Evaluation of graft taking and hearing threshold after tympanoplasty

Background: Tympanoplasty is one of the surgical procedures mainly aimed to restoring the hearing loss and eradication of chronic middle ear diseases. Aim: To evaluate the hearing threshold preoperatively and postoperatively in patients who were subjected to tympanoplasty procedures. Patients and methods: This prospective study included 27 patients attended ENT department of AL-Yarmouk Teaching Hospital ,from February -2017 to October- 2018 , The age of patients between (10-60 years) of both gender . they presented with hearing loss as a result of chronic suppurative otitis media. After full assessment and proper preparation , They underwent Tympanoplasty procedure through post auricular incision using underlay temporalis fascia graft , The type of Tympanoplasty procedure was planned according to the status of the middle ear and ossicular chain .To eradicate disease from both the mastoid and middle ear cavity procedure and could be combined with mastoidectomy, Patients were evaluated preoperatively and followed up for 6 months postoperatively, pure Tone Audiogram was done to asses the change in hearing. Results: The study included 27 patients, (74.06%) of them were the age group between (21–40) years , the least number of patients were younger than 21 years and older than 51 years , 16 females (59.3%) and 11 males (40.7%) , Patients were classified according to tympanoplasty procedures into five groups : (Group1):10 patients (37.03%) underwent only Type I tympanoplasty. (Group2): 11 patients (40.7%) Type I with Cortical Mastoidectomy. (Group3): 2 patients (7.4%) Type II with Cortical Mastoidectomy. (Group4): 3 patients (11.1%) Type III with Cortical Mastoidectomy (Group5): one patient (3.7%) Type III with Modified Radical Mastoidectomy. They had a mean Air-Bone gap improvements were (9.66 dB), (17.4 dB), (13.2 dB), (9.60 dB) and (5.54 dB) respectively. The overall graft success rate was (92.5%). Conclusion: Significant improvement was noted in the subjective symptom of hearing loss following the tympanoplasty procedures. The mean Air-Bone gap closure was greatest for type I with cortical mastoidectomy; followed by type II with Cortical Mastoidectomy, type I alone and then type III with Cortical Mastoidectomy. Modified radical mastoidectomy was associated with the least hearing improvement as otherwise.

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Evaluating Success of Surgery in Mucosal and Squamosal Chronic Otitis Media: A Retrospective Study

Bengal Journal of Otolaryngology and Head Neck Surgery ◽

10.47210/bjohns.2018.v26i2.167 ◽

2018 ◽

Vol 26 (2) ◽

pp. 99-104

Author(s):

Nilank Saroha ◽

Nitin Tomar

Keyword(s):

Hearing Loss ◽

Retrospective Study ◽

Otitis Media ◽

Chronic Otitis Media ◽

Type I ◽

Radical Mastoidectomy ◽

Type Iii ◽

Mucosal Disease ◽

Modified Radical Mastoidectomy ◽

Air Conduction

This study attempted to document success of surgery postoperatively, be it type I tympanoplasty or type III tympanoplasty with or without modified radical mastoidectomy. Materials and Methods This retrospective study involved 90 patients of Chronic Otitis Media who underwent surgery in the Department of Otorhinolaryngology in a tertiary care centre in the state of Uttar Pradesh. Results At 3 week postoperatively, 83 patients (92.22%) had successful uptake of graft. Overall successful graft uptake was reduced to 87.78% (79 patients) after 3 months. Postoperatively, after 3 months, 90% of the patients (n=81) reported improvement in hearing. Preoperatively, 89.71 % patients of mucosal disease and 63.64% of squamosal disease had 21-40 dB hearing loss. Postoperatively, 88.24% patients with mucosal disease and 63.64% of squamosal disease had no conductive hearing loss. There was statistically significant gain in air conduction postoperatively. Average improvement in AB gap was also notably significant postoperatively in both subgroups. Conclusion Both type I and type III tympanoplasty give excellent response in term of graft uptake and postoperative hearing. Abbreviations: COM-Chronic Otitis Media, AC-Air Conduction, AB-Air Bone, TP-Tympanoplasty, MRM-Modified Radical Mastoidectomy

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Clinical study on type 1 tympanoplasty: anatomical and functional outcomes

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20193675 ◽

2019 ◽

Vol 5 (5) ◽

pp. 1197

Author(s):

A. Kusumanjali ◽

V. Krishna Chaitanya

Keyword(s):

