scholarly journals Transcanal endoscopic treatment for congenital middle ear cholesteatoma in children

2021 ◽  
Author(s):  
Nan Zeng ◽  
Meng Liang ◽  
Shang Yan ◽  
Lue Zhang ◽  
Qiong Yang ◽  
...  
Keyword(s):  
Middle Ear ◽  
Endoscopic Treatment ◽  
Bone Conduction ◽  
Hearing Threshold ◽  
Sensorineural Deafness ◽  
Ossicular Chain ◽  
Surgical Trauma ◽  
Process Comparison ◽  
Middle Ear Cholesteatoma ◽  
The Mean

Abstract Background To investigate the feasibility and efficacy of transcanal endoscopic treatment for congenital middle ear cholesteatoma in children. Methods Eleven children diagnosed with congenital middle ear cholesteatoma were collected at Huazhong University of Science and Technology Union Shenzhen Hospital from January 2016 to December 2020. The retrospective study of their operation process, comparison of pre- and post-operative hearing result, surgical complications through the surgical video. Results Eleven children received total ear endoscopic surgery under general anesthesia. One of them received planned second operation to reconstruct the ossicular chain. At six months after operation, 11 children underwent re-examination. The mean bone conduction hearing threshold had no significant change (P>0.05), the mean air conduction hearing threshold was significantly decreased (P<0.05), and the air-bone conduction difference was significantly reduced (P<0.05). In 11 children, the air-bone conduction difference were all reduced to less than 20 dB, and 7 cases were reduced to less than 10 dB. All the children were followed up so far without sensorineural deafness, facial paralysis and other serious complications, as well as no recurrence. Conclusion Otoendoscope can provide a wide-angle field of vision and advantages in small surgical trauma, quick healing, avoiding repeated dressing changes and high acceptance of secondary surgery. Intraoperative application of 30° and 45° otoendoscope can effectively reduce residuals. Otoendoscope is widely used as a surgical method in the treatment of congenital middle ear cholesteatoma in children.

Role of ossiculoplasty in canal wall down tympanoplasty for middle-ear cholesteatoma: hearing results

2006 ◽  
Vol 121 (4) ◽  
pp. 324-328 ◽  
Author(s):  
E De Corso ◽  
M R Marchese ◽  
B Sergi ◽  
M Rigante ◽  
G Paludetti
Keyword(s):  
Middle Ear ◽  
Bone Conduction ◽  
Consecutive Series ◽  
Canal Wall ◽  
Hearing Results ◽  
Middle Ear Cholesteatoma ◽  
Canal Wall Down ◽  
The Mean ◽  
Air Conduction ◽  
Cholesteatoma Surgery

The aim of this study was to evaluate the hearing results of ossiculoplasty in canal wall down tympanoplasty in one stage middle-ear cholesteatoma surgery.We carried out a retrospective review of a consecutive series of 142 cases which had undergone type two or three canal wall down tympanoplasty with ossicular reconstruction, between January 1995 and December 2002, due to chronic otitis media with cholesteatoma.Pre-operative audiometric testing revealed a mean air conduction pure tone average (PTA) of 50.97 dB and a mean bone conduction PTA of 22.14 dB. The mean post-operative result for air conduction PTA was 37.62 and for bone conduction PTA was 23.37 dB. The mean pre- and post-operative air–bone gaps (ABGs) were 28.83 and 13.94 dB, respectively, with a gain of 14.89 dB. Almost 62.67 per cent of patients closed their ABGs to within 20 dB.Our functional results are comparable with those of other authors. In the present study, we show that hearing improvement is possible following cholesteatoma surgery with canal wall down tympanoplasty and ossicular chain reconstruction.

scholarly journals Experimental middle ear surgery in rabbits: a new approach for reconstructing the ossicular chain

2009 ◽  
Vol 43 (2) ◽  
pp. 198-204 ◽  
Author(s):  
M Stieve ◽  
H J Hedrich ◽  
R D Battmer ◽  
P Behrens ◽  
P Müller ◽  
...  
Keyword(s):  
Middle Ear ◽  
Bone Conduction ◽  
Hearing Threshold ◽  
Ossicular Chain ◽  
Ceramic Materials ◽  
Middle Ear Surgery ◽  
Electric Response ◽  
Hearing Level ◽  
Erbium:Yag Laser ◽  
Significant Difference

