scholarly journals Evaluation of Results of Cartilage Augmentation in Type III Tympanoplasty

2017 ◽  
Vol 25 (3) ◽  
pp. 119-123
Author(s):  
Netra Aniruddha Pathak ◽  
Vidya Vasant Rokade
Keyword(s):  
Pure Tone ◽  
Chronic Otitis Media ◽  
Pure Tone Audiometry ◽  
Canal Wall ◽  
Hearing Results ◽  
Type Iii ◽  
Mixed Hearing Loss ◽  
Canal Wall Down ◽  
Canal Wall Down Mastoidectomy ◽  
Conventional Type

Introduction In conventional Type III tympanoplasty, post operative air-bone gap (ABG) is around 10-60dB. This study aimed to assess the hearing results in patients undergoing canal wall down mastoidectomy with cartilage augmented type III tympanoplasty.  Materials and Methods Patients of 6-50 years of age with the diagnosis of Chronic Otitis Media (Squamous) with conductive or mixed hearing loss, requiring canal wall down mastoidectomy and with intact and mobile stapes suprastructure at surgery who underwent cartilage augmentation were included in the study. Pure tone audiometry (PTA) was performed and evaluated. Post- operative hearing was assessed in terms of average air bone gap (ABG) and size of ABG closure.  Results The results concluded that mean of pre and post operative air bone gap were 37.5db and 29.7db respectively with net gain of 7.8db.These differences were significant. Also ABG closure was within 30 db in 28 cases (70%). Discussion The results of this study were compared with other reported series. The mechanical and acoustical aspects of canal wall down surgeries as also the probability of variation in results due to differences in surgical procedures and post-operative fibrosis have been mentioned.   Conclusion There was significant improvement in postoperative hearing after stapes head augmentation in type III tympanoplasty.

scholarly journals Study of Hearing Status After Canal Wall Down Mastoidectomy with Type-III Tympanoplasty

2020 ◽  
Vol 23 (1) ◽  
pp. 52-58
Author(s):  
Utpal Kumar Dutta ◽  
Md Monjurul Alam ◽  
Nasima Akhter ◽  
Kanu Lal Saha ◽  
Md Abul Hossain ◽  
...  
Keyword(s):  
Pure Tone ◽  
Pure Tone Audiometry ◽  
Neck Surgery ◽  
Hearing Level ◽  
Canal Wall ◽  
Cross Sectional ◽  
Type Iii ◽  
Hearing Status ◽  
Canal Wall Down ◽  
Canal Wall Down Mastoidectomy

Objective: To observe hearing status in case of canal wall down mastoidectomy with type III tympanoplasty. Methods: This was a cross sectional study which was carried out in the departments of Otolaryngology and Head-Neck surgery of Bangabondhu Sheikh Mujib Medical University during the period of July’ 2011 to March’ 2012.A Total 38 patients having cholesteatoma underwent canal down mastoidectomy with type III tympanoplasty,were included in this study. Patients were divided into two groups according to their age. Age belonged to 18 years and more than 18 years were considered as child and adult respectively. Patients were examined thoroughly and preoperative hearing level was assessed by pure tone audiometry one one week before operation. Post operative patients were followed up at regular intervals. Pure tone audiogram (PTA) was done after 8 weeks and hearing assessment was compared by closure of air bone gap. Results: In this study majority of patients were within 13-17 years in child group and 18- 35years in adult group. Most of patients were male.Closure of air-bone gap was significantly higher in adults. Improvement of hearing status was more in adults. Conclusion: CWD mastoidectomy with tympanoplasty not only lowers recurrence rate but also improves hearing status although less likely in child and younger age group than adults. Bangladesh J Otorhinolaryngol; April 2017; 23(1): 52-58

scholarly journals Comparison of Pre and Post-operative Hearing Results in Canal Wall Down Mastoidectomy with Type III Tympanoplasty

