scholarly journals The use of total ossicular replacement prosthesis after radical tympanomastoidectomy

2013 ◽  
Vol 70 (5) ◽  
pp. 463-468
Author(s):  
Dejan Rancic
Keyword(s):  
Hearing Aids ◽  
Bone Conduction ◽  
Second Step ◽  
Second Stage ◽  
Hearing Recovery ◽  
Ossicular Replacement ◽  
One Year ◽  
Replacement Prosthesis ◽  
Air Conduction

Background/Aim. This paper presents our operative method for hearing recovery after the previous radical tympanomastoidectomy, radical trepanation of the temporal bone (trepanatio radicalis ossis temporalis - TROT) in eight patients submitted to operations for giant cholesteatotoma. Methods. All the patients were admitted to our clinic after TROT. There were no signs of cholesteatoma or infection. The patients refused any stent implantations or any hearing aids due to possible aesthetic problems. The described procedure developed in two steps. The first one was to restore the destroyed cavum tympany and to covert with chondroperichondral new membrane with a pin-like ?guide? as collumela. The second step was to insert a TORP (total ossicular replacement prosthesis) after guide excision. Results. After the first operation (stage one) there were no infections in the operated area nor chondroperichondral graft rejection. Postoperative audiometry (6 to 8 weeks) was done to demonstrate the improvement of air conduction. Three months following the first, the second (stage two) operation was performed and 2.5 to 3 months after this operation even greater audiometry revealed hearing improvement in air- and bone-conduction. The patients were dismissed from the hospital 2 days after each procedure without any complications. They did not experience any dizziness, vomiting nor a severe pain. Three months after the second operative stage, otoscopic findings were very good. The audiometry findings after a 3-months period (after stage one) and 3 months after final TORP insertion was done for each of the patients. After one year, the audiometric curve was the same. Clinical and audiometry follow up demonstrated a hearing recovery and closure of air bone gap (ABG) to values of 5 to 15 dB. Conclusion. The use of TORP after radical tympanomastoidectomy is feasible. The first step of the procedure is the fixation of a neomembrane. A stabilized neomembrane is essential for light overpressure on the prosthesis and this is important for optimal or better conductivity. A better hearing recovery is confirmed with audiometric findings and ABG reduction to 5-15 dB. This method could be performed in all patients (with good boneconduction) after radical tympanomastoidectomy for better hearing.

Outcomes with gold wire and hydroxyapatite partial ossicular replacement prostheses in type 2 tympanoplasty: a preliminary study

2015 ◽  
Vol 129 (2) ◽  
pp. 142-147 ◽  
Author(s):  
H Katilmis ◽  
M Songu ◽  
H Aslan ◽  
Y Ozkul ◽  
S Basoglu ◽  
...  
Keyword(s):  
Bone Conduction ◽  
Chronic Otitis Media ◽  
Gold Wire ◽  
Complication Rates ◽  
Graft Take ◽  
Ossicular Replacement ◽  
The Mean ◽  
One Year ◽  
Replacement Prosthesis

AbstractObjectives:To compare the hearing results and graft take rates of the recently developed gold wire prosthesis with those of the hydroxyapatite partial ossicular replacement prosthesis in patients with chronic otitis media.Method:This retrospective study examined patients who underwent type 2 tympanoplasty with a minimum follow up of one year. The study population consisted of 32 patients in the partial ossicular replacement prosthesis group and 26 patients in the gold wire group. The main outcome measures were the graft success rate and level of hearing improvement. Complications and extrusion rates were also noted.Results:The graft take rate was 90.6 per cent for the partial ossicular replacement prosthesis group and 92.3 per cent for the gold wire group (p = 0.848). Pre-operatively, there were no significant differences in the air or bone-conduction thresholds between groups. Post-operatively, the mean hearing gain was 18.5 ± 14.0 dB in the partial ossicular replacement prosthesis group and 16.5 ± 10.6 dB in the gold wire group (p = 0.555). The mean air-conduction thresholds were 26.6 ± 12.4 and 32.6 ± 10.5 dB, respectively (p = 0.027), and the mean bone-conduction thresholds were 9.7 ± 7.0 and 10.4 ± 6.4 dB, respectively (p = 0.687).Conclusion:The success and complication rates provided by the gold wire prosthesis seem comparable to those of the hydroxyapatite partial ossicular replacement prosthesis.

