A comparative study of hearing outcomes in myringostapediopexy and myringoplatinopexy in our experience

Background: COM causes considerable morbidity with ear discharge, conductive hearing loss and complications. Myringostapediopexy and myringoplationpexyis a surgical procedure which intends improve the hearing and quality of the life.Methods: The study was conducted in the department of ENT, SMVMCH, Puducherry from April 2017 to April 2018. A detailed history taking thorough clinical examination done for these patients. PTA was done before the procedure, post operatively at 3rd month. Hearing improvement analysed using different parameters like type of graft used, hearing gain and graft uptake. The data collected was tabulated and subjected to statistical analysis. Results: Myringostapediopexy better hearing gain than myingoplatinopexy. Myringostapediopexy mean hearing gain 19.53 dB, myringoplatinopexy 12.59 dB.Conclusions: This study compared the hearing outcomes of Myringostapediopexy and myringoplatinopexy with respect to hearing gain. Myringostapediopexy better hearing gain than myringoplatinopexy due to presence of stapes supra-structure.

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A comparative study of the outcomes of temporalis fascia graft versus tragal perichondrium graft in type 1 tympanoplasty in our experience

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20175063 ◽

2017 ◽

Vol 4 (1) ◽

pp. 60

Author(s):

Santhanakrishnan K. ◽

Poornima S. Bhat

Keyword(s):

Hearing Loss ◽

Conductive Hearing Loss ◽

Temporalis Fascia ◽

Hearing Gain ◽

Type 1 Tympanoplasty ◽

Fascia Graft ◽

Significant Difference ◽

Considerable Morbidity ◽

Conductive Hearing

Background: COM causes considerable morbidity with ear discharge, conductive hearing loss and complications. Type 1 tympanoplasty is a surgical procedure which intends improves the hearing and quality of the life. Comparison of the outcomes will help to determine the merits or demerits of a particular graft. Methods: The study was conducted in the department of ENT, SMVMCH, Pondicherry from April 2015 to April 2017. A detailed history taking, thorough clinical examination done for these patients. PTA was done before the procedure, post operatively at 3rd month. Hearing improvement analysed using different parameters like type of graft used, hearing gain, graft uptake; the data collected was tabulated and subjected to statistical analysis. Results: All the patients had COM, mucosal type, with conductive hearing loss of <40 dB. 23 patients underwent type 1 tympanoplasty by underlay technique using temporalis fascia, 19 patients using tragal perichondrium. There was no significant difference in total hearing gain at 3rd month and graft uptake between temporalis fascia and tragal perichondrium. Conclusions: This study compared the outcomes of temporalis fascia and tragal perichondrium graft with respect to hearing gain and graft uptake. Tragal perichondrium graft equally effective as temporalis fascia graft in terms of hearing gain and graft uptake.

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Comparative study between over underlay with classical underlay techniques of tympanoplasty

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20201687 ◽

2020 ◽

Vol 6 (5) ◽

pp. 918

Author(s):

Prashanth Kudure Basavaraj ◽

Manjunatha H. Anandappa ◽

Veena Prabhakaran ◽

Nishtha Sharma ◽

Shreyas Karkala

Keyword(s):