Success Rate ◽

Middle Ear ◽

Pure Tone Audiometry ◽

Type I ◽

Middle Ear Mucosa ◽

Suppurative Otitis Media ◽

Type 1 Tympanoplasty ◽

Cortical Mastoidectomy ◽

Type I Tympanoplasty

Background: Tympanoplasty is operation to eradicate disease in middle ear and to reconstruct the hearing mechanism. Present study aims at assessment of success rate and hearing improvement following type I tympanoplasty.Methods: 50 patients with chronic suppurative otitis media, tubotympanic type attending department of ENT are taken up for study screened with clinical history and examination. Type I tympanoplasty performed in all patients. Simple mastoidectomy with type I tympanoplasty performed in 8 patients. Patients are followed after surgery on 7th, 14th days and end of 3 months. Anatomical outcome is assessed in terms of graft uptake. Pure tone audiometry was performed at 3 months and air bone gap is considered to assess outcome. Results: Out of 50 cases, 43 cases (86%) showed good success rate by means of graft uptake. Remaining 5 cases showed residual perforation and 3 cases medialization of graft. In 42 patients type1 tympanoplasty is performed, success rate was 80.95% and in cases with where type1 tympanoplasty with cortical Mastoidectomy was done and the success rate was 100%. In the present study mean pre op AB gap was 27.65 dB and mean post op AB gap was 19.07 dB. The difference between the two, i.e., AB gap closure was 8.52 dB which is statistically significant.Conclusions: Type-1 tympanoplasty using temporalis fascia with underlay technique have good surgical success rate with excellent improvement of hearing. Cortical mastoidectomy can be planned depending on the status of the middle ear mucosa.

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Robot-Assisted Middle Ear Endoscopic Surgery: Preliminary Results on 37 Patients

Frontiers in Surgery ◽

10.3389/fsurg.2021.740935 ◽

2021 ◽

Vol 8 ◽

Author(s):

Marine Veleur ◽

Ghizlene Lahlou ◽

Renato Torres ◽

Hannah Daoudi ◽

Isabelle Mosnier ◽

...

Keyword(s):

Middle Ear ◽

Bone Conduction ◽

Case Series ◽

Petrous Apex ◽

Middle Ear Surgery ◽

Type I ◽

Type Ii ◽

Robot Assisted ◽

Ear Surgery ◽

Type Iii

Background: Endoscopy during middle ear surgery is advantageous for better exploration of middle ear structures. However, using an endoscope has some weaknesses as surgical gestures are performed with one hand. This may trouble surgeons accustomed to using two-handed surgery, and may affect accuracy. A robot-based holder may combine the benefits from endoscopic exposure with a two-handed technique. The purpose of this study was to assess the safety and value of an endoscope held by a teleoperated system.Patients and Methods: A case series of 37 consecutive patients operated using endoscopic exposure with robot-based assistance was analyzed retrospectively. The RobOtol® system (Collin, France) was teleoperated as an endoscope holder in combination with a microscope. The following data were collected: patient characteristics, etiology, procedure type, complications, mean air and bone conduction thresholds, and speech performance at 3 months postoperatively. Patients had type I (myringoplasty), II (partial ossiculoplasty), and III (total ossiculoplasty) tympanoplasties in 15, 14, and 4 cases, respectively. Three patients had partial petrosectomies for cholesteatomas extending to the petrous apex. Finally, one case underwent resection of a tympanic paraganglioma. Ambulatory procedures were performed in 25 of the 37 patients (68%).Results: Complete healing with no perforation of the tympanic membrane was noted postoperatively in all patients. No complications relating to robotic manipulation occurred during surgery or postoperatively. The mean air conduction gain was 3.8 ± 12.6 dB for type I (n = 15), 7.9 ± 11.4 dB for type II (n = 14), and −0.9 ± 10.8 for type III tympanoplasties (n = 4), and the postoperative air-bone conduction gap was 13.8 ± 13.3 dB for type I, 19.7 ± 11.7 dB for type II and 31.6 ± 13.0 dB for type III tympanoplasty. They was no relapse of cholesteatoma or paraganglioma during the short follow-up period (<1 year).Conclusion: This study indicates that robot-assisted endoscopy is a safe and trustworthy tool for several categories of middle ear procedures. It combines the benefits of endoscopic exposure with a two-handed technique in middle ear surgery. It can be used as a standalone tool for pathology limited to the middle ear cleft or in combination with a microscope in lesions extending to the mastoid or petrous apex.

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A study of hearing improvement gained after tympanoplasty using various methods in cases of CSOM

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20174682 ◽

2017 ◽

Vol 4 (1) ◽

pp. 107

Author(s):

Faiz Muqtadir ◽

Rahul S.

