scholarly journals Comparative Study of Autologous Ossicular Graft versus Titanium Prosthesis (TORP & PORP) in Ossiculoplasty

2017 ◽  
Vol 25 (1) ◽  
pp. 1-7
Author(s):  
P Thamizharasan ◽  
K Ravi
Keyword(s):  
Ossicular Chain ◽  
Canal Wall ◽  
Hearing Results ◽  
Hearing Gain ◽  
Pure Tone Audiogram ◽  
Conductive Deafness ◽  
Middle Ear Prosthesis ◽  
Short Period ◽  
History Of ◽  
Canal Wall Down

Introduction This prospective cohort study aims to analyze and compare the outcomes of ossiculoplasty in terms of hearing results, intra and post operative course, using autograft incus and titanium middle ear prosthesis. Materials and Methods Patients with a history of chronic ear discharge and conductive deafness were included in the study. Out of 21 patients with ossicular chain defect included in the study, 10 patients underwent ossiculoplasty with autograft incus and 11 with titanium prosthesis. Pure tone audiogram was done after three months. Result In patients with incus ossiculoplasty, average Post operative PTA was 43.5 dB ± 7.934SD and Net gain in hearing was 10.7 decibels ± 15.478SD. In patients with titanium prosthesis ossiculoplasty, average Post operative PTA was 41.4 dB ± 4.789SD and Net gain in hearing was 16 decibels ± 11.981SD. Discussion Three patients underwent only Tympanoplasty post operative PTA was 42 ± 5.292 dB (incus- 39 dB, titanium- 48dB) and hearing gain was 13.33 ± 12.583 (incus-20dB, titanium-0dB). Five patients underwent intact canal wall with Tympanoplasty: Post operative PTA was 35 ± 3 dB (incus-35dB, titanium-30dB) and hearing gain was 23 ± 15.379 (incus-18.33dB, titanium-30dB). Thirteen patients underwent canal wall down procedure with Tympanoplasty: Post operative PTA was 45.67 ± 5.228 dB (incus-50.4dB, titanium-41.8dB) and hearing gain was 9.33 ± 12.309 (incus-2.4dB, titanium-14.285dB). Complications in the short period studied were nil in both groups. Conclusion Incus and titanium have equal postoperative hearing but in terms of hearing gain Titanium prosthesis gave a better hearing gain than incus. 

scholarly journals Hearing Status After Ossiculoplasty in Open Cavity Mastoidectomy

2020 ◽  
Vol 23 (2) ◽  
pp. 195-198
Author(s):  
Md Zakaria Sarker ◽  
DC Talukder ◽  
Khabir Uddin Patuary ◽  
Md Rafiqul Islam ◽  
Saif Rahman Khan ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Ossicular Chain ◽  
Ear Reconstruction ◽  
Canal Wall ◽  
Prospective Longitudinal Study ◽  
Hearing Gain ◽  
Canal Wall Down ◽  
Canal Wall Down Mastoidectomy ◽  
Middle Ear Reconstruction ◽  
Prospective Longitudinal

To evaluate the hearing outcome in canal wall down mastoidectomy with middle ear reconstruction, prospective longitudinal study was done at National Institute of ENT, Dhaka from March 2015 to September 2016. Total 22 patients were included in the study undergoing canal wall down mastoidectomy with 6 months postoperative followup. Hearing outcomes were observed and compared with the preoperative hearing tests. Among the 22 patients 9 (39.1% of subjects) patients had hearing gain, 12 (52.2%) had hearing loss and 1 (4.3%) had no change in hearing postoperatively.Although disease clearance is the main objective in canal wall down mastoidectomy, hearing gain can be achieved if combined with ossiculoplasty and tympanoplasty. The hearing gain or loss depends upon the extension of disease and status of the ossicular chain. Most patients usually experience hearing loss more than the preoperative period due to removal of ossicle or ossicles for the sake of disease clearance. Bangladesh J Otorhinolaryngol; October 2017; 23(2): 195-198

scholarly journals Comparison of Various Graft Materials in the Reconstruction of Ossicular Chain in Patients with Chronic Otitis Media: A Prospective Hospital Based Study

