scholarly journals Minimally invasive cartilage myringoplasty: our technique and experience

2019 ◽  
Vol 5 (4) ◽  
pp. 866
Author(s):  
Venkatesh C. Ballal ◽  
Lohith Shivappa ◽  
Subramanya B. Tmmappaiah ◽  
Sphoorthi Basavannaiah ◽  
Chandralekha T. V. Rangaswamy
Keyword(s):  
Minimally Invasive ◽  
Tympanic Membrane ◽  
Tympanic Membrane Perforation ◽  
Common Procedure ◽  
Suppurative Otitis Media ◽  
Tympanic Membrane Perforations ◽  
Fascia Graft ◽  
First Choice ◽  
Important Health ◽  
The Mean

<p class="abstract"><strong>Background:</strong> Chronic suppurative otitis media is an inflammatory process in the middle ear and is an important health problem in India. Myringoplasty is the most common procedure performed that aims to close the tympanic membrane perforation which is traditionally done with temporalis fascia graft under microscope. Recent studies using the transcanal cartilage “push-through” technique of myringoplasty have demonstrated that it to be very feasible and effective. The aims and objectives of the study was to analyze the results of endoscopic transcanal ‘push-through’ myringoplasty in dry small central perforations in cases of inactive mucosal type of chronic ottitis media.</p><p class="abstract"><strong>Methods:</strong> This retrospective study was conducted in 16 patients who underwent transcanal endoscopic cartilage ‘push through’ myringoplasty and patients were called for regular follow up for 12 weeks and results were statistically analysed.  </p><p class="abstract"><strong>Results:</strong> A total of 16 cases were included in the present study. The graft uptake rate in the present study was found to be 93.75%. The mean preoperative air bone gap was 21.76 dB and the mean postoperative air bone gap was reduced to 12.6 dB. The air bone gap was 10 dB or less in 37.5% ears.</p><p class="abstract"><strong>Conclusions:</strong> Endoscopic push-through technique of cartilage myringoplasty is an effective, minimally invasive and feasible method and has good success rate in terms of graft uptake as well as hearing gain. It may also represent a first choice approach for small and medium sized tympanic membrane perforations.</p>

Repair of subtotal tympanic membrane perforations with Seprafilm®

2004 ◽  
Vol 118 (11) ◽  
pp. 862-865 ◽  
Author(s):  
Ersin Konakçi ◽  
Mehmet Koyuncu ◽  
Recep Ünal ◽  
Atilla Tekat ◽  
Melek Uyar
Keyword(s):  
Hyaluronic Acid ◽  
Tympanic Membrane ◽  
Control Group ◽  
Sprague Dawley ◽  
Tympanic Membrane Perforations ◽  
Sprague Dawley Rats ◽  
First Choice ◽  
The Mean ◽  
Experimental Use

Objectives: We studied the experimental use of Seprafilm, a sheet-like filmform of hyaluronic acid, in the repair of subtotal perforations of the tympanic membrane (TM), and the durability of such repairs.Method: The research was conducted on 42 Sprague–Dawley rats. Right TMs of all rats were subtotally and thermally perforated in the same fashion. Seprafilm was applied to the perforated TMs of the 21 rats comprising the experiment group. The perforated TMs of the remaining 21rats, the control group, were left to heal spontaneously.Results: The mean healing times were recorded as 7.8 ± 0.6 days for the Seprafilm group and 14.9 ± 1.1 days for the control group (p < 0.001).Conclusions: These results suggest that Seprafilm may be a possible first choice (before thedecision to operate) in subtotal perforations, considering its easy application and patient follow-up.

scholarly journals Research of Ear Endoscopic Type I Tympanoplasty——Single-institution Experiences in China

2021 ◽  
Author(s):  
Di Ji ◽  
Jun Jie Yang ◽  
Xian Bai Zhu ◽  
Xue Qin Zhou ◽  
Xiao Jun Liang ◽  
...  
Keyword(s):  
Tympanic Membrane ◽  
Tympanic Membrane Perforation ◽  
Type I ◽  
Hearing Level ◽  
Hearing Improvement ◽  
Suppurative Otitis Media ◽  
Mean Values ◽  
Before And After ◽  
The Mean ◽  
Type I Tympanoplasty

