scholarly journals A comparative study of endoscopic assisted versus conventional middle ear and mastoid surgery at a tertiary care teaching hospital

2021 ◽  
Author(s):  
Jitendra Kumar Sharma ◽  
Sushma Mahich ◽  
Navneet Mathur
Keyword(s):  
Comparative Study ◽  
Middle Ear ◽  
Operative Time ◽  
Middle Ear Surgery ◽  
Wide Field ◽  
Time Duration ◽  
Ear Surgery ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Mastoid Surgery

<p><strong>Background:</strong> Objectives were to compare outcomes, intra operative visualization and operative time duration in endoscopic assisted vs conventional middle ear and mastoid surgery.</p><p><strong>Methods: </strong>This prospective comparative study was conducted in 50 patients; among them 25 cases were of endoscope assisted middle ear surgery and 25 cases with conventional microscopic middle ear surgery. A 4 mm diameter, 18 cm long rigid, zero-degree endoscope and operating microscope was used. Primary outcomes include mean average pre and post operative air-bone (A-B) gap, hearing thresholds, intra operative visualization and duration of surgery.<strong></strong></p><p><strong>Results: </strong>Mean A-B gap closure for endoscopic assisted tympanoplasty was 12.76±6.00 dB, while it was 8.38±5.78 dB for non-endoscopic assisted tympanoplasty. The results were comparative. Mean intra-operative time duration for endoscopic assisted tympanoplasty was 70.23±4.17 min, while it was 77±9.80 min for non-endoscopic assisted tympanoplasty with statically significant difference between both groups (p=0.03). Graft uptake rate for endoscopic assisted tympanoplasty was 92.31% while it was 84.62% for non-endoscopic assisted tympanoplasty. Residual cholesteatoma remnant on endoscopy was found in 43.66% cases out of 12 mastoidectomy cases performed via endoscopic assistance.<strong></strong></p><p><strong>Conclusions: </strong>The endoscope can be successfully applied to ear surgery for most of the ear procedures with a reasonable success rate both in terms of perforation closure and hearing improvement and with minimal exposure. Wide-field zero, 30 or 70° endoscope sallow visualization of hidden anatomic spaces and working around corners i.e., epitympanum, hypotympanum and retro tympanum for safe removal of cholesteatoma.</p>

scholarly journals Középfül-haemangioma endoszkópos műtéti megoldása és irodalmi áttekintése

2019 ◽  
Vol 160 (41) ◽  
pp. 1639-1643
Author(s):  
Andor Hirschberg ◽  
Erzsébet Pozsgay ◽  
Mónika Erős ◽  
Balázs Liktor
Keyword(s):  
Middle Ear ◽  
Treatment Options ◽  
Internal Auditory Canal ◽  
Middle Ear Surgery ◽  
Wide Field ◽  
Ear Surgery ◽  
Capillary Haemangioma ◽  
External Incision ◽  
Wide Field Of View ◽  
A New Technique

Abstract: The endoscopic middle ear surgery as a new technique has been introduced during the past few years in our country and it is available in only a few hospitals. Beyond the lack of external incision, endoscopic transcanal approach provides wide field of view to previously hidden middle ear spaces compared to the traditional microscopic technique. In this case report, we present an endoscopic surgery of middle ear capillary haemangioma that is a rare entity in tympanic cavity, therefore little has been published in the literature. Generally, these kind of vascular tumours occur in the internal auditory canal or in the perigeniculate ganglion area while this lesion originated from the inner surface of the inferior part of the bony tympanic ring. We discuss the difficulties in differential diagnosis and imaging tests then the treatment options. Orv Hetil. 2019; 160(41): 1639–1643.

The value of head dressings for middle ear surgery

1993 ◽  
Vol 107 (1) ◽  
pp. 17-19 ◽  
Author(s):  
Julian M. Rowe-Jones ◽  
Susanna E. J. Leighton
Keyword(s):  
Middle Ear ◽  
Wound Closure ◽  
Prospective Trial ◽  
Wound Complication ◽  
Operative Management ◽  
Middle Ear Surgery ◽  
Ear Surgery ◽  
Mastoid Surgery ◽  
Pressure Dressing

AbstractA prospective trial was performed to ascertain the value of head dressings in the post-operative management of patients undergoing middle ear and mastoid surgery. One hundred consecutive patients were randomly allocated to a head dressing or no head dressing group after wound closure.Nine patients in the head dressing group developed a wound complication as opposed to four patients in the no head dressing group.The application of a pressure dressing following middle ear and mastoid surgery is unnecessary and may contribute to increased wound morbidity.

scholarly journals Effect of Dexmeditomidine on Isofluorane Consumption in Middle Ear Surgery

2020 ◽  
Vol 5 (2) ◽  
pp. 14-19
Author(s):  
Smriti Bandhu ◽  
Arunabh Mukharjee
Keyword(s):  
Heart Rate ◽  
Middle Ear ◽  
Normal Saline ◽  
Middle Ear Surgery ◽  
Ear Surgery ◽  
Mean Values ◽  
Isoflurane Concentration ◽  
Significant Difference ◽  
Surgical Field ◽  
End Tidal

