scholarly journals Outcomes of Type I Tympanoplasty using a Cartilage Shield Graft

2020 ◽  
pp. 100-104
Author(s):  
Murad Ghazi Ahmed ◽  
Said M. Said Aljaff ◽  
Hiwa Asaad Abdulkareem
Keyword(s):  
Hearing Loss ◽  
Tympanic Membrane ◽  
Functional Outcomes ◽  
Neck Surgery ◽  
P Value ◽  
Type I ◽  
Tympanic Membrane Perforations ◽  
Type I Tympanoplasty ◽  
Mean Differences ◽  
Anatomical Outcome

Background: Type I tympanoplasty surgery is an effective routine technic that had been used for tympanic reconstruction to improve hearing. Objectives: The aim was to measure the effect of type I tympanoplasty surgery using the cartilage shield graft (CSG) in term of graft uptake (anatomical outcome) and hearing gains (functional outcomes) of patients with poor prognostic factors. Method and Materials: In this study, 20 patients with perforation exceeded 50%, but limited to the tympanic membrane were recruited for type I tympanoplasty surgery. The study was conducted in the Otolaryngology/Head and Neck surgery training center in Sulaimani Teaching Hospital in Sulaimani city for one year period. Bellucci classification was used to evaluate otorrhea risks. Results: The majority of patients were female (90%), with a mean ± SD (standard deviation) of ages of 37.15 ± 14.01 years. Most of the patients (40%) were presented with a mild hearing loss of 26-40 decibels (dB). Type I tympanoplasty surgery using the cartilage shield graft (CSG) had significantly decreased the hearing loss and air-bone gap (p-value = 0.046 and 0.006, respectively). The mean differences in hearing loss and air-bone gap were 5.05 dB and 6.75 dB, respectively. Conclusions: CSG in type I tympanoplasty surgery is an effective solution in anatomical outcome (Graft uptake) and functional outcomes (hearing gains) which had been reflected in reducing hearing loss and air-bone gap (average hearing gain of 5dB) in patients presented with tympanic membrane perforations. No improvement in the functional outcomes was observed in patients presented with severe hearing loss pre-operatively.

scholarly journals Fat Myringoplasty and its Impact on the Hearing Mechanism of Middle Ear

2015 ◽  
Vol 7 (3) ◽  
pp. 138-140
Author(s):  
Bandar Al-qahtani ◽  
Mohammed Al Tuwaijri ◽  
Mohammed Al Mokhatrish
Keyword(s):  
Tympanic Membrane ◽  
Middle Ear ◽  
Fat Grafting ◽  
Type I ◽  
Tympanic Membrane Perforations ◽  
Large Perforation

ABSTRACT Objectives To address the fat grafting to tympanic membrane perforations—fat myringoplasty type I—and its impact over the hearing mechanism of the middle ear for both small (< 25% of the tympanic membrane) and large perforation (> 75 % of the TM). How to cite this article Al-qahtani B, Al Tuwaijri M, Al Mokhatrish M. Fat Myringoplasty and its Impact on the Hearing Mechanism of Middle Ear. Int J Otorhinolaryngol Clin 2015;7(3):138-140.

scholarly journals Hearing assessment and status of tympanic membrane pre and post-operated tympanoplasty in cases of CSOM.

2020 ◽  
Vol 27 (12) ◽  
pp. 2581-2585
Author(s):  
Tahir Hussain x Tahir Hussain Khan ◽  
Humaira Tahir ◽  
Imran Ali ◽  
Sohail Abdul Malik
Keyword(s):  
Tympanic Membrane ◽  
Pure Tone ◽  
Pure Tone Audiometry ◽  
Medium Size ◽  
P Value ◽  
Safe Procedure ◽  
Hearing Improvement ◽  
Middle Ear Mucosa ◽  
Tympanic Membrane Perforations ◽  
Hearing Assessment