Abstract Purpose: To assess outcomes of one-handed ear endoscopic Type I Tympanoplasty and summarize the experience. Methods: This study retrospectively analyzed 34 cases (23 females and 11 males) of one-handed ear Endoscopic Type I Tympanoplasty. Result: The mean values of air conduction threshold before and after surgery were 48.22+18.36dB HL and 34.34+19.83dB HL, respectively. The mean values of the air-bone gap before and after surgery were 23.60+12.18 dB HL and 11.05+6.62 dB HL, respectively. The results showed statistically significant differences in hearing improvement(P<0.05). Among 34 ears, 30 ears had effective hearing improvement. No vertigo, intracranial infection, suppuration, and any other postoperative complications occurred. Although 1 ear occurred tympanic membrane perforation again, all ears achieved dry. Conclusion: Ear endoscopic Type I Tympanoplasty with fewer complications and shorter surgery time were suitable for the chronic suppurative otitis media. Healing of the tympanic membrane and recovery of hearing level was ensured. However, the experience is still insufficient in China, so a large number of clinical workers need to exchange experience to promote the development of ear minimally invasive surgery.

Myringoplasty: impact of perforation size on closure and audiological improvement

2009 ◽  
Vol 123 (9) ◽  
pp. 973-977 ◽  
Author(s):  
J D Wasson ◽  
C E Papadimitriou ◽  
H Pau
Keyword(s):  
Tympanic Membrane ◽  
Tympanic Membrane Perforation ◽  
Smoking History ◽  
Graft Material ◽  
Tympanic Membrane Perforations ◽  
Membrane Perforation ◽  
Size Grade ◽  
The Mean ◽  
The Impact ◽  
Air Conduction

AbstractObjectives:To investigate the impact of perforation size and other variables on the success of myringoplasty, and also to determine audiological gain following successful closure of tympanic membrane perforations of various sizes.Study design:Retrospective analysis of 130 case notes.Main outcome measures:(1) Successful closure of tympanic membrane following myringoplasty, in relation to recorded variables (i.e. perforation size, grade of surgeon, surgical technique, graft material, previous myringoplasty and smoking history). (2) Mean, four-frequency, air conduction audiometric gain following successful myringoplasty for various, pre-operatively categorised tympanic membrane perforation sizes.Results and Conclusion:The collective myringoplasty success rate was 80.8 per cent (105/130); for successful patients, the mean air conduction audiometric gain was −6.8 dB (t = 5.29, p < 0.0001). Neither perforation size nor any other assessed variable was a statistically significant determinant factor for successful myringoplasty. Air conduction audiometric gains following successful myringoplasty were directly correlated with pre-operative perforation size (−4.0 dB for 0–20 per cent perforations, −5.0 dB for 21–40 per cent, −9.1 dB for 41–60 per cent, −10.8 dB for 61–80 per cent and −13.3 dB for 81–100 per cent).

scholarly journals Outcomes of Myringoplasty In Underlay Technique

2019 ◽  
Vol 10 (2) ◽  
pp. 99-102
Author(s):  
Md Abdur Razzak ◽  
KM Mamun Murshed ◽  
AKMA Sobhan ◽  
Md Abdullah Al Harun ◽  
SM Nafeez Imtiaz
Keyword(s):  
Success Rate ◽  
Tympanic Membrane ◽  
Surgical Techniques ◽  
Neck Surgery ◽  
Tympanic Membrane Perforation ◽  
College Hospital ◽  
Suppurative Otitis Media ◽  
Medical College ◽  
Tympanic Membrane Perforations ◽  
Age Range

Background: Myringoplasty is one of the surgical techniques for the management of chronic suppurative 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. Materials and 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. A total of 100 patients with dry central tympanic membrane perforations of various sizes were included in this study. Results: Myringoplasty was performed in total of 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. J Shaheed Suhrawardy Med Coll, December 2018, Vol.10(2); 99-102

Repair of tympanic membrane perforation using a modified cartilage–perichondrium composite ring graft

2006 ◽  
Vol 120 (11) ◽  
pp. 952-954 ◽  
Author(s):  
M H Mansour ◽  
M H Askar ◽  
O A Albirmawy
Keyword(s):  
Tympanic Membrane ◽  
Otitis Media ◽  
Composite Graft ◽  
Tympanic Membrane Perforation ◽  
Hearing Improvement ◽  
Suppurative Otitis Media ◽  
Composite Ring ◽  
Tympanic Membrane Perforations ◽  
Membrane Perforation ◽  
Peripheral Ring