2017 ◽  
Vol 25 (3) ◽  
pp. 136-141
Author(s):  
Niaz Fakhruddin ◽  
Chethan Kumar Gangaiah ◽  
Gopakumar KP ◽  
Geogin George Thottan ◽  
Mon Noufal
Keyword(s):  
Otitis Media ◽  
Chronic Otitis Media ◽  
Ossicular Chain ◽  
Canal Wall ◽  
Exclusion Criteria ◽  
Hearing Results ◽  
The Status ◽  
Ossicular Chain Reconstruction ◽  
Study Population ◽  
Canal Wall Down

Introduction Ossicular chain reconstruction is the surgical procedure used to correct the hearing problems in patients with chronic otitis media (COM). In this era, where a large variety of innovative artificial prosthetic materials are being used to replace and reconstruct the ossicular chain, autografts still play a significant role. Materials and Methods The present study included 40 patients. Study population was selected based on inclusion and exclusion criteria. The ossicular reconstructive procedure was done under anesthesia and according to the status of the ossicular chain. Temporalis fascia was used to close the perforation. Mainly two procedures were performed: one is intact canal wall and the other is canal wall down.  Results Most of the study population was middle aged and males were more compared to females. Thirty five patients had air bone gap above 30dB. In 38 patients, the incus had undergone necrosis. Most of the patients underwent short columella reconstruction. A closure of air bone gap with in 20 dB was achieved in 72.2% in patients with malleus stapes assembly. In short columella 22.2% of patients had closure of air bone gap within 20 dB. Incus remnant grafts gave better hearing gain. Discussion The published literature on the result of use of sculptured ossicle and cartilage in tympanoplasty have been reviewed Conclusion In the present study, cases with COM showed good hearing results patients implanted with autogenous cartilage and bone.

scholarly journals Outcomes of type III tympanoplasty: our experience

2020 ◽  
Vol 6 (2) ◽  
pp. 287
Author(s):  
Ravishankar C. ◽  
Ramya Bandadka
Keyword(s):  
Middle Ear ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Canal Wall ◽  
Type Iii ◽  
Hearing Gain ◽  
Middle Ear Prosthesis ◽  
Canal Wall Down ◽  
Middle Ear Cleft ◽  
Canal Wall Up

<p class="abstract"><strong>Background:</strong> Type III tympanoplasty involves complete disease clearance from middle ear cleft and retaining or improving the serviceable hearing by ossiculoplasty. Various auto and allografts have been used with variable outcomes. The objective of the study was to evaluate hearing improvement and healing of cavity in patients who underwent type III tympanoplasty.</p><p class="abstract"><strong>Methods:</strong> A retrospective chart review of 21 patients who underwent type III tympanoplasty at Bowring and Lady Curzon Hospital from January 2018 to December 2018 was done. In 7 patients autologous incus, 6 tragal cartilage and 8 teflon prosthesis was used for ossiculoplasty. Intra and postoperative events were assessed. Pure tone audiograms done after 3 and 6 months were compared.  </p><p class="abstract"><strong>Results:</strong> 15 patients who underwent canal wall down procedure (CWDP) had a mean hearing gain of 20.33 dB and 26.67 dB while in 5 patients of canal wall up procedure (CWUP) group mean hearing gain was 22.5 dB and 27.5 dB at 3 and 6 months after surgery respectively. Hearing gain was similar in both groups irrespective of the prosthesis used. Autologous materials were used in most of the CWUP with intact stapes and teflon prosthesis was used in majority of CWDP where only mobile stapes foot plate was present. Prosthesis extrusion was not encountered in any of our cases so far in this series.</p><p class="abstract"><strong>Conclusions:</strong> The post-operative hearing gain with autologous incus, tragal cartilage and teflon middle ear prosthesis are similar. Teflon prosthesis is an effective material for ossiculoplasty, especially useful when incus and stapes are absent while autologous incus or tragal cartilage are preferred in cases with intact stapes head.</p>

scholarly journals Correlation between functional outcome and the SAMEO-ATO framework

