scholarly journals Non-surgical approach for repairing perforations of pars tensa in tympanic membrane using TCA cauterization

2019 ◽  
Vol 5 (2) ◽  
pp. 299
Author(s):  
Sushil Gaur ◽  
Monika Patel ◽  
Prince Hirdesh ◽  
Vandana Singh
Keyword(s):  
Acetic Acid ◽  
Success Rate ◽  
Tympanic Membrane ◽  
Ossicular Chain ◽  
Surgical Approaches ◽  
Cost Burden ◽  
Surgical Interventions ◽  
Pars Tensa ◽  
Tympanic Membrane Perforations ◽  
One Year

<p class="abstract"><strong>Background:</strong> Tympanic membrane perforations occurring due to mucosal COM usually require surgical interventions for repair (myringoplasty or tympanoplasty) depending on the size and site of the perforation and the ossicular chain continuity. Various studies have shown TCA cautery as an efficacious non surgical method for repairing small and medium sized TM perforations. This technique was successfully used and popularized for repairing small and medium sized perforations by Derlacki in 1953.</p><p class="abstract"><strong>Methods:</strong> In this study we included dry pars tensa perforations in 100 patients occurring due to trauma or unresolved cases after inflammation/infection of middle ear. 50% w/v trichloro acetic acid was used for a maximum number of 5 applications at the margins of the perforations which were followed up for the next one year.  </p><p class="abstract"><strong>Results:</strong> In this study, involving a total of 125 perforations (75 unilateral and 50 bilateral), success rate was high among the patients with traumatic perforations and small sized perforations while a few number of perforations only reduced in size, which were later corrected with surgical approaches (myringoplasty/tympanoplasty). The overall success rate achieved in this study was 72.16%.</p><p class="abstract"><strong>Conclusions:</strong> Though there are various materials and methods available for this procedure, the principle remains the same. This technique should be attempted for patients that fit the criteria for undergoing this procedure before being undertaken for surgical approaches to minimize the risks and cost burden associated with surgery and anesthesia.</p>

Middle-ear reconstruction: a review of 150 cases

2002 ◽  
Vol 116 (6) ◽  
pp. 435-439 ◽  
Author(s):  
Ikramullah Khan ◽  
Amir M. Jan ◽  
Farrukh Shahzad
Keyword(s):  
Success Rate ◽  
Tympanic Membrane ◽  
Ossicular Chain ◽  
Tympanic Membrane Perforation ◽  
Ear Reconstruction ◽  
Membrane Perforation ◽  
Ossicular Chain Reconstruction ◽  
Post Operation ◽  
One Year ◽  
Intact Tympanic Membrane

This study is based on a retrospective analysis of 150 cases of tympanoplasty and ossicular chain reconstruction as a one-stage procedure. It was conducted at the Federal Government Services Hospital, Islamabad from 1983 to 1999. Temporalis fascia was used for myringoplasty and a sculptured autologous incus to bridge the malleus to stapes head and malleus to footplate gap. These interpositions have produced stable ossicular assemblies and provided satisfactory post-operative hearing gains. One hundred and twenty-six (84 per cent) patients achieved a healed tympanic membrane three months post-operatively. One year post-operatively, 121 (81 per cent) patients had an intact tympanic membrane and at five years 119 (79 per cent) had an intact tympanic membrane. The success rate was based on an intact tympanic membrane and an air-bone gapof less than 30 dB one-year post-operation. Accordingly, the overall success rate was 80 per cent (120 cases). Hearing gains in cases with an absent stapes arch were poorer than in cases with an intact arch. Early (one to three months) post-operative complications included tympanic membrane perforation, lateralization of the graft and persistence of infection. Late (one to five years) complications included the appearance of an anterior perforation and retraction and thinning of the tympanic membrane.

scholarly journals Surgical Outcomes of Pure-Fat Myringoplasty for Small Tympanic Membrane Perforations: A Retrospective Study and Summary of the Literature in the Last 10 Years

2021 ◽  
Vol 64 (10) ◽  
pp. 711-719
Author(s):  
Min Kyu Lee ◽  
Tae Min Kim ◽  
Sung Jin Lim ◽  
Dong Heun Park ◽  
Yoon Chan Rah ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Success Rate ◽  
Tympanic Membrane ◽  
Surgical Outcomes ◽  
Pure Tone ◽  
Current Knowledge ◽  
Tympanic Membrane Perforations ◽  
The Mean ◽  
Hearing Outcomes ◽  
Paired T Test