Ring graft is a modified cartilage-perichondrium composite graft (CPCG) with only a peripheral ring shaped cartilage. In this series, tympanic membrane perforations were repaired using (ring graft) during treatment of 18 cases of non-cholesteatomatous chronic suppurative otitis media (CSOM).This study showed that ring graft has the advantages of both CPCG and perichondrial graft but without their disadvantages. Complete closure of the perforations was achieved in all cases without delay in hearing improvement.It is recommended to use the ring graft whenever needed to repair central tympanic membrane perforations even with difficult anterior or total perforations.

En Hamac tympanoplasty and canalplasty for optimal type 1 tympanoplasty outcomes

2020 ◽  
Vol 134 (9) ◽  
pp. 769-772
Author(s):  
S Vandenbroeck ◽  
R Kuhweide ◽  
B Lerut
Keyword(s):  
Tympanic Membrane ◽  
Tympanic Membrane Perforation ◽  
Type 1 Tympanoplasty ◽  
Tympanic Membrane Perforations ◽  
Membrane Perforation ◽  
The Mean ◽  
Primary Type ◽  
Optimal Type

AbstractObjectiveMultiple tympanoplasty techniques have been developed with numerous differences in grafting and approach. This study aimed to improve type 1 tympanoplasty outcomes by using the ‘en hamac’ technique as well as performing a complete canalplasty for anterior perforations.MethodA retrospective review was performed using the prospective Otology-Neurotology Database tool for otological surgery. All primary type 1 tympanoplasty cases performed for tympanic membrane perforations from 2010 to 2016 were selected for analysis, all performed by one author. Minimal clinical and audiometric follow up was 18 months.ResultsTympanic membrane perforation closure was achieved in 62 of the patients (96.88 per cent). None of the en hamac cases had residual or recurrent perforation (p = 0.02). The mean remaining air–bone gap was 8.50 dB. The remaining air–bone gap was less than 10 dB in 72.55 per cent, 10–20 dB in 25.49 per cent and more than 20 dB in 1.96 per cent.ConclusionUsing the en hamac technique for anterior perforations as well as systematically performing a complete canalplasty provides multiple surgical advantages with excellent post-operative results.

scholarly journals Endoscopic tympanoplasty using Tutoplast versus conventional microscopic tympanoplasty

2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Taha M. Abdelaal ◽  
Ahmed A. Ibrahim
Keyword(s):  
Tympanic Membrane ◽  
Operative Time ◽  
Tympanic Membrane Perforation ◽  
Temporalis Fascia ◽  
Fascia Graft ◽  
Significant Difference ◽  
Membrane Perforation ◽  
Group A ◽  
The Mean ◽  
Group B

Abstract Background Temporalis fascia and perichondrium are still the most successful graft materials for primary microscopic repair of tympanic membrane perforations worldwide with 80% to 90% success rate. However, minimally invasive surgery is becoming standard in many fields and the endoscope has been largely incorporated in ear surgery over the past 10 years. This study aimed to evaluate the success rate of endoscopic transcanal closure of tympanic membrane perforation using Tutoplast® compared with the conventional post auricular approach using homologous temporalis fascia graft. Results Our study was conducted on 50 patients, were equally divided into 2 groups. Group A patients have been operated endoscopic transcanal using the Tutoplast as a graft material. Group B patients have been operated using a temporalis fascia graft through a post-auricular approach. The graft take rate, the pre- and post-operative pure tone audiogram, and operative time were compared in both the groups. The graft uptake rate was 100% in both groups. The mean of ABG showed significant improvement in both groups. In group A, the mean of ABG was 28.2 pre-operatively and became 12.12 post-operatively. In group B, the mean of ABG was 29.72 pre-operatively then became 15.2 post-operatively. Comparing the mean of post-operative ABG between both groups showed statistically significant difference as p value was 0.000496. We found a significant difference of the mean average operative time between both groups as the mean average time for group A was 48.08 min compared to 69.4 min for group B with p value 0.049772295. Conclusions Endoscopic closure of tympanic membrane perforation using Tutoplast is successful short-time procedure avoiding the postauricular or endaural incisions with shorter operative time.