Hearing Loss ◽

Informed Consent ◽

Conductive Hearing Loss ◽

Hearing Threshold ◽

Chronic Otitis Media ◽

Success Rates ◽

Hearing Improvement ◽

Group A ◽

Group B ◽

Conductive Hearing

Background: The objective of the study was to compare the over underlay tympanoplasty technique with classical underlay tympanoplasty in terms of hearing impairment, graft acceptance and complications.Methods: 60 patients of chronic otitis media, mucosal, inactive, aged between 16-60 years who presented to ENT OPD with small, medium, large and subtotal perforations having mild to moderate conductive hearing loss were included in the study. After taking informed consent, patients were randomly divided into 2 groups containing 30 patients each. In group A, graft was placed medial to the handle of malleus and medial to the annulus (underlay technique), while in group B, graft was placed lateral to the handle of malleus and medial to the annulus (over underlay technique). Both groups were reviewed after 6 months. Pre-operative and post-operative air bone gap were compared. Surgery was considered successful based on post-operative graft uptake, hearing improvement and maintenance of middle ear space. Results: In group A, re-perforation was seen in 8 cases (26.7%) whereas only 3 cases (10%) in group B had re-perforation. Medialization was noted among 4 patients in group A (13.3%), and was absent in group B. Lateralization was absent in both the groups. Post-operative hearing threshold in group A was 6.2±4.56 dB and in group B was 11.45±7.38 dB.Conclusions: Over underlay tympanoplasty is a safer technique as compared to classical underlay, showing lower rates of re-perforation or medialization and a significant improvement in hearing. Hence over-underlay is an effective method, having higher success rates.

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Outcomes and Quality of Life in Conductive Hearing Loss

Otolaryngology ◽

10.1067/mhn.2000.110364 ◽

2000 ◽

Vol 123 (5) ◽

pp. 527-532 ◽

Cited By ~ 11

Author(s):

Michael G. Stewart ◽

Newton J. Coker ◽

Herman A. Jenkins ◽

Spiros Manolidis ◽

Marilyn H. Bautista

Keyword(s):

Quality Of Life ◽

Hearing Loss ◽

Conductive Hearing Loss ◽

Conductive Hearing

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Rosen mobilization of the stapes: does it have a place in modern otology?

The Journal of Laryngology & Otology ◽

10.1017/s0022215106002490 ◽

2006 ◽

Vol 120 (12) ◽

pp. 1067-1071 ◽

Cited By ~ 3

Author(s):

G Thiel ◽

R Mills

Keyword(s):

Hearing Loss ◽

Conductive Hearing Loss ◽

Stapes Surgery ◽

Hearing Gain ◽

Stapes Fixation ◽

Conductive Hearing

We describe two patients with stapes fixation, in both of whom Rosen mobilization seemed to be the most prudent surgical choice. In both cases, a useful hearing gain was achieved initially. In the patient with otosclerosis, the conductive hearing loss recurred and a stapedectomy was subsequently carried out. In the patient with congenital stapes fixation, the hearing gain was maintained for two years eight months. We believe that this technique still has a place in stapes surgery in rare instances.

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Hearing Benefit in Allograft Tympanoplasty Using Tutoplast Processed Malleus

International Journal of Otolaryngology ◽

10.1155/2014/931308 ◽

2014 ◽

Vol 2014 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Anja Lieder ◽

Wolfgang Issing

Keyword(s):

Hearing Loss ◽

Middle Ear ◽

Conductive Hearing Loss ◽

Canal Wall ◽

Hearing Improvement ◽

Safe Alternative ◽

Hearing Thresholds ◽

Canal Wall Down ◽

Canal Wall Down Mastoidectomy ◽

Conductive Hearing

Objectives.Tutoplast processed human cadaveric ossicular allografts are a safe alternative for ossicular reconstruction where there is insufficient material suitable for autograft ossiculoplasty. We present a series of 7 consecutive cases showing excellent air-bone gap closure following canal-wall-down mastoidectomy for cholesteatoma and reconstruction of the middle ear using Tutoplast processed malleus.Patients and Methods.Tympanoplasty with Tutoplast processed malleus was performed in seven patients to reconstruct the middle ear following canal-wall-down mastoidectomy in a tertiary ENT centre.Main Outcome Measures.Hearing improvement and recurrence-free period were assessed. Pre-and postoperative audiograms were performed.Results.The average pre operative hearing loss was 50 ± 13 dB, with an air-bone gap of 33 ± 7 dB. Post operative audiograms at 25 months demonstrated hearing thresholds of 29 ± 10 dB, with an air-bone gap of 14 ± 6 dB. No prosthesis extrusion was observed, which compares favourably to other commercially available prostheses.Conclusions.Tutoplast processed allografts restore conductive hearing loss in patients undergoing mastoidectomy and provide an excellent alternative when there is insufficient material suitable for autograft ossiculoplasty.