2021 ◽  
Author(s):  
Vito Pontillo ◽  
Marialessia Damiani ◽  
Giusi Graziano ◽  
Nicola Quaranta
Keyword(s):  
Functional Outcome ◽  
Middle Ear ◽  
Petrous Bone ◽  
Canal Wall ◽  
Hearing Results ◽  
Tertiary Referral Center ◽  
Ossicular Reconstruction ◽  
Canal Wall Down ◽  
Mastoid Surgery ◽  
Canal Wall Up

Abstract Purpose To evaluate the recently proposed SAMEO-ATO framework for middle ear and mastoid surgery, by correlating it with the functional outcome in a large cohort of patients operated for middle ear and mastoid cholesteatoma in a tertiary referral center. Methods We retrospectively included all surgeries for middle ear and mastoid cholesteatoma undergone in our Department between January 2009 and December 2014, by excluding revision surgeries, congenital and petrous bone cholesteatoma. All surgeries were classified according to the SAMEO-ATO framework. The post-operative air bone gap (ABG) was calculated and chosen as benchmark parameter for the correlation analysis. Results 282 consecutive surgeries for middle ear and mastoid cholesteatoma were released in the study period on a total of 273 patients, with a mean age of 41.2 years. All patients were followed for an average period of 55.3 months. 54% of patients underwent M2c mastoidectomy (Canal Wall Down, CWD), while the remaining underwent Canal Wall Up (CWU) procedures, being M1b2a mastoidectomy the most common one (33%). Mean pre-operative and post-operative ABGs were 29.2 and 23.5 dB, with a significant improvement (p < 0.0001). ‘Mastoidectomy’ and ‘Ossicular reconstruction’ parameters of SAMEO-ATO showed significant association with postoperative ABG, with smaller residual gaps for the classes Mx and On, and worse hearing results for M3a and Ox. Conclusion Our results show the utility of SAMEO-ATO framework, and in particular of ‘M’ (Mastoidectomy) and ‘O’ (Ossicular reconstruction) parameters, in predicting the hearing outcome.

Tensa retraction cholesteatoma: treatment and long-term results

1989 ◽  
Vol 103 (2) ◽  
pp. 149-157 ◽  
Author(s):  
T. Lau ◽  
M. Tos
Keyword(s):  
Ossicular Chain ◽  
Observation Time ◽  
Long Term Results ◽  
Mastoid Process ◽  
Canal Wall ◽  
Pars Tensa ◽  
Results Of Treatment ◽  
Acquired Cholesteatoma ◽  
Canal Wall Down

AbstractTo obtain the best possible results of treatment of acquired cholesteatoma, we made a subdivision of cholesteatoma types into attic and pars tensa cholesteatomas, and subdivided the latter further into tensa retraction cholesteatoma and sinus cholesteatomas. Tensa retraction cholesteatoma is defined as arising from a retraction or perforation of the whole pars tensa, whereas sinus cholesteatoma is defined as arising from a retraction or perforation of the postero-superior part of the tensa. We present the long-term results obtained in tensa retraction cholesteatomas treated with one stage surgery from 1964 to 1980. Median observation time was 9 years, range 2 to 19 years. Sixty-one ears were treated without mastoidectomy, whereas 71 ears had canal wall-up mastoidectomy and 64 ears had canal wall-down mastoidectomy. The total recurrence rate was 13.3 per cent; 17 ears had residual cholesteatoma, and nine ears had recurrent cholesteatoma. The best results were obtained in ears with an intact ossicular chain where mastoidectomy was not performed. In 49 per cent of the cases, the cholesteatoma was confined to the tympanic cavity without reaching the aditus, antrum or mastoid process. About one-third to one-quarter of the ears had tympanoplasty only, with removal of the cholesteatoma through the ear canal.