Keyword(s):

Middle Ear ◽

Chronic Otitis Media ◽

Type I ◽

Medical College ◽

Type Iv ◽

Cortical Mastoidectomy ◽

Modified Radical Mastoidectomy ◽

Common Ailment ◽

Middle Ear Disease ◽

Type I Tympanoplasty

Background: Chronic otitis media (COM), is a common ailment with which patients present to the ENT OPD. In patients with COM, the active infection needs to be controlled following which the definitive line of management is surgery. Tympanoplasty is the surgery performed with the goals of establishing an intact tympanic membrane, eradicating middle ear disease, creating an air-containing middle ear space and restoring the hearing by building a secure connection between the ear drum and the cochlea. Methods: 50 patients presenting with CSOM in ENT OPD at Medical College. Preoperative audiometry was done before tympanoplasty, followed by post-operative audiometry after 3 months. Results: The mean air-bone gap closure was 12.06 dB; with type I tympanoplasty with cortical mastoidectomy giving a maximum mean improvement of 16db. Minimum mean improvement of 1db was seen in type IV with modified radical mastoidectomy. Conclusions: Type I tympanoplasty with cortical mastoidectomy is a far superior method of surgical treatment of CSOM than all other methods.

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Labelling of non-A, non-B hepatitis infected chimpanzee hepatocytes with nuclease-gold conjugates

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100111367 ◽

1984 ◽

Vol 42 ◽

pp. 250-251

Author(s):

G. D. Gagne ◽

M. F. Miller ◽

D. A. Peterson

Keyword(s):

Endoplasmic Reticulum ◽

Experimental Infection ◽

Uranyl Acetate ◽

Type I ◽

Cellular Injury ◽

Type Ii ◽

Tubular Structures ◽

Type Iii ◽

Type Iv ◽

Infected Chimpanzee

Experimental infection of chimpanzees with non-A, non-B hepatitis (NANB) or with delta agent hepatitis results in the appearance of characteristic cytoplasmic alterations in the hepatocytes. These alterations include spongelike inclusions (Type I), attached convoluted membranes (Type II), tubular structures (Type III), and microtubular aggregates (Type IV) (Fig. 1). Type I, II and III structures are, by association, believed to be derived from endoplasmic reticulum and may be morphogenetically related. Type IV structures are generally observed free in the cytoplasm but sometimes in the vicinity of type III structures. It is not known whether these structures are somehow involved in the replication and/or assembly of the putative NANB virus or whether they are simply nonspecific responses to cellular injury. When treated with uranyl acetate, type I, II and III structures stain intensely as if they might contain nucleic acids. If these structures do correspond to intermediates in the replication of a virus, one might expect them to contain DNA or RNA and the present study was undertaken to explore this possibility.

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Perforator preservation technologies (PPT) based on a new neuro-interventional classification in endovascular treatment of perforator involving aneurysms (piANs)

Chinese Neurosurgical Journal ◽

10.1186/s41016-021-00243-3 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Chen Li ◽

Ao-Fei Liu ◽

Han-Cheng Qiu ◽

Xianli Lv ◽

Ji Zhou ◽

...

Keyword(s):

Endovascular Therapy ◽

Saccular Aneurysm ◽

Type I ◽

Type Ii ◽

Fusiform Aneurysm ◽

Type Iii ◽

Perforating Artery ◽

Protection Technology ◽

Perforating Arteries

Abstract Background Treatment of perforator involving aneurysm (piAN) remains a challenge to open and endovascular neurosurgeons. Our aim is to demonstrate a primary outcome of endovascular therapy for piANs with the use of perforator preservation technologies (PPT) based on a new neuro-interventional classification. Methods The piANs were classified into type I: aneurysm really arises from perforating artery, type II: saccular aneurysm involves perforating arteries arising from its neck (IIa) or dome (IIb), and type III: fusiform aneurysm involves perforating artery. Stent protection technology of PPT was applied in type I and III aneurysms, and coil-basket protection technology in type II aneurysms. An immediate outcome of aneurysmal obliteration after treatment was evaluated (satisfactory obliteration: the saccular aneurysm body is densely embolized (I), leaving a gap in the neck (IIa) or dome (IIb) where the perforating artery arising; fusiform aneurysm is repaired and has a smooth inner wall), and successful perforating artery preservation was defined as keeping the good antegrade flow of those perforators on postoperative angiography. The periprocedural complication was closely monitored, and clinical and angiographic follow-ups were performed. Results Six consecutive piANs (2 ruptured and 4 unruptured; 1 type I, 2 type IIa, 2 type IIb, and 1 type III) in 6 patients (aged from 43 to 66 years; 3 males) underwent endovascular therapy between November 2017 and July 2019. The immediate angiography after treatment showed 6 aneurysms obtained satisfactory obliteration, and all of their perforating arteries were successfully preserved. During clinical follow-up of 13–50 months, no ischemic or hemorrhagic event of the brain occurred in the 6 patients, but has one who developed ischemic event in the territory of involving perforators 4 h after operation and completely resolved within 24 h. Follow-up angiography at 3 to 10M showed patency of the parent artery and perforating arteries of treated aneurysms, with no aneurysmal recurrence. Conclusions Our perforator preservation technologies on the basis of the new neuro-interventional classification seem feasible, safe, and effective in protecting involved perforators while occluding aneurysm.