This experimental animal study aimed at evaluating a new prosthesis to replace the ossicular chain; we developed a new technique for surgical implantation into the middle ear of rabbits. The rabbit middle ear is, owing to the relative anatomical dimensions involved, an ideal environment for implantation procedures involving the ossicles, as the surgical conditions are similar to those of the human middle ear. This study included a total of 34 approximately six-month-old female white rabbits (New Zealand) weighing between 3.2 and 4.4 kg. The implants used were constructed of ceramic materials (titania, TiO2) of various pore sizes. Directly prior to implanting the total ossicular reconstruction prostheses (TORPs), as well as at 28, 84 and 300 days after implantation, electric response audiometry was used to determine the hearing thresholds of the animals (bone conduction; click stimulus nHL). An erbium:YAG laser was used to excise the original ossicular chain. Following implantation, we were unable to detect any stenosis of the outer ear canal or perforation of the tympanic membrane. The conductive hearing threshold was in the range of 4.21 ± 6.68 dB nHL ( n = 131). The hearing level showed no significant difference before and after surgery ( P < 0.05).

Ossicular chain reconstruction improves bone conduction threshold in chronic otitis media

2008 ◽  
Vol 122 (4) ◽  
pp. 351-356 ◽  
Author(s):  
H-S Lee ◽  
S-D Hong ◽  
S H Hong ◽  
Y-S Cho ◽  
W-H Chung
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Bone Conduction ◽  
Chronic Otitis Media ◽  
Ossicular Chain ◽  
Bone Conduction Threshold ◽  
Ossicular Chain Reconstruction ◽  
Duration Of Disease ◽  
The Mean ◽  
Conductive Mechanism

AbstractThis study aimed to assess the elevation of bone conduction threshold in patients with chronic otitis media and to investigate the mechanism of this phenomenon. One hundred and six patients with unilateral chronic otitis media who had undergone a tympanomastoidectomy were reviewed retrospectively. The differences in the bone conduction thresholds between the diseased and normal sides were assessed and compared according to the duration of the disease and the presence of cholesteatoma. Post-operative changes in the bone conduction threshold were also assessed. The mean bone conduction thresholds were significantly elevated on the diseased side, ranging from 3.4 to 11.6 dB across frequencies, with a maximal elevation at 2000 Hz. The duration of disease and the presence of cholesteatoma did not affect the degree of the bone conduction elevation. After ossicular reconstruction, bone conduction thresholds improved significantly at all frequencies, with the greatest improvement being observed at 2000 Hz. These results suggest that the elevation in the bone conduction threshold in chronic otitis media is mainly caused by a change in the conductive mechanism in the middle ear.

Effect of Changes in Mass on Middle Ear Function

1993 ◽  
Vol 109 (5) ◽  
pp. 899-910 ◽  
Author(s):  
Shinsei Nishihara ◽  
Hiroshi Aritomo ◽  
Richard L. Goode
Keyword(s):  
Middle Ear ◽  
Hearing Threshold ◽  
Laser Doppler Vibrometer ◽  
Ossicular Chain ◽  
High Frequencies ◽  
Before And After ◽  
Ventilation Tubes ◽  
Temporal Bones ◽  
Middle Ear Transfer Function ◽  
Vibrating Systems

Vibrating systems such as the middle ear are affected by changes in mass. After disease or ear surgery, significant changes in mass may contribute positively or negatively to the postoperative hearing threshold. This article describes experiments in 15 human temporal bones of the addition or reduction of mass on the middle ear transfer function. Measurement of stapes and umbo vibration was performed using a Laser Doppler Vibrometer before and after the addition of different masses at several sites on the tympanic membrane (TM) and ossicular chain. The input was 61 pure tones swept from 147 to 19433 Hz at 80 dB SPL. The addition of mass onto the TM produced varying detrimental effects on sound transmission, depending on the location and amount of mass. The insertion of ventilation tubes, weighing 12 to 17 mg each, produced losses at 1.5 to 5.0 kHz compared with tympanotomy alone. Addition of mass to the umbo and malleus head produced a loss at mid and high frequencies, whereas addition of mass on the incus long process and stapes also produced a high-frequency decrease in stapes displacement. Reduction of TM mass by removal of the epithelium produced an increase, especially at 2.0 to 4.0 kHz.