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Jugular bulb diverticulum dehiscence towards the vestibular aqueduct in a patient with otosclerosis

The Journal of Laryngology & Otology ◽

10.1017/s0022215111003100 ◽

2012 ◽

Vol 126 (3) ◽

pp. 313-315 ◽

Cited By ~ 3

Author(s):

V Van Rompaey ◽

E Offeciers ◽

B De Foer ◽

T Somers

Keyword(s):

Computed Tomography ◽

Hearing Loss ◽

Temporal Bone ◽

Conductive Hearing Loss ◽

Jugular Bulb ◽

Hearing Improvement ◽

Computed Tomography Imaging ◽

Vestibular Aqueduct ◽

Revision Stapes Surgery ◽

Conductive Hearing

AbstractObjectives:To demonstrate the need for computed tomography imaging of the temporal bone before considering revision stapes surgery in patients with recurrent or residual conductive hearing loss.Case report:We report the case of a high-riding jugular bulb with an associated jugular bulb diverticulum, which was dehiscent towards the vestibular aqueduct, in a patient with confirmed otosclerosis who did not experience hearing improvement after stapedotomy.Conclusion:This case demonstrates the usefulness of temporal bone computed tomography in the evaluation of patients with otosclerosis in whom stapedotomy has not improved hearing. In such patients, revision surgery to address residual hearing loss would eventually prove unnecessary and avoidable.

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Endoscopic Ear Surgery for the Management of Traumatic Ossicular Disruption with Intact Tympanic Membrane

10.21203/rs.3.rs-103560/v1 ◽

2020 ◽

Author(s):

Chunlin Zhang ◽

Dan Long ◽

Yuan Deng ◽

Mei Ynag ◽

Dandan Guo ◽

...

Keyword(s):

Hearing Loss ◽

Retrospective Study ◽

Conductive Hearing Loss ◽

Ossicular Chain ◽

Endoscopic Ear Surgery ◽

Ear Surgery ◽

Temporal Bone Fracture ◽

Hearing Outcomes ◽

Conductive Hearing ◽

Facial Function

Abstract Background Traumatic ossicular disruption (TOD) usually had a severe conductive hearing loss, the exploratory tympanotomy is critical for the diagnosis and improve hearing. Endoscopic ear surgery (EES) is becoming popular in the last decade, we conducted a retrospective study to explore the efficacy of EES for management of TOD and the accompanied injuries.Methods A retrospective study was performed on 18 ears (16 patients) of TOD with intact TM from May 2017 to Jun 2019 in our department. EES was conducted to check the ossicular chain anomalies, and to perform the ossiculoplasty and facial nerve (FN) decompression depending on the intraoperative findings. Hearing outcomes and surgical complications were assessed at 6 months postoperatively. Results The incus injury was the most common type of TOD, which was observed in 14 ears (77.8%), stapes suprastructure fracture was observed in 4 ears (22.2%). FN injury was found in 4 out of 13 ears with temporal bone fracture (TBF), the injury sites were mainly located in the perigeniculate area and the tympanic segment of FN. It showed the postoperative average pure-tone average (PTA) gain was 22.9 ± 9.5 dB, and the average ABG closure was 22.2 ± 8.3 dB, ABG closure to 20 dB or less and ABG closure to 10 dB or less were achieved in 18 ears (100%) and 14 ears (77.8%), respectively. The facial function achieved favorable recovery of House-Brackmann (H-B) grade Ⅰ (3 ears) and grade Ⅱ (1 ear) in all the 4 cases in 6 months after surgery. No iatrogenic FN paralysis and significant sensorineural hearing loss were observed. Conclusions ESS was effective in diagnosis and management of TOD and the accompanied otologic injuries, such as FN paralysis, it showed favorable surgical outcomes. ESS provides an alternative method to manage TOD with the advantage of excellent vision and less invasion.

