scholarly journals COMPARATIVE STUDY BETWEEN UNDERLAY AND OVERRLAY TECHNIQUE IN TYPE 1 TYMPANOPLASTY IN CSOM MUCOSAL INACTIVE TYPE

2020 ◽  
pp. 1-3
Author(s):  
Chandpreet Kour ◽  
Saima Tabassum ◽  
Madeha Drabu
Keyword(s):  
Surgical Techniques ◽  
Tympanic Membrane Perforation ◽  
Surgical Closure ◽  
Type 1 Tympanoplasty ◽  
Grafting Technique ◽  
Membrane Perforation ◽  
Air Cells ◽  
Middle Ear Cleft ◽  
Mastoid Air Cells

Otitis Media (OM) is an inflammatory condition which usually involves muco-periosteal covering of middle ear cleft (partial or full) comprising of eustachain tube (ET), hypo-tympanum, meso-tympanum, epi-tympanum,additus and the mastoid air cells. Myringoplasty was introduced by Berthold5 long back in 1878 and included the surgical closure of tympanic membrane perforation including removal of epithelium and grafting with skin. This period witnessed an improvement in surgical techniques with improved optics and emergence of microsurgery, thus making the Myringoplasty safer and lowered the rate of graft rejection. In this study we have compared the the grafting technique in type-1 tympanoplasty of in CSOM mucosal inactive type.

scholarly journals A study to compare the outcomes of CO2 laser assisted myringoplasty versus conventional type1 tympanoplasty in small central tympanic perforations

2021 ◽  
Vol 7 (5) ◽  
pp. 809
Author(s):  
Inderdeep Singh ◽  
Basavaraj S. Patil ◽  
Mohammad Z. Akhtar
Keyword(s):  
Success Rate ◽  
Tympanic Membrane ◽  
Acute Otitis Media ◽  
Tympanic Membrane Perforation ◽  
Surgical Closure ◽  
Type 1 Tympanoplasty ◽  
Microscopic Surgery ◽  
Membrane Perforation ◽  
Conventional Type

<p class="abstract"><strong>Background:</strong> The standard treatment of tympanic membrane perforation is conventional surgical closure using myringoplasty or a tympanoplasty type 1. In this study the role of cabon dioxide (CO<sub>2</sub>)-laser-assisted de-epitheliazation of perforation margins and application of bioinert silastic sheet. Success rate was compared with conventional microscopic surgery.</p><p class="abstract"><strong>Methods:</strong> This was a comparative study containing 60 patients with small dry tympanic membrane perforation (diameter 1-3 mm). The causes of tympanic membrane perforations were mainly traumatic or the eardrum did not heal after spontaneous perforation caused by an acute otitis media or after surgery. The procedure was performed under local anaesthesia. CO<sub>2</sub> (acupulse) applied along the edge of the perforation until complete de-epitheliazation and application of bioinert silastic sheet in small dry perforation. Closure of eardrum perforation was monitored using an otoendoscope. Success rate of the CO<sub>2</sub> laser myringoplasty was compared with conventional type 1 tympanoplasty.  </p><p class="abstract"><strong>Results:</strong> Complete eardrum closure occurred in 24 cases (80%), 06 patients (20%) had a residual perforation. The success rate of this procedure is lower than conventional type 1 tympanoplasty, which is 90-94%. There were no complications during and after the treatment.</p><p class="abstract"><strong>Conclusions:</strong> A closure rate of 80% (24/30) was achieved with a CO<sub>2</sub>-laser-assisted de-epitheliazation. This procedure can be offered carefully to selected cases with perforation size &lt;3 mm, where the CO<sub>2</sub> facility is available before they undergo formal conventional microscopic surgery.</p><p class="abstract"> </p>

scholarly journals Comparative study of outcomes of type-1 tympanoplasty with and without anterior tucking

2020 ◽  
Vol 6 (4) ◽  
pp. 657
Author(s):  
Kiran Gangadar S. ◽  
G. Priyadarshini
Keyword(s):  
Tympanic Membrane ◽  
Otitis Media ◽  
Chronic Otitis Media ◽  
Pure Tone Audiometry ◽  
Tympanic Membrane Perforation ◽  
Hearing Improvement ◽  
Type 1 Tympanoplasty ◽  
Membrane Perforation ◽  
Group 2