Background and Objectives Fat myringoplasty is a simple, fast, and effective procedure for repairing tympanic membrane (TM) perforations. The aim of this study is to evaluate the surgical outcomes of pure-fat myringoplasty for small TM perforations at our hospital and review the current knowledge regarding fat myringoplasty, with consideration of the effectiveness of additional substances used in the treatment of small TM perforations.Subjects and Method We retrospectively studied 41 patients who underwent pure-fat myringoplasty at our hospital from March 2008 through April 2019 and were followed up for at least 2 months thereafter.Results Of 41 patients, 16 were males and 25 were females, with the mean age of 48 (male, 9-75 years; female, 16-65 years). All perforations were classified as small perforations, ranging from 1% to 17% of the TM. The overall success rate was 92.7%, with the TMs of 3 patients (7.3%) failing to close. Air-bone gap (ABG) decreased in 19 out of 24 patients who underwent both preoperative and postoperative pure tone audiometric examinations. The mean ABG was 4.42 dB (n=24; paired-t test, p=0.001; 95% confidence interval, 1.77-7.07). The literature review revealed that TM closure success rate of over 80% was associated with pure-fat myringoplasty, while the TM closure success rate for fat myringoplasty with additional substances was 85% to 100%.Conclusion Our study revealed a high TM closure success rate and good hearing outcomes are associated with pure-fat myringoplasty. Pure-fat myringoplasty seems to be sufficient for repairing small TM perforations.

scholarly journals Outcome of Myringoplasty in Underlay Technique

2019 ◽  
Vol 24 (2) ◽  
pp. 131-136
Author(s):  
Md Abdur Razzak ◽  
KM Mamun Murshed ◽  
AKMA Sobhan ◽  
Md Rakib Hossain ◽  
SM Nafeez Imtiaz
Keyword(s):  
Success Rate ◽  
Tympanic Membrane ◽  
Surgical Techniques ◽  
Neck Surgery ◽  
Tympanic Membrane Perforation ◽  
College Hospital ◽  
Medical College ◽  
Tympanic Membrane Perforations ◽  
Membrane Perforation ◽  
Age Range

Background: Myringoplasty is one of the surgical techniques for the management of chronic supportive otitis media with permanent perforation of tympanic membrane. It is defined as simple surgical repair of tympanic membrane perforation without doing ossicular reconstruction. Objective: To determine the success rate of myringoplasty and to examine whether the hearing improvement is a potential indication for surgery. Methods: This study was conducted in the Department of Otorhinolaryngology and Head and Neck Surgery, Shaheed Suhrawardy Medical College Hospital from January 2017 to December 2017 and 100 patients who underwent myringoplasty in this period were analyzed. About 100 patients with dry central tympanic membrane perforations of various size were included in this study Results: Myringoplasty was performed in 100 patients. Male were (45%) and females were (55%).Twenty one (7%) of them belonged to age group of 10-20 years, 31 (31%) were in the age range of 21-33 years, 38(38%) were the age range 31-40 years while 24 (24%) aged between 41-50 years with mean age of 26.32 ±S.D 9.59 years. Overall success rate of graft uptake was noted in 88 (88%) out of 100 cases Conclusion: Myringoplasty is a safe surgical procedure in achieving intact tympanic membrane and to improve the hearing loss. Therefore, underlay technique being technically simple should be preferred, but the ultimate decision about the technique to be employed depends on the surgeons preference and the site of perforation  Bangladesh J of Otorhinolaryngology; October 2018; 24(2): 131-136

scholarly journals ENDOSCOPIC CARTILAGE TYMPANOPLASTY. OUR TECHNIQUE AND EXPERIENCE OF 157 CASES

2021 ◽  
Vol 71 (Suppl-3) ◽  
pp. S440-444
Author(s):  
Muhammad Atif Najam ◽  
Urwa Sarwar ◽  
Maqbool Raza ◽  
Khalid Azam Khan ◽  
Humaira Saleem ◽  
...  
Keyword(s):  
Tympanic Membrane ◽  
Demographic Data ◽  
Tympanic Membrane Perforation ◽  
Pars Tensa ◽  
Tympanic Membrane Perforations ◽  
Cartilage Tympanoplasty ◽  
Membrane Perforation ◽  
Percent Success ◽  
And Gender ◽  
Endoscopic Cartilage Tympanoplasty