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Myringoplasty and the factors that affect its success- a case based review

Morecambe Bay Medical Journal ◽

10.48037/mbmj.v7i9.110 ◽

2017 ◽

Vol 7 (9) ◽

pp. 214-223

Author(s):

Natalia Kyrtata ◽

Shadaba Ahmed

Keyword(s):

Hearing Loss ◽

Side Effects ◽

Conductive Hearing Loss ◽

Treatment Options ◽

Risk Groups ◽

Antibiotic Administration ◽

Detailed History ◽

Anatomy And Physiology ◽

Conductive Hearing ◽

Case Based

Myringoplasty is the surgical treatment for the repair of tympanic membrane (TM) perforations. It is indicated for treatment of recurrent ear discharge, improving conductive hearing loss, and preventing future infections, especially in high risk groups. In this case-based review, the normal anatomy and physiology of the ear is described, followed by the way conductive and sensorineural hearing loss are differentiated through a detailed history, examination and investigations, including audiometry and tympanometry. The anatomy of the TM is explored and the causes, presentation and diagnosis of TM perforations, which are a cause of conductive hearing loss, are described This review focuses on how myringoplasty is used to repair TM perforations, and what factors affect its success, relating the findings to four patients who have undergone myringoplasty. The underlay technique is used more frequently, yielding better results with fewer side-effects, especially for posterior perforations, whereas overlay is shown to be better for anterior perforations due to a better view of the TM, but has higher risks for graft lateralisation and blunting. Over-underlay is similar to underlay in success, but can only be applied where the handle of malleus is intact. TM repair was shown to be independent of age, sex and timing of antibiotic administration, although chronic perforations take longer to heal. The effect of size on the surgical outcome is debatable, with different studies showing opposite results. Side-effects, alternative treatment options and potential biases in the studies are discussed, as well as the limitations of the information obtained from the cases. The conclusion is that there is no “one-fits-all” procedure or graft that is suitable for the repair of all TM perforations, and each patient should be assessed on an individual basis, taking into consideration their own needs and wishes.

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Congenital Oval Window Aplasia: An Unusual Cause of Conductive Hearing Loss in an Adult

Philippine Journal of Otolaryngology Head and Neck Surgery ◽

10.32412/pjohns.v31i1.315 ◽

2016 ◽

Vol 31 (1) ◽

pp. 39-44

Author(s):

Charlotte M. Chiong ◽

Rachel T. Mercado-Evasco ◽

Alessandra E. Chiong ◽

Mary Ellen C. Perez ◽

Franco Louie L. Abes ◽

...

Keyword(s):

Hearing Loss ◽

Facial Nerve ◽

Recent Literature ◽

Conductive Hearing Loss ◽

Oval Window ◽

Surgical Approaches ◽

Hearing Gain ◽

Temporal Bone Ct ◽

Conductive Hearing

Objective: To report a case of congenital oval window aplasia (COWA) in a Filipino adult presenting with unilateral maximal conductive hearing loss and discuss the diagnostic considerations, pathophysiology and management. Methods: Study Design: Case report Subjects: One (1) Setting: Tertiary Public Referral Center Results: Audiometric evaluation showed a maximal unilateral left conductive hearing loss. High resolution temporal bone CT showed absence of the oval window on the left along with facial and stapes abnormalities. Exploratory tympanotomy showed an aberrant facial nerve, monopodal and abnormally located stapes and absent oval window. Postoperative hearing gain achieved after a neo-oval window and Schuknecht piston wire prosthesis remained stable over two years. Conclusion: A congenital minor ear anomaly classified as Cremers Class 4a in which a congenital oval window aplasia was associated with an aberrant facial nerve anomaly and a monopodal stapes is reported. Recent literature supported the view that congenital oval window aplasia can in selected cases be amenable to various surgical approaches and a stable postoperative hearing gain is achievable in the long term. Keywords: oval window absence, Cremers classification, congenital middle ear

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