scholarly journals Factors that have an influence on bone conduction thresholds changes after otosurgery in the patients operated on due to the perforation of the tympanic membrane with the preserved ossicular chain

2017 ◽  
Vol 71 (4) ◽  
pp. 26-33
Author(s):  
Maciej Wiatr ◽  
Agnieszka Wiatr ◽  
Sebastian Kocoń ◽  
Jacek Składzień
Keyword(s):  
Tympanic Membrane ◽  
Middle Ear ◽  
Negative Impact ◽  
Positive Impact ◽  
Round Window ◽  
Bone Conduction ◽  
Ossicular Chain ◽  
Middle Ear Surgery ◽  
Ear Surgery ◽  
Study Objective

Introduction: The aim of the middle ear surgery is to eliminate abnormalities from the mucous, ensure the due airing of the postoperative cavity and reconstruct the sound-conducting system in the middle ear. Numerous reports can be found in literature on the changes to bone conduction as a consequence of middle ear surgery. Study objective: The aim of the work is to define the factors that affect bone conduction in the patients operated on due to the perforation of the tympanic membrane with the preserved and normal mobile ossicular chain. Material and method: A prospective analysis of patients operated on due to diseases of the middle ear in 2009–2012 was carried out. The cases of patients operated on for the first time due to chronic otitis media were taken into consideration. The analysis encompassed the patients who had undergone myringoplasty. The patients were divided into several groups taking into account the abnormalities of the mucous observed during otosurgery. Results: A significant improvement of bone conduction was observed in the patients with dry perforation, without other lesions in the middle ear. The appropriate pharmacological treatment before otosurgery in patients with permanent discharge from the ear resulted in significant bone conduction improvement. The elimination of granulation lesions turned out to be a positive factor for the future improvement of the function of the inner ear. Conclusions: The lack of abnormalities on the mucous of the middle ear (e.g. granulation,) and discharge has a positive impact on improvement of bone conduction after myringoplasty. Adhesions in the tympanic cavity, especially in the niche of the round window, have a negative impact on improvement of bone conduction in patients after myringoplasty.

scholarly journals Hearing and hearing rehabilitation after obliteration of troublesome mastoid cavities

2020 ◽  
Vol 277 (12) ◽  
pp. 3307-3313
Author(s):  
Simon Geerse ◽  
Tim J. M. Bost ◽  
Samira Allagul ◽  
Maarten J. F. de Wolf ◽  
Fenna A. Ebbens ◽  
...  
Keyword(s):  
Hearing Aids ◽  
Revision Surgery ◽  
Residual Disease ◽  
Bone Conduction ◽  
Hearing Threshold ◽  
Patient Characteristics ◽  
Ossicular Chain ◽  
Mastoid Cavity ◽  
Hearing Thresholds ◽  
Ossicular Chain Reconstruction

Abstract Purpose The purpose of this study is the evaluation of post-operative hearing threshold after revision surgery and obliteration of troublesome canal wall down mastoidectomy cavities (CWDMCs). The ability to use and tolerate conventional hearing aids (CHAs) was also evaluated. Methods A retrospective chart analysis of 249 patients with chronically draining CWDMCs who underwent revision surgery including obliteration of the mastoid cavity between 2007 and 2017 at the AMC location of the Amsterdam University Medical Centers (Amsterdam UMC) was performed. Patient characteristics, pre- and post-operative Merchant grade, surgical outcomes, pre- and post-operative hearing thresholds, and the ability/necessity to use a CHA or the ability/necessity to use a Bone Conduction Device (BCD) were recorded. Results Dry ears were found in 95% of the total cohort. Residual disease was detected in 1.6% during MRI follow-up with no residual cholesteatoma in the obliterated area. In 3.2% of the patients, recurrent disease was found. A significant improvement in mean air conduction level, mean bone conduction level, and mean air-bone gap (ABG) was found post-operatively (p < 0.05). For all types of ossicular chain reconstruction, a significant improvement in mean Pure Tone Average was observed (p < 0.05). The percentage of patients with an indication for CHA was similar pre- and post-operatively (67% both pre- and post-operatively). The ability to use a CHA improved from 3% pre-operatively to 57% post-operatively (p < 0.001). Conclusion This study shows that revision surgery and obliteration of CWDMCs enable successful CHA rehabilitation post-operatively. Upon this type of surgery, hearing thresholds improve significantly, but the need for rehabilitation with a CHA remains necessary in most cases.