Objective: To assess the graft take rate and hearing gain in trans-canal endoscopic tympanoplasty Study Design: Descriptive study. Place and Duration of Study: Pakistan Naval Ship Hafeez, Islamabad Pakistan, form Dec 2015 to Jun 2018 Methodology: All patients with dry central perforations of >3 months history were included in the study. All Patients with perforations of pars tensa were booked for endoscopic cartilage tympanoplasty. All perforations were divided into four types small, medium, large and subtotal or total based on size of the tympanic membrane perforations. Small perforations involving <25% area of Pars Tensa. Medium perforation are Perforations involving 25-50% of Tympanic membrane. Large perforations include Perforations involving 50-75% of pars tensa. Subtotal or total perforations are defined as perforations with >75% perforation of the tympanic membranes. Wet Ears and perforations involving the Pars Flacida were excluded from the study. Preoperative Audiogram was carried out for all patients and A-B Gap were noted for all groups separately so as the demographic data including age and gender. Success was defined as complete closure of Tympanic membrane perforation at 3 months. All patients were operated with 0 Degree 3mm, 14cm rigid endoscope under general anesthesia. Results: Mean age of patients was. 37 years and standard deviation was 12.34 (range 12-58 years). Out of total 157 cases 81 patients male were males (51%) and 76 patients were females (49). Out of 157 ears operated 146 Perforations healed completely an overall success rate of 92%. Patients with small perforations had 100 percent success.....

scholarly journals The Effect of External Auditory Canal Packing Duration on Healing After Endoscopic Cartilage Myringoplasty

2020 ◽  
pp. 014556132092211
Author(s):  
Zhengcai Lou
Keyword(s):  
Success Rate ◽  
Tympanic Membrane ◽  
External Auditory Canal ◽  
Cartilage Graft ◽  
Early Group ◽  
Tympanic Membrane Perforations ◽  
Removal Time ◽  
Graft Success ◽  
Late Group ◽  
And Cartilage

Introduction: The external auditory canal (EAC) packing is widely used in otosurgery and is considered to promote hemostasis and to support tympanic membrane grafts. However, few studies have investigated the effects of packing removal time on healing. Objective: We investigated the effect of EAC packing duration on healing after endoscopic cartilage myringoplasty in patients with chronic tympanic membrane perforations (TMPs). Materials and Methods: Patients with chronic TMPs who underwent endoscopic “push-through” cartilage myringoplasty were divided into early and late groups based on the length of time before EAC packing was removed. The graft success rate, eardrum appearance, and hearing gain were assessed 3 months after surgery. Results: The study included 137 patients. Three months after surgery, the graft success rate was 83.5% (66/79) in the early group and 94.8% (55/58) in the late group ( P = .042). The graft was displaced in 8 (10.1%) patients in the early group and in 1 (1.7%) patient in the late group ( P = .050). No epithelialization was found on the surface of the grafts in the early group, whereas epithelialization was nearly complete 4 weeks after surgery in the late group. Conclusions: Delaying removal of the EAC packing after endoscopic cartilage myringoplasty may promote tympanic membrane better healing and cartilage graft epithelialization and improve the appearance of the eardrum.

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.

Composite chondro-perichondrial clip myringoplasty: our experience

2016 ◽  
Vol 2 (4) ◽  
pp. 249
Author(s):  
Shrikrishna B. H. ◽  
Jyothi A. C.
Keyword(s):  
Prospective Study ◽  
Success Rate ◽  
Tympanic Membrane ◽  
Canal Wall ◽  
Inclusion Criteria ◽  
Temporalis Fascia ◽  
Tympanic Membrane Perforations ◽  
Complete Closure ◽  
External Canal ◽  
A Prospective Study

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">There are several studies on the efficacy of the commonly used temporalis fascia for myringoplasty where the temporalis fascia is placed by underlay method after incising external canal wall skin. This study was conducted assess the success rate and efficacy of use of a composite chondro-perichondrial graft in a combined overlay-underlay fashion where the external canal wall is not incised. </span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">A prospective study was conducted where 30 cases of non-marginal perforation of tympanic membrane were properly selected based on the inclusion criteria. All the 30 cases underwent myringoplasty using composite chondro-perichondrial graft harvested from tragal cartilage and placed in a combined overlay-underlay fashion.  </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">There was complete closure of the perforation in 27 of the total 30 cases. Also there was reduction in the air-bone gap post-operatively in all the 27 cases with complete closure of the tympanic membrane perforations. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Composite chondro-perichondrial clip myringoplasty is an effective method of closing non-marginal perforations of the tympanic membrane.</span></p>

Surgical management of retraction pockets of the pars tensa with cartilage and perichondrial grafts

