Endoscopic Stapedotomy: A New Dimension to the Conventional Microscopic Procedure

Introduction Endoscopes are not only complementing microscopic ear surgery but are also establishing their independent role in recent years. Materials and Methods This observational study was conducted from February 2018 to February 2019. Thirteen patients with clinical and audio-tympanometric features suggestive of stapedial otosclerosis underwent unilateral endoscopic stapedotomy from February to July 2018. They were followed up for a minimum of 6 months, till February 2019. Zero degree naso-endoscopes were exclusively used. Details of the surgical technique, its usefulness and subjective drawbacks are described. Results Two patients with sequel of otitis media with effusion evident at surgery were excluded. With a female predilection, the average age of the subjects was 31 years (range: 17-56 years). Curettage of the posterosuperior wall was needed in 7 patients; significant canalplasty was performed in 2 of them where the endoscope was difficult to negotiate. The chorda tympani required mobilization in only 3 patients, including those requiring significant canalplasty. Per-operative complications included injury to the chorda, tearing of tympanomeatal flap, and instability of the long process of incus in 1 patient each. One patient was lost to follow up. Average pre-operative bone conduction was 10±5dB with an air-bone gap at 35±5dB. At 6 months follow up, air-bone gap of <10dB was achieved in 5 patients, and that at10-20dB in 4. One patient developed moderate sensorineural component. Otherwise, there was no significant complication at 6 months following surgery. Conclusion Endoscopic stapedotomy is a safe and effective approach towards stapes surgery, with better surgical field of view and minimal tissue trauma

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Early complications of surgery for chronic otitis media

The Journal of Laryngology & Otology ◽

10.1017/s0022215100145268 ◽

1999 ◽

Vol 113 (9) ◽

pp. 803-810 ◽

Cited By ~ 10

Author(s):

P. J. D. Dawes

Keyword(s):

Otitis Media ◽

Bone Conduction ◽

Chronic Otitis Media ◽

Chorda Tympani ◽

Threshold Elevation ◽

Early Complications ◽

Ear Surgery ◽

Bone Conduction Threshold ◽

Operative Complications ◽

Complications Of Surgery

AbstractThis audit report details early post-operative complications following surgery for chronic otitis media. One hundred and forty-five cases were assessed. There were no facial nerve palsies, a bone conduction threshold elevation occurred in 4.6 per cent of cases. A wound infection occurred in six per cent of cases as did BIPP allergy. Twenty-six per cent of patients reported symptoms consistent with chorda tympani trauma. Short-lived symptoms of jaw discomfort were reported by 46 per cent of patients and imbalance or vertigo by 10 per cent of patients. The findings are compared with other published reports of complications following ear surgery.

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Long-term Follow-up Results of Regeneration Process of Fungiform Taste Buds After Severing the Chorda Tympani Nerve During Middle Ear Surgery

Annals of Otology Rhinology & Laryngology ◽

10.1177/0003489415617775 ◽

2015 ◽

Vol 125 (5) ◽

pp. 393-399 ◽

Cited By ~ 7

Author(s):

Takehisa Saito ◽

Tetsufumi Ito ◽

Yumi Ito ◽

Yasuhiro Manabe

Keyword(s):

Middle Ear ◽

Taste Buds ◽

Regeneration Process ◽

Middle Ear Surgery ◽

Chorda Tympani ◽

Chorda Tympani Nerve ◽

Ear Surgery ◽

Long Term Follow Up

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Management of conductive deafness from Otitis Media with Effusion (known as ‘glue ear’) in children using bone conduction headsets when grommet operations were unavailable during COVID-19

10.1101/2021.01.21.21249496 ◽

2021 ◽

Author(s):

T Holland Brown ◽

Isobel Fitzgerlad O’Connor ◽

Jessica Bewick ◽

Colin Morley

Keyword(s):