scholarly journals Endoscopic Ossiculoplasty for the Management of Isolated Congenital Ossicular Chain Malformation: Surgical Results in 16 Ears

2020 ◽  
pp. 014556132093121
Author(s):  
Chunlin Zhang ◽  
Jiaoping Mi ◽  
Dan Long ◽  
Yuan Deng ◽  
Qiang Sun ◽  
...  
Keyword(s):  
Bone Conduction ◽  
Ossicular Chain ◽  
Chorda Tympani ◽  
Chorda Tympani Nerve ◽  
Hearing Outcome ◽  
Before And After ◽  
Ossicular Replacement ◽  
The Mean ◽  
Replacement Prosthesis ◽  
Air Conduction

Objective: The aim of this study is to describe the clinical characteristics and intraoperative findings and further evaluate the efficacy of endoscopic ossiculoplasty for the management of isolated congenital ossicular chain malformation. Methods: A retrospective study was performed on 16 ears (15 patients) with the isolated congenital ossicular chain malformation who underwent endoscopic ossiculoplasty in our department from May 2017 to January 2019. Endoscopic exploratory tympanotomy was conducted to check the ossicular chain; at the same time, endoscopic ossiculoplasty was performed depending on intraoperative findings. Air-conduction thresholds, bone-conduction thresholds, and air-bone gaps (ABGs) were measured before and after surgery, and the hearing outcome was assessed at 6 months postoperatively. Results: The most common malformations of ossicular chain were the missing of the incus long process and stapes suprastructure. A serial assessment of the hearing status was conducted before and 6 months after surgery. It showed the mean postoperative pure-tone average (PTA) was significantly reduced, and the mean postoperative ABG was obviously closed, respectively ( P < .001). The mean PTA gain was 36.3 ± 8.6 dB, and the ABG closure was 35.1 ± 8.3 dB; ABG closure to 20 dB or less and ABG closure to 10 dB or less were achieved in 14 cases (87.5%) and 5 cases (31.3%), respectively. No differences were observed in postoperative hearing outcome between type Ⅲ cases and type Ⅳ cases; however, cases with partial ossicular replacement prosthesis implantation showed a larger hearing gain ( P = .049) and a higher proportion of postoperative ABG less than 10 dB ( P = .021). No facial palsy and significant sensorineural hearing loss occurred; all patients completed the surgery without the need of canalplasty, and the chorda tympani nerve was preserved in all patients. Conclusions: This research showed endoscopic surgery was effective in the diagnosis and management of isolated congenital ossicular chain malformation; the endoscopic ossiculoplasty provides an alternative method to manage congenital ossicular chain malformation, with comfortable hearing outcome and the advantage of excellent vision and less invasion.

Frequency-Specific Analysis of Hearing Outcomes Associated with Ossiculoplasty Versus Stapedotomy

2021 ◽  
pp. 000348942199016
Author(s):  
Denis D. Nguyen ◽  
Ryan T. Judd ◽  
Terence E. Imbery ◽  
Michael B. Gluth
Keyword(s):  
Bone Conduction ◽  
Retrospective Chart Review ◽  
Ossicular Chain ◽  
Specific Analysis ◽  
Mass Load ◽  
Ossicular Replacement ◽  
The Mean ◽  
Hearing Outcomes ◽  
Replacement Prosthesis