<p class="abstract"><strong>Background:</strong> Tympanoplasty is a surgical procedure for closing the tympanic membrane perforation and reconstructing the tympanic membrane and hearing, commonly after trauma and chronic otitis media. The aim of the study was to compare the clinical and audiological outcomes of tympanoplasty with or without anterior tucking.</p><p class="abstract"><strong>Methods:</strong> In this prospective study, 50 patients with chronic otitis media (COM) were divided into two groups. Group 1 underwent type 1 tympanoplasty with anterior tucking method, and group 2 underwent type 1 tympanoplasty without anterior tucking. The result was measured on graft uptake and hearing outcome at 6 months postoperatively by performing pure tone audiometry.  </p><p class="abstract"><strong>Results:</strong> The hearing improvement was almost the same in both the groups. Graft uptake was good in type 1 tympanoplasty with tucking (96%) when compared to without tucking tympanoplasty (92%). Complications like residual perforation were seen in both groups equally. Anterior marginal blunting was noted (8%) in type 1 tympanoplasty with tucking.</p><p class="abstract"><strong>Conclusions:</strong> The hearing improvement of type-1 tympanoplasty with anterior tucking and without anterior tucking is the same. Type-1 tympanoplasty with anterior tucking has a better graft acceptance. The only disadvantage of type-1 tympanoplasty with anterior tucking is anterior marginal blunting.</p>

scholarly journals Reinforced temporalis fascia with conchal cartilage versus exclusive temporalis fascia grafting in type 1 tympanoplasty: a comparative study

2020 ◽  
Vol 6 (7) ◽  
pp. 1268
Author(s):  
Rahul S. Gosavi ◽  
Shishir D. Gosavi ◽  
Digwijay A. Bandgar ◽  
Akash D. Gupta ◽  
Pradny S. Naik ◽  
...  
Keyword(s):  
Chronic Otitis Media ◽  
Tympanic Membrane Perforation ◽  
Temporalis Fascia ◽  
Conchal Cartilage ◽  
Type 1 Tympanoplasty ◽  
Fascia Graft ◽  
Membrane Perforation ◽  
A Prospective Study ◽  
Grafting Materials

<p class="abstract"><strong>Background:</strong> Various grafting materials have been used for the repair of a tympanic membrane perforation over the years, with temporalis fascia and conchal cartilage being the most widely used. Our study is an attempt to compare and analyse the use of exclusive temporalis fascia as grafting material against a reinforced graft consisting of temporalis fascia and conchal cartilage.</p><p class="abstract"><strong>Methods:</strong> This is a prospective study of 100 patients having inactive mucosal chronic otitis media with a dry central perforation with moderate conductive hearing loss, undergoing type 1 tympanoplasty using underlay technique. 50% of the subjects were grafted with temporalis fascia alone while a reinforced temporalis fascia graft along with conchal cartilage was used in the remaining 50% of the cases. The results were evaluated at an interval of 24 weeks after surgery on the basis of graft uptake and hearing restoration (closure of air-bone gap &lt;10 dB).  </p><p class="abstract"><strong>Results:</strong> Graft uptake in exclusive temporalis fascia grafting was 86% while it was 94% when a reinforced graft was used; the hearing restoration rates in both the groups were 82% and 80% respectively.   </p><p class="abstract"><strong>Conclusions:</strong> Reinforced temporalis fascia grafting along with conchal cartilage gives better results than grafting with temporalis fascia alone as regards to graft uptake, while the audiometric results are comparable in both the groups.   </p>

scholarly journals A prospective study of the hearing gain achieved in relation to the site and size of tympanic membrane perforation after type 1 tympanoplasty with temporalis fascia graft

2019 ◽  
Vol 6 (1) ◽  
pp. 20
Author(s):  
Gopinathan N. Pillai ◽  
Anjana Mary Reynolds ◽  
Nazneen Parammal Ayyappankandi ◽  
Cyril C. Ninan
Keyword(s):  
Hearing Loss ◽  
Tympanic Membrane ◽  
Pure Tone ◽  
Tympanic Membrane Perforation ◽  
Temporalis Fascia ◽  
Hearing Gain ◽  
Type 1 Tympanoplasty ◽  
Fascia Graft ◽  
Membrane Perforation