scholarly journals Comparative study between fascia lata and temporalis fascia in myringoplasty

2020 ◽  
Vol 36 (1) ◽  
Author(s):  
Ayman Ali Abdel Fattah ◽  
Abdel Hay Rashad Elasy ◽  
Ahmed Helmy Hoseini ◽  
Tarek Abdel Rahman Abdel Hafez
Keyword(s):  
Tympanic Membrane ◽  
Good Alternative ◽  
Fascia Lata ◽  
The Body ◽  
Temporalis Fascia ◽  
Fascia Graft ◽  
Fascia Lata Graft ◽  
Group A ◽  
The Mean ◽  
Group B

Abstract Background Repair of a perforated tympanic membrane (myringoplasty) can facilitate normal middle ear function, resist infection, and help re-establish normal hearing. Autogenous graft materials are the most popular graft materials used in myringoplasty because of their easy acceptability by the body. This study is conducted to compare between temporalis fascia graft and fascia lata graft in myringoplasty for patients with tubo-tympanic dry perforation. Results A total of 60 patients with persistent dry tympanic membrane perforation were included in our study during the period from January 2018 to May 2020. Patients underwent myringoplasty with temporalis fascia (30 patients as group A) or fascia lata (30 patients as group B). Patients were scheduled for follow-up visits concerning graft status, ear discharge, and audiograms. The mean postoperative air-bone gap in group A was 17.5 ± 4 after 1 month and 8.6 ± 6.9 after 3 months, while in group B, the mean postoperative air-bone gap was 17.6 ± 4.9 after 1 month and 9.4 ± 7.5 after 3 months. There was 90% success in graft uptake in group A, while there was 80% success in group B. Conclusion Using temporalis fascia is still the best and most trustworthy technique of myringoplasty compared to fascia lata graft. However, fascia lata can be a good alternative to temporalis fascia especially in cases of revision myringoplasty, ears having large perforation, or near-total perforation where the chances of residual perforation are high because of the limited margin of remnant tympanic membrane overlapping the graft.

scholarly journals Closure of small perforation in tympanic membrane by use of fat plug

2020 ◽  
Vol 6 (9) ◽  
pp. 1647
Author(s):  
Nehal R. Patel ◽  
Vaibhav V. Patel ◽  
Dimpal Padavi ◽  
Mayur Prajapati ◽  
Rachana M. Khokhani ◽  
...  
Keyword(s):  
Tympanic Membrane ◽  
Ossicular Chain ◽  
Tympanic Membrane Perforation ◽  
Major Surgery ◽  
Graft Material ◽  
Middle Ear Mucosa ◽  
Suppurative Otitis Media ◽  
Membrane Perforation ◽  
Conventional Myringoplasty ◽  
Small Perforation

<p class="abstract"><strong>Background: </strong>Chronic suppurative otitis media presents mostly with ear discharge and associated decreased hearing. Tympanoplasty is the established surgery for tympanic membrane perforation. Most commonly used graft material for tympanoplasty is temporalis fascia. Others are fascia lata, tragal perichondrium, tragal cartilage, fat. The objective of the study was to compare the graft taken up and hearing improvement following myringoplasty with use of fat.</p><p class="abstract"><strong>Methods:</strong> Patients of CSOM aged 10 to 65 years old with small central perforation which is dry for at least 3 weeks with normal middle ear mucosa and intact ossicular chain with mild conductive hearing loss. The present study was carried out in Ear, neck and throat (ENT) Department of SCL hospital, Ahmedabad from July 2016 till September 2018 and 25 patients were randomly selected fulfilling the above criteria.</p><p class="abstract"><strong>Result: </strong>The choice of graft affects not only the outcome of surgery, but also determines the complexity of the procedure and the time taken for the same. Study proves that fat is also a one of the good grafting material which is easily available and keep to prevent from major surgery. The results have been quite encouraging.</p><p class="abstract"><strong>Conclusion: </strong>Study proves that fat is also a one of the good grafting material which is easily available and keep to prevent from major surgery. An added advantage of this technique was the excellent post-operative quality of life of the operated patients, assessed in terms of the chronic ear survey and evident by the absence of the usual post-operative complaints following a conventional myringoplasty.</p>

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