Objective: Surgery on the ossicular chain may impact its underlying mechanical properties. This study aims to investigate comparative differences in frequency-specific hearing outcomes for ossiculoplasty versus stapedotomy. Methods: A retrospective chart review was conducted on subjects who underwent ossiculoplasty with partial ossicular replacement prosthesis (PORP) or laser stapedotomy with self-crimping nitinol/fluoroplastic piston, and achieved closure of postoperative pure tone average air-bone gap (PTA-ABG) ≤ 15 dB. 45 PORP and 38 stapedotomy cases were included, with mean length of follow-up of 7.6 months. Results: The mean change in PTA-ABG was similar for the 2 procedures (−17.9 dB vs −18.1 dB, P = .98). Postoperative ABG closure for stapedotomy was superior at 1000 Hz (8.9 dB vs 13.9 dB, P = .0003) and 4000 Hz (11.8 dB vs 18.0 dB, P = .0073). Both procedures also had improved postoperative bone conduction (BC) thresholds at nearly all frequencies, but there was no statistical difference in the change in BC at any particular frequency between the 2 procedures. Conclusion: Both procedures achieved a similar mean change in PTA-ABG. Stapedotomy was superior to PORP at ABG closure at 1000 Hz and at 4000 Hz, with 1000 Hz the most discrepant. The exact mechanism responsible for these changes is unclear, but the specific frequencies affected suggest that differences in each procedure’s respective impact on the native resonant frequency and mass load of the system could be implicated.

Autologous total ossicular replacement prosthesis

2014 ◽  
Vol 128 (12) ◽  
pp. 1050-1055 ◽  
Author(s):  
M Malhotra ◽  
S Varshney ◽  
R Malhotra
Keyword(s):  
Pure Tone ◽  
Chronic Otitis Media ◽  
Canal Wall ◽  
Hearing Improvement ◽  
Hearing Results ◽  
Replacement Technique ◽  
Ossicular Replacement ◽  
Canal Wall Down ◽  
Replacement Prosthesis ◽  
Air Conduction

AbstractObjective:To develop an autologous total ossicular replacement prosthesis with sustainable hearing results.Methods:The ears of 40 patients, who had chronic otitis media with absent suprastructure of the stapes and long process of the incus, were repaired using the autologous total ossicular replacement technique. Post-operative results were evaluated after 6 and 12 months on the basis of average pure tone air conduction and average air–bone gap measured at 0.5, 1, 2 and 3 kHz.Results:Successful rehabilitation of pure tone average to 30 dB or less was achieved in 75 per cent of patients, and air–bone gap to 20 dB or less was attained in 82.5 per cent of patients. Overall mean improvement in air–bone gap was 23.9 ± 8.5 dB (p < 0.001). Mean improvements in air–bone gap were significantly greater (p < 0.05) in the tympanoplasty only group (27.3 ± 6.6 dB) and the intact canal wall tympanoplasty group (25.9 ± 6.3 dB) than in the canal wall down tympanoplasty group (16.3 ± 8.9 dB).Conclusion:This paper describes an autologous total ossicular replacement prosthesis that is biocompatible, stable, magnetic resonance imaging compatible and, above all, results in sustainable hearing improvement.

The styloid process in ossicular chain reconstruction

1988 ◽  
Vol 102 (2) ◽  
pp. 136-137 ◽  
Author(s):  
S. B. Ogale ◽  
C. Desouza ◽  
J. Sheode ◽  
K. L. Shah
Keyword(s):  
Bone Conduction ◽  
Chronic Otitis Media ◽  
Ossicular Chain ◽  
Styloid Process ◽  
Long Term Results ◽  
Graft Material ◽  
Ossicular Chain Reconstruction ◽  
One Year

AbstractOur pilot study reports twenty-six cases of resolved chronic otitis media in which the human, cadaveric styloid process was used as an ossicular graft material. A maximum follow-up of one year is presented in this paper. There was no extrusion or rejection of the styloid processes. Hearing improvement with a closure of the air-bone gap to within 10–15 dB. of the pre-operative bone conduction was found in most cases. So far the styloid process has proved to be an ideal ossicular graft though the long-term results are yet to be seen.