<p class="abstract"><strong>Background:</strong> Chronic otitis media (COM) mucosal type is characterised by recurrent ear discharge and hearing loss secondary to tympanic membrane perforation. Type 1 tympanoplasty is the surgical option for its closure. The objective of this study is to record the site and size of tympanic membrane perforation, quantify the hearing loss with pure tone audiogram and to assess the hearing gain achieved following type 1 tympanoplasty with temporalis fascia graft.</p><p class="abstract"><strong>Methods:</strong> This prospective study comprises 120 patients of the age group of 15 to 60 years with COM who attended the otorhinolaryngology department, from June 2015 to May 2018. Site and size of perforation were assessed by the number of quadrants involved. Hearing loss was quantified by pure tone audiometry (PTA) pre-op and 3, 6 and 12 months post-op. The pure tone average with the air-bone gap (ABG) at 12 months is used for the assessment.  </p><p class="abstract"><strong>Results:</strong> In this study, mean pure tone average pre-operatively for small, medium, large and subtotal perforations were 26 dB, 32 dB,35 dB, 42 dB respectively and 14.37 dB, 23 dB, 23.66 dB, and 32.5 dB post operatively after one year. On statistical analysis by ANOVA test, postoperative hearing gain was statistically significant.</p><p class="abstract"><strong>Conclusions:</strong> The study shows that hearing loss was proportional to the size of perforation. Air-bone closure following type 1 tympanoplasty was more for subtotal perforation and for perforations involving both anterior and posterior quadrants.</p><p> </p>

scholarly journals Interlay technique type 1 tympanoplasty, an alternative for closing large central tympanic membrane perforation

2020 ◽  
Vol 50 (1) ◽  
pp. 84
Author(s):  
Anton Budhi Darmawan
Keyword(s):  
Success Rate ◽  
Tympanic Membrane ◽  
Otitis Media ◽  
Tympanic Membrane Perforation ◽  
Google Scholar ◽  
High Success Rate ◽  
Suppurative Otitis Media ◽  
Type 1 Tympanoplasty ◽  
Membrane Perforation

Background: Type 1 tympanoplasty or myringoplasty is the most frequently performed procedure in the field of otology. Type 1 tympanoplasty is a surgical procedure to repair and only involves the restoration of the perforated tympanic membrane. There are three most accepted methods often used universally, namely underlay, overlay, and interlay. The interlay method is a relatively new method developed in 1992 for closing tympanic membrane perforation. This method has a high success rate of 96%. Objective: To report the success of type 1 tympanoplasty with an interlay method to close large central tympanic membrane perforations at Margono Soekarjo District Hospital. Case Report: Reporting 3 cases of chronic tubotympanic suppurative otitis media with large central tympanic membrane perforation which were repaired by type 1 tympanoplasty using interlay method. Clinical Question: Does interlay method type 1 tympanoplasty performed on large central tympanic membrane perforation provide better result compared with other methods of type 1 tympanoplasty? Review Method: Studying the evidence-based literatures on type 1 tympanoplasty interlay methods through Cochrane, Pubmed, and Google Scholar databases. Based on the inclusion and exclusion criteria, three journals were relevant with the reported cases. Result: All three journals stated that interlay method type 1 tympanoplasty had high success rate in terms of closing the tympanic membrane perforation and diminishing air-bone gap. Conclusion: Type 1 Tympanoplasty interlay method could be used as an alternative for the closure of a large central tympanic membrane perforation.Keywords: Chronic Tubotympanic Suppurative Otitis Media, large central tympanic membrane perforation, interlay tympanoplasty ABSTRAK Latar belakang: Timpanoplasti tipe 1 atau miringoplasti merupakan prosedur di bidang otologi yang paling sering dilakukan. Timpanoplasti tipe 1 merupakan metode pembedahan yang bertujuan untuk memperbaiki, dan terbatas hanya di membran timpani. Terdapat tiga metode yang paling diterima dan sering digunakan secara universal, yaitu underlay, overlay, dan interlay. Metode interlay merupakan metode penambalan perforasi membran timpani yang relatif baru, dikembangkan pada tahun 1992. Metode ini mempunyai keberhasilan yang tinggi yaitu mencapai 96%. Tujuan: Melaporkan keberhasilan timpanoplasti tipe 1 dengan metode interlay untuk penutupan perforasi membran timpani sentral besar di RSUD Margono Soekarjo. Laporan kasus: Dilaporkan 3 kasus otitis media supuratif kronik tipe tubotimpani dengan perforasi sentral besar, yang dilakukan timpanoplasti tipe 1 dengan metode interlay. Pertanyaan klinis: Apakah metode interlay timpanoplasti tipe 1 yang dilakukan pada perforasi membran timpani yang besar, dapat memberikan hasil yang lebih baik daripada metode lain timpanoplasti tipe 1? Telaah literatur: Telaah berbasis bukti mengenai timpanoplasti tipe 1 metode interlay melalui database Cochrane, Pubmed, dan Google Scholar. Berdasarkan kriteria inklusi dan ekslusi didapatkan tiga jurnal yang relevan dengan kasus yang dilaporkan. Hasil: Ketiga jurnal tersebut menyatakan bahwa timpanoplasti tipe 1 metode interlay mempunyai angka keberhasilan yang tinggi dalam hal penutupan perforasi membran timpani maupun mengurangi air-bone gap. Kesimpulan: Timpanoplasti tipe 1 metode interlay dapat digunakan sebagai alternatif untuk penutupan perforasi membran timpani sentral yang besar