2008 ◽  
Vol 47 (172) ◽  
Author(s):  
Bikash Lal Shrestha ◽  
CL Bhusal ◽  
H Bhattarai
Keyword(s):  
Hearing Loss ◽  
Otitis Media ◽  
Chronic Otitis Media ◽  
Classical Type ◽  
Canal Wall ◽  
Hearing Results ◽  
Type Iii ◽  
Canal Wall Down ◽  
Canal Wall Down Mastoidectomy

This study was done to compare the pre and post-operative hearing results in patients undergoingcanal wall down mastoidectomy with classical type III tympanoplasty using temporalis fasciaalone.Patients of ≥5 years age with the diagnosis of Chronic otitis media (squamous) with conductive ormixed hearing loss, needing canal wall down mastoidectomy and with intact and mobile stapessuprastructure at surgery who underwent classical type III tympanoplasty were included in thestudy. The pre and post-operative PTA was performed and evaluated. The post-operative hearingwas assessed in terms of average ABG and size of ABG closure.Mean pre and post-operative air bone gap in classical type III tympanoplasty were 37.8 dB and 29.8dB respectively and these differences were statistically significant. The postoperative PTA-ABGranged from 15-61.2 dB.Hearing results after type III tympanoplasty varied widely showing statistically significantimprovement in mean post-operative PTA-ABG but there was a great variation.Key words: air bone gap, chronic otitis media, mastoidectomy, tympanoplasty

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.

scholarly journals Comparison of Pre and Postoperative Hearing Results after Cartilage Augmentation Type III Tympanoplasty

1970 ◽  
Vol 1 (2) ◽  
pp. 3-5
Author(s):  
BL Shrestha ◽  
H Bhattarai ◽  
CL Bhusai
Keyword(s):  
Canal Wall ◽  
Hearing Results ◽  
Type Iii ◽  
Canal Wall Down ◽  
Canal Wall Down Mastoidectomy ◽  
Head Neck

Keywords: Air bone gap; chronic media (squamous); canal wall down mastoidectomy; cartilage augmentation type III tympanoplastyDOI: 10.3126/njenthns.v1i2.4752 Nepalese J ENT Head Neck Surg Vol.1 No.2 (2010) p.3-5

Hearing Status After Cartilage Augmented Type III Tympanoplasty: In Chronic Otitis Media Squamous Type

2021 ◽  
Vol 18 (2) ◽  
pp. 27-30
Author(s):  
Lok Ram Verma ◽  
Dhundi Raj Paudel
Keyword(s):  
Otitis Media ◽  
Chronic Otitis Media ◽  
Effective Area ◽  
Canal Wall ◽  
Hearing Improvement ◽  
Type Iii ◽  
Hearing Status ◽  
Fascia Graft ◽  
Canal Wall Down ◽  
Canal Wall Down Mastoidectomy

Introduction: Tympanoplasty is typically performed in conjunction with a canal wall down mastoidectomy in patient with Chronic Otitis Media Squamous. The results from experimental and clinical studies of the type III stapes columellar reconstruction have shown that interposing a disk of cartilage between the graft and the stapes head improves hearing in the lower frequencies by 5 to 10 dB. They hypothesize that the cartilage acts to increase the “effective” area of the graft that is coupled to the stapes, which leads to an increase in the middle ear gain of the reconstructed ear. Aims: To assess the hearing improvement after cartilage augmented Type III Tympanoplasty in chronic otitis media squamous disease. Methods: This study was conducted in 44 patients with Chronic Otitis Media squamous in the patients attending the department of Otorhinolaryngology in NGMC teaching hospital from November 2018 to March 2020. Canal Wall Down mastoidectomy with cartilage augmented type III Tympanoplasty and was done. Augmentation was done with thin 3-4 mm conchal cartilage interposed between stapes and Temporalis fascia graft. Results: There were 11(25%) male and 33(75%) female, with mean age of 29.48 years, ranging from minimum of 15 years to maximum 56 years. The preoperative mean A–B gap was 21.82 and postoperatively means AB gap was 12.20 dB with overall AB gap gain was 9.64 dB. Conclusion: Significant hearing improvement is seen in Canal Wall Down mastoidectomy Chronic Otitis Media squamous after cartilage augmented type III tympanoplasty.