Background: With the introduction of intentional hypotensive anesthesia in the surgical field to achieve a relatively bloodless surgical field along with the use of the operative microscope, it has revolutionized the middle ear surgery practice. Dexmedetomidine is a relatively new and potent α2 agonist prototype found efficient in rendering bloodless intra-surgical field and inducing controlled hypotension during the surgeries of the middle ear. The objective is to present prospective study was aimed at evaluating with and without dexmedetomidine infusion effect on end-tidal isoflurane concentration for lowering blood pressure by 30%, awakening time and quality of bloodless surgical field during middle ear surgical procedure. Subjects and Methods:54 patients who were to undergo middle ear surgery and had ASA I and II were randomly divided into the two groups. In Group I Dexmedetomidine was used and in Group II Normal saline. Effect of Dexmedetomidine infusion on end-tidal isoflurane concentration for lowering blood pressure by 30%, awakening time, quality of bloodless surgical field during middle ear surgical procedure, heart rate was evaluated. The data collected were statistically analyzed. Results: The mean values of the heart rate were statistically non-significant between the groups when recorded at the baseline, whereas, a statistically significant difference was seen in the values for heart rate intra-operatively. The mean values for heart rates were significantly higher for the placebo group. A significant difference in Isoflurane concentration was found with dexmedetomidine requiring a percentage of 0.6 0.4 and normal saline 1.8 0.5. Less bleeding was seen with dexmedetomidine. Conclusion:  Dexmedetomidine is a potent hypotensive agent which also reduces the requirement of Isoflurane compared  to the normal saline placebo. The use of dexmedetomidine is relatively safe and provide a relatively bloodless surgical field, hence, increasing efficacy, and improving visibility at the surgical site.

Evaluation of Taste Disturbance in Pre and Post Mastoid Surgery Patients

2019 ◽  
Vol 2 (2) ◽  
pp. 4-11
Author(s):  
Sriti Manandhar ◽  
ST Chettri ◽  
DR Kandel
Keyword(s):  
Tympanic Membrane ◽  
Middle Ear ◽  
Analytical Study ◽  
Middle Ear Surgery ◽  
Chorda Tympani ◽  
Chorda Tympani Nerve ◽  
Ear Surgery ◽  
Taste Disturbance ◽  
Duration Of Operation ◽  
Mastoid Surgery

Background: Mastoid surgery is one of the commonest surgeries in Otolaryngology & Head & Neck department. Surgeons are less aware of preserving chorda tympani nerve (CT). Injury to the chord tympani nerve is common in middle ear surgery as the course of CT runs between ossicles and close to tympanic membrane. It makes the surgeon difficult to preserve it during the surgery. The study was done to observe frequency of taste disturbances (TD) in all patients undergoing mastoid surgery and to correlate between intra operative status of CT and type of intra operative status of CT injury with postoperative taste disturbances. Methods: A prospective analytical study was conducted in patients who underwent mastoid surgery. The intra operative status of CT was studied, different forms of injury to the nerve were noticed and its impact on taste disturbances was assessed subjectively with questionnaire. The patients with taste disturbances were followed till twelve weeks. Result: None of the patients had taste disturbances prior to surgery. Out of 65 patients, only 15 patients became symptomatic in second postoperative day and the taste disturbances were in the form of altered taste (26.66%), dry mouth (26.66%) and numbness (46.66%). Symptoms like altered taste and numbness were present till the eighth week of surgery and disappeared by the twelfth week except one patient in whom numbness persisted till twelfth week. The symptoms did not correlate with the intra operative status of CT. The symptoms disappeared with duration of operation and it was significant. Conclusion: None of the patients voluntarily complained regarding taste disturbances until they were specifically asked. Only 15 patients had taste disturbances; 7 had numbness, 4 dryness of mouth and 4altered taste. The taste disturbances did not correlate with the type of intra operative status of CT. CT was not identified in 9 patients and only 3 (33.3%) became symptomatic and CT was cut with micro scissors in 26 patients but only 4 (15.38%) patients were symptomatic.

scholarly journals Effects of nitrous oxide on middle ear pressure

2007 ◽  
Vol 60 (9-10) ◽  
pp. 473-478
Author(s):  
Branislava Majstorovic ◽  
Radomir Radulovic ◽  
Vojko Djukic ◽  
Dragana Kastratovic ◽  
Nada Popovic ◽  
...  
Keyword(s):  
Nitrous Oxide ◽  
Hearing Loss ◽  
General Anesthesia ◽  
Middle Ear ◽  
Wilcoxon Test ◽  
Middle Ear Surgery ◽  
Study Group ◽  
Ear Surgery ◽  
Significant Difference ◽  
Balanced Anesthesia

Introduction. Recent literature data suggest that permanent or reversible hearing loss may occur after general anesthesia. The etiology varies, while hearing loss following middle ear surgery is attributed to exposure to nitrous oxide (N2O). The objective of our study was to measure, using tympanometry, the middle air pressure change caused by nitrous oxide during general anesthesia and to establish its emetogenic effects during the postoperative period. Material and Methods. This academic (non-commercial) prospective study included two groups of patients (a total of 58), with ASA status I, II and III. The study group (n 30) consisted of patients undergoing unilateral ear surgery. In this group, the intratympanic pressure was measured in the unoperated (healthy) ear before and during the surgery. The control group (n 28) patients underwent nose, throat or neck surgical interventions. This group underwent measurement of bilateral intratympanic pressure in healthy ears, before and during the surgery. Both groups were operated under general balanced anesthesia. Pain, nausea and antiemetics were monitored during the first 24 postoperative hours. Statistical analysis was performed using the Mann-Whitney-Wilcoxon test. Results. This perioperative study confirmed the following: highly significant (p<0.001) increase in intratympanic pressure in non-operated ears in the study group and significant (p<0.05) in controls. However, there was no statistical significance (p>0.05) between groups. Pain was more frequent in controls, and nausea in the study group, but without significant difference (p>0.05). Conclusions. Postoperative audiometry findings showed no conductive or sensorineural hearing loss after interventions. Nitrous oxide can be used in general balanced anesthesia with discontinuation 15 to 45 minutes before insertion of the tympanic membrane and completion of middle ear surgery. .

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