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.

Topical Therapeutics for Otitis Media

1981 ◽  
Vol 89 (3) ◽  
pp. 381-385 ◽  
Author(s):  
David N.F. Fairbanks
Keyword(s):  
Bacterial Contamination ◽  
Topical Therapy ◽  
Tympanic Membrane Perforation ◽  
Definitive Treatment ◽  
Intracranial Extension ◽  
Membrane Perforation ◽  
Aerobic And Anaerobic ◽  
Ear Drops ◽  
Middle Ear Cleft ◽  
Antiseptic Solutions

In chronic draining ear associated with a tympanic membrane perforation, cholesteatoma, or both, the infection is that of bacterial contamination. Both aerobic and anaerobic organisms are found, notably Pseudomonas, staphylococcus, and enteric organisms, particularly bacteroides. The disease exists because of a structural defect in the middle ear cleft, which requires surgery as definitive treatment. Medical therapy is valuable as a temporary measure in preoperative preparation, and in prevention and management of intracranial extension. Topical therapy with antibiotic ear drops is often helpful, but also important is local care with cleansing, drying, and antiseptic solutions or powders. Therapy is usually directed toward the Pseudomonas organisms with aminoglycoside-polymyxin combination otic drops. However, Bacteroides fragilis now looms as an important pathogen in 13% of affected patients. Chloramphenicol otic drops are indicated when such an infection is suspected or identified.

scholarly journals Outcome of Myringoplasty in Underlay Technique

2019 ◽  
Vol 24 (2) ◽  
pp. 131-136
Author(s):  
Md Abdur Razzak ◽  
KM Mamun Murshed ◽  
AKMA Sobhan ◽  
Md Rakib Hossain ◽  
SM Nafeez Imtiaz
Keyword(s):  
Success Rate ◽  
Tympanic Membrane ◽  
Surgical Techniques ◽  
Neck Surgery ◽  
Tympanic Membrane Perforation ◽  
College Hospital ◽  
Medical College ◽  
Tympanic Membrane Perforations ◽  
Membrane Perforation ◽  
Age Range

Background: Myringoplasty is one of the surgical techniques for the management of chronic supportive 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. 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. About 100 patients with dry central tympanic membrane perforations of various size were included in this study Results: Myringoplasty was performed in 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  Bangladesh J of Otorhinolaryngology; October 2018; 24(2): 131-136

scholarly journals Epitympanic Diaphragm: Endoscopic Functional Tympanoplasty

2018 ◽  
Vol 01 (01) ◽  
pp. 023-028
Author(s):  
Sreerama Boddepalli ◽  
Rajesh Boddepalli
Keyword(s):  
Gas Exchange ◽  
Tympanic Membrane ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Normal Mucosa ◽  
Tympanic Membrane Perforation ◽  
Middle Ear Mucosa ◽  
Tympanic Membrane Perforations ◽  
Membrane Perforation ◽  
Middle Ear Cleft