2006 ◽  
Vol 120 (9) ◽  
pp. 725-729 ◽  
Author(s):  
P Spielmann ◽  
R Mills
Keyword(s):  
Tympanic Membrane ◽  
Incidental Findings ◽  
Conductive Hearing Loss ◽  
Pars Tensa ◽  
Early Results ◽  
Retraction Pockets ◽  
Successful Technique ◽  
One Year ◽  
Conductive Hearing ◽  
Results Of Surgery

Stable, self-cleansing retraction pockets of the pars tensa are common incidental findings and require no treatment. In other cases, recurrent discharge occurs and there may also be associated conductive hearing loss. In a minority of cases, cholesteatoma may develop.This paper presents the results of surgery using a graft composed of cartilage and perichondrium for retraction pockets involving the posterior half of the tympanic membrane, as well as early results using a larger graft designed to manage retraction of the entire tympanic membrane. Data on 51 patients with posterior retraction pockets are presented. Forty-two (82 per cent) patients had no aural discharge one year following surgery and the tympanic membrane was not retracted in 43 (84 per cent). The larger ‘Mercedes-Benz’ graft was used in four patients and the results obtained suggested that it may prove a successful technique for extensive retraction pockets.

Regeneration of the tympanic membrane using fibroblast growth factor-2

2018 ◽  
Vol 132 (06) ◽  
pp. 470-478 ◽  
Author(s):  
Z-C Lou ◽  
Z-H Lou ◽  
J Xiao
Keyword(s):  
Growth Factor ◽  
Success Rate ◽  
Tympanic Membrane ◽  
Fibroblast Growth Factor ◽  
Tympanic Membrane Perforation ◽  
Fibroblast Growth Factor 2 ◽  
Fibroblast Growth ◽  
Tympanic Membrane Perforations ◽  
Membrane Perforation ◽  
Chronic Tympanic Membrane Perforation

AbstractObjectiveA systematic review was conducted to investigate the effectiveness of fibroblast growth factor-2 on the regeneration of tympanic membrane perforation.MethodsThe PubMed database was searched for relevant studies. Experimental studies, human randomised controlled trials, prospective single-arm studies and retrospective studies reporting acute and chronic tympanic membrane perforations in relation to two healing outcomes (success rate and closure time), were selected.ResultsAll 11 clinical studies investigating the effect of fibroblast growth factor-2 on traumatic tympanic membrane perforations in humans reported a success rate of 89.3–100 per cent, with a closure time of around 2 weeks. Three studies of fibroblast growth factor-2 combined with Gelfoam showed that the success rate of chronic tympanic membrane perforation was 83–98.1 per cent in the fibroblast growth factor-2 group, but 10 per cent in the gelatine sponge groups.ConclusionFibroblast growth factor-2 with or without biological material patching promotes regeneration in cases of acute and chronic tympanic membrane perforation, and is safe and efficient. However, the best dosage, application time and administration pathway of fibroblast growth factor-2 are still to be elucidated.

scholarly journals Clinical study of transcanal closure of tympanic membrane perforations using a collagen sponge

2015 ◽  
Vol 129 (S2) ◽  
pp. S21-S26 ◽  
Author(s):  
A Tamae ◽  
S Komune
Keyword(s):  
Minimally Invasive Surgery ◽  
Clinical Study ◽  
Minimally Invasive ◽  
Success Rate ◽  
Tympanic Membrane ◽  
Low Cost ◽  
Collagen Sponge ◽  
Closure Rate ◽  
Tympanic Membrane Perforations ◽  
Initial Surgery

AbstractMaterials and methods:We used an artificial dermis (Terdermis®), which is an atero-collagen sponge covered with a sheet of silicon.Patients:Nineteen ears of 17 patients with perforation of the tympanic membrane under various conditions, including large and wet perforations, underwent operation using this collagen sponge.Results:The success rate of closure after the initial surgery was 8/19. The overall success rate of closure after initial and re-operation was 14/19. The success rate of closure was 12/14 for small-sized perforations, 1/4 for middle-sized perforations and 1/1 for a large-sized perforation. Middle- and large-sized perforations required multiple surgeries. The success rate of closure was 11/11 for dry perforations, 3/4 for perforations with light otorrhoea and 0/4 for perforations with extensive otorrhoea.Conclusion:This surgery is a low-cost and minimally invasive surgery and has a high closure rate. This surgery is effective on small-sized, dry perforations although it can also close middle- and large-sized dry perforations.

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