External Auditory Canal Reconstruction and Mastoid Obliteration Using Modified Palva Flap in Canal Wall Down Mastoidectomy With Tympanoplasty

2019 ◽  
Vol 128 (6_suppl) ◽  
pp. 69S-75S
Author(s):  
Ji-Sun Kim ◽  
Il Gye Lim ◽  
Jeong-Hoon Oh ◽  
Byung Guk Kim ◽  
Ki-Hong Chang
Keyword(s):  
Temporal Bone ◽  
External Auditory Canal ◽  
Pure Tone ◽  
Pure Tone Audiometry ◽  
Canal Wall ◽  
Mastoid Obliteration ◽  
Before And After ◽  
The Status ◽  
Canal Wall Down ◽  
Canal Wall Down Mastoidectomy

Objective: To evaluate the effectiveness of a modified Palva flap used for external auditory canal reconstruction and mastoid obliteration in canal wall down mastoidectomy. Methods: We retrospectively analyzed patients who underwent canal wall down mastoidectomy with tympanoplasty using modified Palva flap. All patients underwent pure tone audiometry and temporal bone computed tomography (CT) before surgery, and the same tests were performed in the first year after surgery. The external auditory canal volumes were calculated by summing the areas of each section selected in temporal bone CT. For each patient, the ratio of external auditory canal volume was calculated from CT taken before and after surgery. Results: The mean of external auditory canal volume after canal wall down with a modified Palva flap was about 1.4 times larger than before surgery. The modified Palva flap is effective for the reconstruction of the external auditory canal. Both pure tone audiometry level and air-bone gap showed statistically significant improvement after surgery ( Ps = .001 and .002, respectively). Conclusions: The external auditory canal volume slightly increased, but the status of mastoid obliteration was well maintained 1 year after surgery. The modified Palva flap used in this study is an easy and effective method in external auditory canal reconstruction and mastoid obliteration.

scholarly journals Functional outcomes of middle ear cholesteatoma surgery

2018 ◽  
Vol 71 (3-4) ◽  
pp. 109-113
Author(s):  
Dalibor Vranjes ◽  
Sanja Spiric ◽  
Slobodan Spremo ◽  
Dmitar Travar ◽  
Predrag Spiric ◽  
...  
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Lower Incidence ◽  
Functional Outcomes ◽  
Pure Tone ◽  
Chronic Otitis Media ◽  
Pure Tone Audiometry ◽  
Canal Wall ◽  
Canal Wall Down ◽  
Canal Wall Up

Introduction. Chronic otitis media is defined as a persistent inflammation of the middle ear with signs of an infection lasting for three months or longer. Chronic otitis media may occur either with or without cholesteatoma. For both types of conditions, surgical treatment with closed canal wall-up or open canal wall-down techniques of tympanoplasty are considered. Our aim was to evaluate functional outcomes in two groups of patients (chronic otitis media with cholesteatoma and chronic otitis media without cholesteatoma) treated with various tympanoplasty techniques. Material and Methods. This retrospective study included 100 patients who underwent canal wall-down and canal wall-up tympanoplasty for the treatment of chronic otitis media with cholesteatoma and chronic otitis media without cholesteatoma from 2015 to 2016. All study patients underwent routine clinical and audiometric examinations. The study evaluated preoperative and postoperative functional results (evaluation of pure-tone audiogram screening). Results. A statistically significant lower incidence (p < 0.05) of postoperative air-bone gap < 20 decibels was established in patients with chronic otitis media with cholesteatoma, but there were no statistically significant differences between the two groups. There was a statistically lower incidence (p < 0.05) of patients with postoperative pure tone audiometry < 40 decibels in patients with chronic otitis media with cholesteatoma, but the difference between the two groups was not statistically significant. When analyzing the mean postoperative pure tone audiometry and air-bone gap in the study patients, canal wall-up tympanoplasty was found to be statistically more effective (p < 0.05). Conclusion. Various pathomorphological and pathophysiological changes in the middle ear, presence of extensively different forms of cholesteatomas, the choice of surgical procedures and poor preoperative hearing are in direct correlation with postoperative hearing.