Abstract Background Simple closure of tympanic membrane perforation is not a successful myringoplasty. It has to obey a lot of functional aspects of the middle ear cleft. Certain factors play a role in failure cases. The endoscopic functional myringoplasty or tympanoplasty is a clear visualization of all the parts of the middle ear; examination and removal of the disease from the hidden parts of the middle ear, examination of inter-attico-tympanic diaphragm; and removal of blocks, if any, in isthmus, to reestablish the gas exchange pathways and finally preserve the middle ear mucosa at maximum to further restore the ventilation. Methods Endoscopic tympanoplasty was performed in 100 patients with large tympanic membrane perforations and patent eustachian tube, using 4-mm “0” and “45” degree endoscopes by proper visualization of the tympanic diaphragm and isthmus in every patient and clearing its blockage if present. Results Among the 100 patients, 78 had epitympanic diaphragm blockage at the level of isthmus, 5 patients were found with closed tensor tympani folds, both vertical and horizontal without any ventilatory routes in them. Although in all the patients the eustachian tube was patent, we found majority of them had a dysventilation at the level of the epitympanic diaphragm. Thus, by performing endoscopic ventilatory pathway clearance and tympanoplasty, we achieved 94% positive results. Conclusion Epitympanic diaphragm is a functional barrier between upper and lower compartments of the middle ear cleft, which play important role in the ventilation and partial pressure regulation, blockage of its isthmus may lead to tympanic membrane retractions and perforations. With the aid of endoscopes of various degrees, removing any pathological blocks, recreating proper ventilation, reestablishing gas exchange mechanism, and maximum preservation of normal mucosa for the gas exchange are the aims of an endoscopic functional tympanoplasty procedure.

scholarly journals Boomerang-Shaped vs. Shield-Shaped Chondroperichondrial Cartilage Grafts for Type 1 Tympanoplasty in Children: A Study of 121 Patients

2017 ◽  
Vol 96 (10-11) ◽  
pp. 419-432 ◽  
Author(s):  
Can Özbay ◽  
Fatih Kemal Soy ◽  
Erkan Kulduk ◽  
Riza Dundar ◽  
Ahmet Yükkaldiran ◽  
...  
Keyword(s):  
Tympanic Membrane ◽  
Graft Material ◽  
Success Rates ◽  
Cartilage Grafts ◽  
Type 1 Tympanoplasty ◽  
Grafting Technique ◽  
Study Population ◽  
Graft Success ◽  
The Impact

Many techniques and graft materials have been used for the reconstruction of the tympanic membrane. We conducted a retrospective study to compare anatomic and functional outcomes of type 1 tympanoplasty that we performed with boomerang-shaped chondroperichondrial cartilage grafts (BSGs) and shield-shaped chondroperichondrial cartilage grafts (SSGs) in pediatric patients. Our study population was made up 121 patients—61 boys and 60 girls, aged 7 to 16 years (mean: 12.4)—who had undergone a type 1 tympanoplasty. Patients were divided into two groups according to the grafting technique used; there were 59 patients in the BSG group and 62 patients in the SSG group. Ear examinations were performed at postoperative months 3, 6, 12, and 24, and pure-tone average (PTA) for air-conduction threshold values and air-bone gaps (ABGs) were evaluated at 0.5, 1.0, 2.0, and 4.0 kHz at the same visits. We also investigated the impact of the graft material on functional graft success and intergroup differences (if any) in surgical success. Mean postoperative follow-up periods were 30.5 and 30.2 months in the BSG and SSG groups, respectively. We found that the success rates for tympanic membrane reconstruction were not significantly different in the two groups (91.5 and 88.7%). Postoperatively, the mean PTA and ABG values in both groups at 3, 6, 12, and 24 months were significantly lower than the preoperative values (p < 0.05). There were no significant differences in mean PTA values between the two groups at 3, 6, 12, and 24 months. However, the extent of the decrease in PTA values in the BSG group at 3 months was significantly greater than that of the SSG group (p < 0.05). There were no significant differences in mean ABG values between the two groups at 3, 6, and 12 months, but at 24 months, the value was significantly higher in the BSG group (p < 0.05). Finally, the extent of the decrease in ABG in the BSG group at both 3 and 6 months was significantly greater than that of the SSG group (p < 0.05). We conclude that the BSG procedure is a reliable and safe method of performing pediatric tympanoplasty.

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