Objectives: To compare assessment of hearing by PTA and status of tympanic membrane by oto-endoscope, pre-operative and post-operative tympanoplasty. Study Design: Retrospective/ Comparative study. Setting: Two different hospitals in Karachi. 1-Social Security Landhi Hospital Karachi. 2- Al-Tibri medical College & Hospital, Old Thana, Malir, Karachi. Period: July 2017 to June 2018. Material & Methods: 76 patients were included for this study with both genders who had dry tympanic membrane perforations. Age ranges between 18 to 40 years. Made two groups A (pre-operative and B (post-operative). In group-A, examined tympanic membrane perforations. 45 patients had small size (25%) perforations, 15 medium size (50%) and 16 subtotal (75%). Hearing assessment done by Pure tone Audiometry (PTA). After 1. 2 and 3 months post-tympanoplasty, examined grafted tympanic membrane and compared pre-operated status of tympanic membrane with post-operated status of tympanic membrane. PTA done after 3 months and compared it with pre-operated PTA. Results: Examination of tympanic membrane before tympanoplasty performed, perforations noted in all patients with different sizes in their tympanic membrane. PTA (pure tone audiometry) advised before tympanoplasty to all patients. Weber test performed on 1st post-operated day, it was lateralized towards operated ear which indicate the safety of inner ear. Post-operated 1, 2 and 3 months examined tympanic membrane with oto-endoscope. Intact grafted tympanic membrane seen in 70 patients after 1 months. After 2 months 72 patients had intact grafted tympanic membrane and after 3 months 73 patients out of 76 patients had intact grafted tympanic membrane. PTA also advised after 3 months of tympanoplasty and compared it with pre-operated pure tone audiometry (PTA). Air conduction (AC) decreased 15.39dB after tympanoplasty. AB-gap reduction 13.95dB seen in 73 patients which showed hearing improvement. P value is < 0.001 significant. Conclusion: Tympanoplasty is a good and safe procedure for hearing improvement by reduction of AB-gap as well as provide protection of middle ear mucosa from infections due to closure of perforations of tympanic membranes.

scholarly journals Evaluation of hearing status after type I tympanoplasty

2020 ◽  
Vol 24 (1) ◽  
pp. 50-55
Author(s):  
Mashuque Mahamud ◽  
Mani Lal Aich ◽  
Abdullah Al Mamun ◽  
Rafiul Alam
Keyword(s):  
Otitis Media ◽  
Chronic Otitis Media ◽  
Neck Surgery ◽  
Cross Sectional Study ◽  
Type I ◽  
Cross Sectional ◽  
Female Ratio ◽  
The Mean ◽  
Type I Tympanoplasty ◽  
Air Conduction

Objective: To evaluate hearing outcome after type I tympanoplasty in inactive mucous type of chronic otitis media. Methods: It was a cross-sectional study conducted in the department of Otolaryngology & Head Neck Surgery, Sir Salimullah Medical College and Mitford Hospital, Dhaka, from July 2014 to June 2016. 50 cases were selected by matching inclusion and exclusion criteria. Paired t-test and Z test was used to analyze the variables. P values <0.05 was considered as statistically significant. Results: The mean age was found 28.5 years with range from 15 to 41 years and male female ratio was 1.3:1. All patients had intermittent otorrhoea and varying degree of hearing loss. The mean air conduction threshold was 40.2 dB preoperatively and 27.1 dB post-operatively. Air-bone gap was found 26.9 dB in preoperative and 16.1 dB in post-operative group. The differences were statistically significant between preoperative and post-operative group. Thus mean improvement of air conduction threshold was 13.1 dB and air-bone gap was 10.8 dB. Two third (66.%) patients improved <15 db air conduction thresholds and 17(34%) improved ≥15 db air conduction thresholds. Using the proportion of patients with a postoperative hearing within 40 dB as the criterion, this study showed 46(92%) patients achieving this and 40(80%) patients achieving AB gap within 20 db postoperatively. Conclusion: Improvement of air conduction threshold and AB gap after type I tympanoplasty was statistically significant. Thus from this study it can be concluded that type I tympanoplasty is an effective technique for hearing improvement in inactive mucous type of chronic otitis media. Bangladesh J Otorhinolaryngol; April 2018; 24(1): 50-55

scholarly journals Correlation of Site and Size of Tympanic Membrane Perforation and Middle Ear Air Space Volume with Magnitude of Hearing Loss

2019 ◽  
Vol 02 (01) ◽  
pp. 10-15
Author(s):  
Ramandeep Singh Virk ◽  
Krishan Kudawla ◽  
Sandeep Bansal ◽  
Ramya Rathod ◽  
Samarendra Behera
Keyword(s):  
Hearing Loss ◽  
Tympanic Membrane ◽  
Middle Ear ◽  
Tympanic Membrane Perforation ◽  
Tympanic Membrane Perforations ◽  
Air Space ◽  
Membrane Perforation ◽  
Volume Group ◽  
Space Volume ◽  
Lower Frequencies