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Intracellular and Extracellular Markers of Lethality in Osteogenesis Imperfecta: A Quantitative Proteomic Approach

International Journal of Molecular Sciences ◽

10.3390/ijms22010429 ◽

2021 ◽

Vol 22 (1) ◽

pp. 429

Author(s):

Luca Bini ◽

Domitille Schvartz ◽

Chiara Carnemolla ◽

Roberta Besio ◽

Nadia Garibaldi ◽

...

Keyword(s):

Osteogenesis Imperfecta ◽

Type I Collagen ◽

Type I ◽

Tandem Mass ◽

Type Ii ◽

Type Iii ◽

Bioinformatic Tools ◽

Proteomic Approach ◽

Fibrillin 1 ◽

Heritable Disorder

Osteogenesis imperfecta (OI) is a heritable disorder that mainly affects the skeleton. The inheritance is mostly autosomal dominant and associated to mutations in one of the two genes, COL1A1 and COL1A2, encoding for the type I collagen α chains. According to more than 1500 described mutation sites and to outcome spanning from very mild cases to perinatal-lethality, OI is characterized by a wide genotype/phenotype heterogeneity. In order to identify common affected molecular-pathways and disease biomarkers in OI probands with different mutations and lethal or surviving phenotypes, primary fibroblasts from dominant OI patients, carrying COL1A1 or COL1A2 defects, were investigated by applying a Tandem Mass Tag labeling-Liquid Chromatography-Tandem Mass Spectrometry (TMT LC-MS/MS) proteomics approach and bioinformatic tools for comparative protein-abundance profiling. While no difference in α1 or α2 abundance was detected among lethal (type II) and not-lethal (type III) OI patients, 17 proteins, with key effects on matrix structure and organization, cell signaling, and cell and tissue development and differentiation, were significantly different between type II and type III OI patients. Among them, some non–collagenous extracellular matrix (ECM) proteins (e.g., decorin and fibrillin-1) and proteins modulating cytoskeleton (e.g., nestin and palladin) directly correlate to the severity of the disease. Their defective presence may define proband-failure in balancing aberrances related to mutant collagen.

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Brachial supporting structure of Spiriferida (Brachiopoda)

Journal of Paleontology ◽

10.1017/jpa.2020.106 ◽

2020 ◽

pp. 1-15

Author(s):

Zhiwei Yuan ◽

Wen Guo ◽

Dan Lyu ◽

Yuanlin Sun

Keyword(s):

Mantle Cavity ◽

Family Type ◽

Type I ◽

Type Ii ◽

Feeding Apparatus ◽

Single Family ◽

Supporting Structure ◽

Type Iii ◽

Type Iv ◽

Evolutionary Lineages

Abstract The filter-feeding organ of some extinct brachiopods is supported by a skeletal apparatus called the brachidium. Although relatively well studied in Atrypida and Athyridida, the brachidial morphology is usually neglected in Spiriferida. To investigate the variations of brachidial morphology in Spiriferida, 65 species belonging to eight superfamilies were analyzed. Based on the presence/absence of the jugal processes and normal/modified primary lamellae of the spiralia, four types of brachidium are recognized. Type-I (with jugal processes) and Type-II (without jugal processes), both having normal primary lamellae, could give rise to each other by losing/re-evolving the jugal processes. Type-III, without jugal processes, originated from Type-II through evolution of the modified lateral-convex primary lamellae, and it subsequently gave rise to Type-IV by evolving the modified medial-convex primary lamellae. The evolution of brachidia within individual evolutionary lineages must be clarified because two or more types can be present within a single family. Type-III and Type-IV are closely associated with the prolongation of the crura, representing innovative modifications of the feeding apparatus in response to possible shift in the position of the mouth towards the anterior, allowing for more efficient feeding on particles entering the mantle cavity from the anterior gape. Meanwhile, the modified primary lamellae adjusted/regulated the feeding currents. The absence of spires in some taxa with Type-IV brachidium might suggest that they developed a similar lophophore to that in some extant brachiopods, which can extend out of the shell.

