
Susen Lailach ◽  
Theresa Langanke ◽  
Thomas Zahnert ◽  
Susan Garthus-Niegel ◽  
Marcus Neudert
Keyword(s):  
Quality Of Life ◽  
Depressive Symptoms ◽  
Otitis Media ◽  
Middle Ear ◽  
Short Form ◽  
Chronic Otitis Media ◽  
Middle Ear Surgery ◽  
Ear Surgery ◽  
Sf 36

Abstract Purpose The aim of this study was to determine whether preoperative depressive symptoms influence health-related quality of life (HRQOL) after middle ear surgery in patients with chronic otitis media (COM). Methods This prospective clinical case study was conducted at a tertiary referral center. All 102 patients who had undergone middle ear surgery for COM were assessed clinically and by audiometric testing (pure tone audiometry) in pre- and postoperative settings. Disease-specific HRQOL was assessed by the validated chronic otitis media outcome test 15 (COMOT-15) and the Zurich chronic middle ear inventory (ZCMEI-21). General HRQOL was measured using the short form 36 (SF-36). Depressive symptoms were assessed using the patient health questionnaire (PHQ-D). The Charlson comorbidity index (CCI) was used to classify comorbidities. The middle ear status was determined using the ossiculoplasty outcome parameter staging (OOPS) index. Results After middle ear surgery, the total COMOT-15 and ZCMEI-21 scores improved significantly (p < 0.001). General HRQOL (total SF-36 score) was unaffected by surgery (p < 0.05). Patients without elevated depressive symptoms had significantly better total scores for the COMOT-15 (p < 0.01), ZCMEI-21 (p < 0.001), and for SF-36 (p < 0.001) postoperatively. The results of the multiple regression analyses show that, after adjusting for the OOPS, CCI, and hearing improvement, preoperative depressiveness was significantly associated with worse postoperative COMOT-15 and ZCMEI-21 outcome scores (β = 0.425 and β = 0.362, p < 0.001). Conclusion Preoperative depressiveness was an essential predictive factor for HRQOL in patients with COM. This should be considered during patient selection to provide more suitable preoperative counseling.

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