Abstract Introduction The effects of tympanic membrane perforations on middle ear sound transmission are not well characterized, largely because ears with perforations typically have additional pathological changes. It has been established that the larger the perforation, the greater is the hearing loss (HL). Aim This study aimed to correlate the location and size of tympanic membrane perforation and middle ear air space volume with the magnitude of HL in patients with tubotympanic or inactive mucosal type of chronic otitis media (COM). Materials and Methods A prospective clinical study of patients with tympanic membrane perforations due to COM and without any other ear disease and who attended the Otolaryngology services at our institute between July 2010 and December 2011 was conducted. A total of 300 ears were evaluated by performing otoendoscopy, followed by photo documentation and audiological investigations (pure-tone audiometry and tympanometry). Tympanic membrane perforations were categorized based on their size and location, and the mean air-bone (AB) gap between the various types of perforations was compared and statistically analyzed with significance level of p < 0.05. Results Out of 300 ears, maximum number of ears (n = 124, 41.3%) had large-sized perforations (> 30 mm2) that had a maximum mean AB gap of 26.43 dB, and minimum number of ears (n = 60, 20%) had small-sized perforations (0–9 mm2) that had minimum mean AB gap of 9.12 dB. The remaining were medium-sized perforations that had mean AB gap of 16.13 dB. Depending on the location, maximum were central perforations (n = 198, 66%) and minimum were anterosuperior (AS) perforations (n = 9, 3%). Based on the middle ear volume on tympanometry, maximum ears were of low-volume group (n = 246, 92%) that had larger mean AB gap of 19.96 dB HL when compared with the high-volume group (n = 24, 8%) with 11.80 dB HL. AB gap was maximum at lower frequencies and decreased with increase in frequencies except at 4,000 Hz, that is, 56.9 dB HL at 250 Hz, 42.6 at 500 Hz, 41.5 at 1,000 Hz, 32.4 at 2,000 Hz, and 49.5 at 4,000 Hz. Conclusion HL increases as the area of tympanic membrane perforation increases. There is an inverse relationship between HL and middle ear air space volume. Comparing the small-sized perforations at different sites with the middle ear volume being low, it was found that posterosuperior (PS) perforations had 4 to 7 dB greater HL than AS and anteroinferior (AI). However, the relationship was statistically insignificant. The phase cancellation effect of round window causing greater HL in posteroinferior (PI) perforations does not exist in small- and medium-sized perforations. HL is greater at lower frequencies and less at higher frequencies.

The Management of Tympanic Membrane Perforation With Endoscopic Type I Tympanoplasty

2019 ◽  
pp. 1 ◽  
Author(s):  
Daniele Marchioni ◽  
Luca Gazzini ◽  
Stefano De Rossi ◽  
Flavia Di Maro ◽  
Luca Sacchetto ◽  
...  
Keyword(s):  
Tympanic Membrane ◽  
Tympanic Membrane Perforation ◽  
Type I ◽  
Membrane Perforation ◽  
Type I Tympanoplasty

Analysis of Type I Tympanoplasty Versus Simple Underlay Myringoplasty for Tympanic Membrane Perforation

2015 ◽  
Vol 108 (5) ◽  
pp. 339-345
Author(s):  
Ryo Suzuki ◽  
Shinichi Sato ◽  
Kazuyuki Ichimaru ◽  
Tomoyuki Haji ◽  
Juichi Ito
Keyword(s):  
Tympanic Membrane ◽  
Tympanic Membrane Perforation ◽  
Type I ◽  
Membrane Perforation ◽  
Type I Tympanoplasty

scholarly journals Frequency Dependence Hearing Loss Evaluation in Perforated Tympanic Membrane

2017 ◽  
Vol 21 (04) ◽  
pp. 336-342 ◽  
Author(s):  
Mohammed Dawood
Keyword(s):  
Hearing Loss ◽  
Frequency Dependence ◽  
Tympanic Membrane ◽  
Cross Sectional Study ◽  
Tympanic Membrane Perforation ◽  
Hearing Level ◽  
Cross Sectional ◽  
Maximum Loss ◽  
Tympanic Membrane Perforations ◽  
Membrane Perforation

Introduction Tympanic membrane perforation is a relatively common problem that predisposes patients to varying degrees of conductive hearing loss. Objective The objective of this study is to evaluate and analyze the frequency dependence hearing loss in tympanic membrane perforation based on the size and the site of perforation. Methods For the study, I selected 71 patients' (89) ears for the cross-sectional study with tympanic membrane perforations; I examined the size and the site of perforations under the microscope and classified them into small, moderate, large, and subtotal perforations, and into anterior central, posterior central, malleolor central, and big central perforations. I measured mean level of speech frequencies hearing loss, and its relation with the site and the size of the perforation analyzed. Results The mean hearing loss at different sizes of the perforation at all speech frequencies was 37.4 dB, with ABG of 26.6 dB, and its maximum loss was detected in subtotal perforation of 42.3 dB, with ABG of 33.7 dB, at 500 Hz frequency, while in relation to the sites, it was 38.2 dB, with ABG of 26.8 dB, and its maximum loss was detected in big central site perforation of 42.1 dB, with ABG of 33.6 dB, at 500 Hz frequency. Conclusions The hearing loss was proportionally related with the sizes of the perforations, and the posterior site had greater impact on the hearing than anterior site perforations. This was also applied to the frequency dependence hearing level, as was detected to be worse at lower frequencies as 500 Hz, than those of 1000–2000 Hz.

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