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Understanding the Evolution and Applications of Intelligent Systems via a Tri-X Intelligence (TI) Model

Processes ◽

10.3390/pr9061080 ◽

2021 ◽

Vol 9 (6) ◽

pp. 1080

Author(s):

Min Zhao ◽

Zhenbo Ning ◽

Baicun Wang ◽

Chen Peng ◽

Xingyu Li ◽

...

Keyword(s):

Intelligent Systems ◽

Intelligent Manufacturing ◽

Type I ◽

Type Ii ◽

Multiple Perspectives ◽

Ternary Interaction ◽

Physical Systems ◽

Type Iii ◽

Dynamic Level ◽

Systematic Scheme

The evolution and application of intelligence have been discussed from perspectives of life, control theory and artificial intelligence. However, there has been no consensus on understanding the evolution of intelligence. In this study, we propose a Tri-X Intelligence (TI) model, aimed at providing a comprehensive perspective to understand complex intelligence and the implementation of intelligent systems. In this work, the essence and evolution of intelligent systems (or system intelligentization) are analyzed and discussed from multiple perspectives and at different stages (Type I, Type II and Type III), based on a Tri-X Intelligence model. Elemental intelligence based on scientific effects (e.g., conscious humans, cyber entities and physical objects) is at the primitive level of intelligence (Type I). Integrated intelligence formed by two-element integration (e.g., human-cyber systems and cyber-physical systems) is at the normal level of intelligence (Type II). Complex intelligence formed by ternary-interaction (e.g., a human-cyber-physical system) is at the dynamic level of intelligence (Type III). Representative cases are analyzed to deepen the understanding of intelligent systems and their future implementation, such as in intelligent manufacturing. This work provides a systematic scheme, and technical supports, to understand and develop intelligent systems.

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Morphological types of spermatheca in Coreidae: bearing on intra-familial classification and tribal-groupings (Hemiptera: Heteroptera)

Zootaxa ◽

10.11646/zootaxa.4834.4.1 ◽

2020 ◽

Vol 4834 (4) ◽

pp. 451-501

Author(s):

DOMINIQUE PLUOT-SIGWALT ◽

PIERRE MOULET

Keyword(s):

Western Hemisphere ◽

Type I ◽

Type Ii ◽

Type Iii ◽

Spermathecal Duct ◽

Eastern Hemisphere ◽

Intermediate Part ◽

Muscular Pump ◽

Familial Classification

The morphology of the spermatheca is described in 109 species of 86 genera representing all four currently recognised subfamilies of Coreidae, covering the undivided Hydarinae, both tribes of Pseudophloeinae, all three tribes of Meropachyinae and 27 of the 32 tribes of Coreinae. Three types of spermatheca are recognised. Type I is bipartite, consisting only of a simple tube differentiated into distal seminal receptacle and proximal spermathecal duct and lacks the intermediate part present in most Pentatomomorpha, in which it serves as muscular pump. Type II is also bipartite but more elaborate in form with the receptacle generally distinctly wider than the duct. Type III is tripartite, with receptacle, duct and an often complex intermediate part. Four subtypes are recognised within type III. Type I is found only in Hydarinae and type II only in Pseudophloeinae. Type III is found in both Coreinae and Meropachyinae. Subtype IIIA (“Coreus-group”) unites many tribes from the Eastern Hemisphere and only one (Spartocerini) from the Western Hemisphere. Subtypes IIIB (“Nematopus-group”) and IIID (“Anisoscelis-group”) are confined to taxa from the Western Hemisphere and subtype IIIC (“Chariesterus-group”) is found in tribes from both hemispheres. The polarity of several characters of the intermediate part and some of the spermathecal duct is evaluated, suggesting autapomorphies or apomorphies potentially relevant to the classification of Coreidae at the sufamilial and tribal levels. Characters of the intermediate part strongly indicate that the separation of Meropachyinae and Coreinae as currently constituted cannot be substantiated. The tribes Anisoscelini, Colpurini, Daladerini and Hyselonotini are heterogeneous, each exhibiting two subtypes of spermatheca, and probably polyphyletic. Two tribes, Cloresmini and Colpurini, requiring further investigation remain unplaced. This study demonstrates the great importance of characters of the spermatheca, in particular its intermediate part, for research into the phylogeny and taxonomy of Pentatomomorpha.

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