Otitis Media ◽

Otitis Media With Effusion ◽

Bone Conduction ◽

Hearing Impairments ◽

Remote Consultation ◽

Glue Ear ◽

Conductive Hearing ◽

At Home

AbstractBackgroundOtitis Media with Effusion (OME) causing hearing impairments affects ∼1 in 10 children starting school in UK/ Europe. 80% have at least one episode with most having conductive hearing loss. Studies showed children with OME hear better with bone conducting headsets. During COVID-19 we investigated whether children with deafness secondary OME, without access to audiology or grommet surgery, could be aided with bone conduction kits and the HearGlueEar app.MethodsStarting July 2020, during COVID-19, children aged 3-11 years with OME and on a grommet waiting list were invited to a single arm, prospective study. They received the kit, instructions and HearGlueEar app by post. By 3 weeks parents were asked to charge and pair the devices, attend a remote consultation and complete an OMQ-14 questionnaire. Remote follow-up lasted 3 months. Outcomes: ability to use the equipment, complete the questionnaire about child’s hearing and behaviour before and with the equipment, declining grommet surgery or where deafness resolved, and give opinion about the intervention.Findings26 children enrolled. Families used the kit at home and school. Most found remote consultations positive and convenient. OMQ-14 responses were 90% positive. Comments were: “Other people have said, wow his speech is clearer.”, “It is making a real difference at home.”, “He said over and over again, “I can hear everybody, wow, wow, wow.”, “It is no exaggeration to say this has made an astronomical improvement to his quality of life”. One child reported “I can hear my best friend again”. “She is getting on really well with the headphones - pairing them with the iPad at home is simply brilliant.” Three families continued with the headset to avoid grommets.InterpretationPosting a bone conduction kit, HearGlueEar app and remote consultation is effective support for children with deafness secondary to OME.FundingNone

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Mastoidectomy and Epitympanotomy

Annals of Otology Rhinology & Laryngology ◽

10.1177/00034894760850s255 ◽

1976 ◽

Vol 85 (2_suppl) ◽

pp. 289-292 ◽

Cited By ~ 9

Author(s):

G. O. Proud ◽

W. E. Duff

Keyword(s):

Otitis Media ◽

Chorda Tympani ◽

Chorda Tympani Nerve ◽

Retraction Pocket ◽

Lost To Follow Up ◽

Serous Otitis Media ◽

Inflamed Tissue

The procedure of mastoidectomy and epitympanotomy effected a two-year arrest of serous otitis media and correction of a refractory retraction pocket in 12 out of 20 patients with one patient lost to follow-up. Each mastoid and epitympanum was extensively involved with chronically inflamed tissue which surrounded the ossicles and chorda tympani nerve.

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Results after Treatment of Otitis Media with Effusion

Annals of Otology Rhinology & Laryngology ◽

10.1177/00034894800890s372 ◽

1980 ◽

Vol 89 (3_suppl) ◽

pp. 308-311 ◽

Cited By ~ 20

Author(s):

G. Muenker

Keyword(s):

Inner Ear ◽

Otitis Media ◽

Middle Ear ◽

Otitis Media With Effusion ◽

Bone Conduction ◽

Tube Insertion ◽

Tympanostomy Tubes ◽

Ear Infections ◽

Inner Ear Damage

Otitis media with effusion will be observed in every fifth child admitted for adenoid surgery; in children with cleft palates the incidence is 50%. With adenoidectomy alone, normal hearing can be restored in 50% and improved in further 25% of the patients. Over a 12-year period 1,683 patients with otitis media with effusion were treated with adenoidectomy and with insertion of tympanostomy tubes in those cases where adenoidectomy proved to be ineffective. Since the tubes only substitute tubal function, recurrences have to be expected in more than 30% after spontaneous extrusion of the tubes. Of all recurrences, 93% occur within two years after tube insertion. With thorough follow-up and repeated insertion of tubes, deterioration of the middle ear can be avoided and hearing kept normal. Impaired bone conduction does not reflect inner ear damage, but will improve with ventilation of the middle ear. Infections occur in 15% (5% postoperatively, 10% later); persistent perforations in 2.5% and cholesteatoma in 0.9%.

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