Insertion of middle-ear Silastic sheeting during tympanoplasty: hearing outcomes

2010 ◽  
Vol 125 (5) ◽  
pp. 445-448 ◽  
Author(s):  
S M Elmorsy ◽  
H E Amer
Keyword(s):  
Retrospective Study ◽  
Surgical Treatment ◽  
Chronic Inflammation ◽  
Middle Ear ◽  
Bone Conduction ◽  
Chronic Otitis Media ◽  
One Year ◽  
Operative Findings ◽  
Hearing Outcomes ◽  
Air Conduction

AbstractObjective:To study the effect of Silastic®sheeting placed in the middle ear during tympanoplasty, including the effect on hearing.Design:Retrospective study.Background:Chronic inflammation of the middle ear is common. Surgical treatment sometimes results in middle-ear adhesions and hearing deterioration.Materials and methods:We selected 106 patients with chronic otitis media, middle-ear adhesions and intact ossicles, based on intra-operative findings. These patients underwent single-stage tympanoplasty either with or without insertion of Silastic sheeting. Audiometry was undertaken pre-operatively and one and 12 months post-operatively.Results:Patients who had undergone Silastic sheet insertion showed significantly better air conduction, bone conduction and air–bone gap averages one year post-operatively, compared with those who had not.

Hearing Results in the Second Stage of Open Mastoidectomy: A Comparison of the Different Techniques

2000 ◽  
Vol 122 (5) ◽  
pp. 748-751 ◽  
Author(s):  
Fernando Cristóbal ◽  
Rafael Gómez-Ullate ◽  
Isabel Cristóbal ◽  
Alfredo Arcocha ◽  
Ramón Arroyo
Keyword(s):  
Point Of View ◽  
Open Cavity ◽  
The Other ◽  
Hearing Results ◽  
Hearing Gain ◽  
Second Stage ◽  
Restoration Techniques ◽  
Ossicular Replacement ◽  
The Difference ◽  
Replacement Prosthesis

OBJECTIVE: The goal of this study was to compare the hearing results obtained through different hearing-restoration techniques in open-cavity mastoidectomy. METHODS AND MATERIAL: A total of 116 ears operated on during the second stage of open mastoidectomy were studied. The hearing gain was registered as the difference between preoperative and 1-year postoperative conversational frequency means (500, 1000, 2000 Hz). High-pitched frequencies (4000 Hz) were used equally. Two groups of studies were carried out: in one study the stapes was intact, and in the other the stapes arch was absent. The columella techniques we examined, from a hearing point of view, are total and partial ossicular replacement prostheses, ossiculoplasty, cartilage with or without perichondrium, and the myringostapediopexy. RESULTS AND CONCLUSIONS: In the group of patients in whom the stapes was intact, the differences in high-pitched frequencies found between the different techniques were negligible, but the differences were quite significant in conversational frequencies, where the partial ossicular replacement prosthesis turned out to be the technique with the worst results. In ears in which only the footplate was present, the total ossicular replacement prosthesis gave better results than any other technique, both in conversational frequencies and in 4000-Hz frequency.

Hearing Levels of Patients with Otosclerosis 10 Years after Stapedectomy

1993 ◽  
Vol 108 (3) ◽  
pp. 251-255 ◽  
Author(s):  
Eero Vartiainen ◽  
Jukka Virtaniemi ◽  
Markku Kemppainen ◽  
Seppo Karjalainen
Keyword(s):  
Bone Conduction ◽  
Hearing Level ◽  
Long Run ◽  
Hearing Function ◽  
The Mean ◽  
Normal Controls ◽  
Air Conduction