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.

Revision Surgery for Chronic Otitis Media: A Learning Experience

1998 ◽  
Vol 107 (6) ◽  
pp. 486-491 ◽  
Author(s):  
Jan E. Veldman ◽  
W. Weibel Braunius
Keyword(s):  
Otitis Media ◽  
Revision Surgery ◽  
Learning Experience ◽  
Chronic Otitis Media ◽  
Canal Wall ◽  
Long Term Follow Up ◽  
Surgical History ◽  
History Of ◽  
Canal Wall Down ◽  
Residual Air

The objective of this study was to evaluate, during a long-term follow-up period, the results of revision surgery for chronic otitis media with or without cholesteatoma. Intact canal wall and canal wall down procedures were performed. The surgical history of every patient was assessed before the operation. A dry, relatively safe, and disease-free ear was created in 90% of the reoperated ears (N = 389). The recurrence rate of cholesteatoma was 5% for the total group. Reperforations of the tympanic membrane occurred in 10%, and persistent or recurrent otorrhea was present in 10% of cases. The functional hearing results were quite satisfactory. A residual air-bone gap of ≤30 dB was reached in 70.3% of the cases after revision tympanoplasty only (N = 41). Revision mastoidectomy with revision tympanoplasty as a one-stage procedure led subsequently, in 76% of intact canal wall procedures (N = 113) and 55% of canal wall down procedures (N = 98), to a residual air-bone gap of ≤30 dB.

scholarly journals Management of Benign Middle Ear Tumors: A Series of 7 Cases

2017 ◽  
Vol 96 (10-11) ◽  
pp. 426-432
Author(s):  
Z. Jason Qian ◽  
Amy M. Coffey ◽  
Kathleen M. O'Toole ◽  
Anil K. Lalwani
Keyword(s):  
Surgical Management ◽  
Middle Ear ◽  
Ossicular Chain ◽  
Clinical Findings ◽  
Mastoid Cavity ◽  
Canal Wall ◽  
Tumor Excision ◽  
Canal Wall Down ◽  
Canal Wall Down Mastoidectomy ◽  
Rare Group

Benign middle ear tumors represent a rare group of neoplasms that vary widely in their pathology, anatomy, and clinical findings. These factors have made it difficult to establish guidelines for the resection of such tumors. Here we present 7 unique cases of these rare and diverse tumors and draw from our experience to recommend optimal surgical management. Based on our experience, a postauricular incision is necessary in nearly all cases. Mastoidectomy is required for tumors that extend into the mastoid cavity. Whenever exposure or hemostasis is believed to be inadequate with simple mastoidectomy, canal-wall-down mastoidectomy should be performed. Finally, disarticulation of the ossicular chain greatly facilitates tumor excision and should be performed early in the procedure.

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.

Unusual case of bilateral conductive deafness

1990 ◽  
Vol 104 (7) ◽  
pp. 560-561 ◽  
Author(s):  
T. J. Hoare ◽  
C. J. Aldren ◽  
D. W. Morgan ◽  
T. R. Bull
Keyword(s):  
Unusual Case ◽  
Ossicular Chain ◽  
Late Presentation ◽  
Conductive Deafness ◽  
History Of

AbstractA 30-year-old female presented with a ten-year history of bilateral conductive deafness. A pre-operative diagnosis of otosclerosis was made but at tympanotomy, the stapes crura in each ear was found to be disconnected from the foot- plate, the ossicular chain being otherwise normal. A Teflon-wire prosthesis was used to join incus and footplate, with good results. In the absence of a history of trauma or sepsis this may be a late presentation of a congenital stapedial anomaly which has not previously been reported.

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