Risk Factors for Deterioration of Bone Conduction Hearing in Cases of Labyrinthine Fistula Caused by Middle Ear Cholesteatoma

2012 ◽  
Vol 121 (3) ◽  
pp. 162-167 ◽  
Author(s):  
Ryoukichi Ikeda ◽  
Toshimitsu Kobayashi ◽  
Tetsuaki Kawase ◽  
Takeshi Oshima ◽  
Toshinori Sato
Keyword(s):  
Risk Factors ◽  
Middle Ear ◽  
Bone Conduction ◽  
Labyrinthine Fistula ◽  
Middle Ear Cholesteatoma ◽  
Bone Conduction Hearing

Mechanism of Hearing Loss in Irradiated Ears: A Long-Term Longitudinal Study

2001 ◽  
Vol 110 (10) ◽  
pp. 904-906 ◽  
Author(s):  
Yi-Ho Young ◽  
Ying-Chih Lu
Keyword(s):  
Hearing Loss ◽  
Otitis Media ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Bone Conduction ◽  
Chronic Otitis Media ◽  
Pure Tone Audiometry ◽  
Tube Function ◽  
The Mean ◽  
Air Conduction

A 10-year longitudinal follow-up study of hearing was conducted in patients with nasopharyngeal carcinoma (NPC) in order to elucidate the mechanism of hearing loss in irradiated ears. Ten NPC patients were subjected to a battery of audiological tests before irradiation and 6 months, 5 years, and 10 years after irradiation. The tests included pure tone audiometry, tympanometry, eustachian tube function testing, and myringotomy to confirm middle ear effusion. The prevalences of otitis media with effusion (OME) were 25%, 25%, 40%, and 25% at the 4 testing periods described above, respectively. The prevalences of chronic otitis media were 0%, 0%, 15%, and 25%, respectively. In myringotomized ears (n = 17), the mean hearing levels for both air conduction and bone conduction were preserved from the preirradiation period to 10 years after irradiation. In contrast, in grommeted ears (n = 3), the mean hearing levels for both air conduction and bone conduction deteriorated progressively from the preirradiation period to 10 years after irradiation. We conclude that hearing can be preserved in NPC patients 10 years after irradiation if middle ear inflammation is well controlled. We do not recommend grommet insertion in irradiated NPC patients with OME, as it may result in persistent otorrhea and hearing deterioration.

scholarly journals Correlation between peri-operative complication in middle ear cholesteatoma surgery using STAMCO, ChOLE, and SAMEO-ATO classifications

2021 ◽  
Author(s):  
Tommaso Cacco ◽  
Stefano Africano ◽  
Gilda Gaglio ◽  
Luca Carmisciano ◽  
Enrico Piccirillo ◽  
...  
Keyword(s):  
Middle Ear ◽  
Ossicular Chain ◽  
Male Gender ◽  
The Other ◽  
Care Centre ◽  
Health Care Centre ◽  
Increased Risk ◽  
Middle Ear Cholesteatoma ◽  
The Relationship ◽  
Cholesteatoma Surgery

Abstract Purpose To compare the relationship between the variable “complication” and the other variables of middle ear cholesteatoma classifications (STAMCO, ChOLE, and SAMEO-ATO). Methods Retrospective study of 110 patients that underwent 132 middle ear surgeries between the 1 January 2012 and the 31 December 2019 for chronic otitis with cholesteatoma classified according to STAMCO, ChOLE, and SAMEO-ATO classifications in a tertiary health care centre. Results Older age, male gender, STAMCO-T, and SAMEO-ATO [O1, T, O2, (s -)] and mastoid involvement (STAMCO-M and ChOLE-Ch) were associated with an increased risk of complication report. Conclusions In our series, statistical analysis pointed out a relationship between surgical complications and age, gender, site, mastoidectomy type, and ossicular chain status at surgery. The choice of variables to be recorded for cholesteatoma staging should be carefully balanced, considering that “complication” variable could be a repetitive item.

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