Hearing levels of 174 patients (213 ears operated on) with otosclerosis undergoing stapedectomy were analyzed. All patients had followup of 10 years or more, the mean follow-up period being 13.4 years. Eighty-seven ears (41%) underwent posterior crus stapedectomy, and in the remaining 126 ears (59%) a prosthesis was inserted. Large fenestra technique was used in all cases. In the long run, both air conduction and bone conduction thresholds of ears operated on showed remarkable deterioration from the best values obtained 6 to 12 months postoperatively. Ten years after surgery both air conduction and bone conduction thresholds of ears operated on were significantly worse than those of normal controls. At 10 years, 70 percent of the ears operated on had hearing levels (at 0.5 to 2.0 kHz) of 30 dB or better and 88 percent had 40 dB or better. At the last follow-up examination, in 90% of the patients the better hearing ear had a hearing level of 40 dB or better. In 90% of patients with bilateral otosclerosis who had operations in only one ear, the ear operated on had better hearing function than the opposite ear that had not been operated on.

Hearing results in the second stage of open mastoidectomy: A comparison of the different techniques

2000 ◽  
Vol 122 (5) ◽  
pp. 748-751
Author(s):  
Fernando CristÔBal ◽  
Rafael Gômez-Ullate ◽  
Isabel CristÔBal ◽  
Alfredo Arcocha ◽  
Ramon ArrÔO
Keyword(s):  
Point Of View ◽  
Open Cavity ◽  
The Other ◽  
Hearing Results ◽  
Hearing Gain ◽  
Second Stage ◽  
Restoration Techniques ◽  
Ossicular Replacement ◽  
The Difference ◽  
Replacement Prosthesis

OBJECTIVE: The goal of this study was to compare the hearing results obtained through different hearing-restoration techniques in open-cavity mastoidectomy. METHODS AND MATERIAL: A total of 116 ears operated on during the second stage of open mastoidectomy were studied. The hearing gain was registered as the difference between preoperative and 1-year postoperative conversational frequency means (500, 1000, 2000 Hz). High-pitched frequencies (4000 Hz) were used equally. Two groups of studies were carried out: in one study the stapes was intact, and in the other the stapes arch was absent. The columella techniques we examined, from a hearing point of view, are total and partial ossicular replacement prostheses, ossiculoplasty, cartilage with or without perichondrium, and the myringostapediopexy. RESULTS AND CONCLUSIONS: In the group of patients in whom the stapes was intact, the differences in high-pitched frequencies found between the different techniques were negligible, but the differences were quite significant in conversational frequencies, where the partial ossicular replacement prosthesis turned out to be the technique with the worst results. In ears in which only the footplate was present, the total ossicular replacement prosthesis gave better results than any other technique, both in conversational frequencies and in 4000-Hz frequency.

Audiometric Results of Torp and Porp Middle Ear Reconstruction

1989 ◽  
Vol 98 (6) ◽  
pp. 429-433 ◽  
Author(s):  
I. W. S. Mair ◽  
S. Pedersen ◽  
E. Laukli
Keyword(s):  
Middle Ear ◽  
Hearing Aids ◽  
Functional Results ◽  
Middle Ear Surgery ◽  
Hearing Level ◽  
Ear Reconstruction ◽  
Ossicular Replacement ◽  
Middle Ear Reconstruction ◽  
Air Conduction ◽  
Observation Period

The results of 70 middle ear reconstructions using either total or partial ossicular replacement prostheses are presented, the mean observation period being 45 months. Twenty-seven of the prostheses (39%) were extruded, this occurring as late as 72 months after surgery, and four (6%) were removed at reoperation. The surgical results when assessed by the magnitude of the air-bone gap are comparable to those of other series in the literature. However, postoperative air conduction thresholds remained high, and 23 % of the patients are using hearing aids. The average air-bone gap for the frequencies 0.5, 1, and 2 kHz does not provide information on patients' everyday hearing level, and should no longer be employed as an index for assessing the functional results of middle ear surgery.

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