scholarly journals Canal wall window tympanomastoidectomy – A review of 84 cases

1970 ◽  
Vol 16 (1) ◽  
pp. 3-8
Author(s):  
Delwar Hossain ◽  
Mosleh Uddin ◽  
Ahmmad Taous ◽  
Kazi Shameemus Salam ◽  
Rafiqul Islam
Keyword(s):  
Retrospective Study ◽  
Pure Tone ◽  
Canal Wall ◽  
Retraction Pocket ◽  
Female Ratio ◽  
Primary Surgery ◽  
Male Female Ratio ◽  
Canal Wall Down ◽  
Canal Wall Down Mastoidectomy ◽  
Materials Used

Canal wall window (CWW) tympanomastoidectomy is a modified form of attico-antrostomywhich can be a substituted for canal wall down procedure. A retrospective study of 84 casesof CWW tympanomastoidectomy were collected from department of otolaryngology and Headnecksurgery, BSMMU and ENT Foundation Hospital, Dhaka from June 2005 to July 2009.In this study majority of the patients were 16 to 48 years 57(67.86%). Male female ratio was3:1. Most of the patients were found cholesteatoma 27 (32.14%), granulation tissue 25(29.76%),retraction pocket 22(26.19%),Postoperative hearing gain (mean three frequency pure tone air bone gap) assessed 3 monthsafter primary surgery, most of the patients 34(40.48%) had gain 20dB+, 26 patients (30.95%)had gain 10dB+,18 patients (2143%) had gain 30dB+.Materials used in tympano-ossiculoplasty were chonchal cartilage, sculptured incus, PORPand TORP. Most of the patients we used incus reposition 36(42.86%), cartilage ossiculoplasty28(33.33%), PORP 12(14.29%) and TORP 8 (9.52%).Post operative followup of the patient was done in 1 month, 3 month and 6 month intervals andcondition of external auditory canal assessed. Dry ear were found 70 patients (83.33%), moistear were found 8 patients (9.52%) and 6 patients (7.14%) were found purulent dischargingears and later canal wall down mastoidectomy done .Key words: Canal wall window; Tympanomastoidectomy.DOI: 10.3329/bjo.v16i1.5774Bangladesh J Otorhinolaryngol 2010; 16(1): 3-8

scholarly journals Repair of Temporal Bone Encephalocele following Canal Wall Down Mastoidectomy

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Sarantis Blioskas ◽  
Ioannis Magras ◽  
Stavros Polyzoidis ◽  
Konstantinos Kouskouras ◽  
Georgios Psillas ◽  
...  
Keyword(s):  
Temporal Bone ◽  
Chronic Otitis Media ◽  
Base Deficit ◽  
Layer By Layer ◽  
Canal Wall ◽  
Temporalis Fascia ◽  
Dural Graft ◽  
Canal Wall Down ◽  
Canal Wall Down Mastoidectomy

We report a rare case of a temporal bone encephalocele after a canal wall down mastoidectomy performed to treat chronic otitis media with cholesteatoma. The patient was treated successfully via an intracranial approach. An enhanced layer-by-layer repair of the encephalocele and skull base deficit was achieved from intradurally to extradurally, using temporalis fascia, nasal septum cartilage, and artificial dural graft. After a 22-month follow-up period the patient remains symptom free and no recurrence is noted.

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