scholarly journals Factors that have an influence on bone conduction thresholds changes after otosurgery in the patients operated on due to the perforation of the tympanic membrane with the preserved ossicular chain

2017 ◽  
Vol 71 (4) ◽  
pp. 26-33
Author(s):  
Maciej Wiatr ◽  
Agnieszka Wiatr ◽  
Sebastian Kocoń ◽  
Jacek Składzień
Keyword(s):  
Tympanic Membrane ◽  
Middle Ear ◽  
Negative Impact ◽  
Positive Impact ◽  
Round Window ◽  
Bone Conduction ◽  
Ossicular Chain ◽  
Middle Ear Surgery ◽  
Ear Surgery ◽  
Study Objective

Introduction: The aim of the middle ear surgery is to eliminate abnormalities from the mucous, ensure the due airing of the postoperative cavity and reconstruct the sound-conducting system in the middle ear. Numerous reports can be found in literature on the changes to bone conduction as a consequence of middle ear surgery. Study objective: The aim of the work is to define the factors that affect bone conduction in the patients operated on due to the perforation of the tympanic membrane with the preserved and normal mobile ossicular chain. Material and method: A prospective analysis of patients operated on due to diseases of the middle ear in 2009–2012 was carried out. The cases of patients operated on for the first time due to chronic otitis media were taken into consideration. The analysis encompassed the patients who had undergone myringoplasty. The patients were divided into several groups taking into account the abnormalities of the mucous observed during otosurgery. Results: A significant improvement of bone conduction was observed in the patients with dry perforation, without other lesions in the middle ear. The appropriate pharmacological treatment before otosurgery in patients with permanent discharge from the ear resulted in significant bone conduction improvement. The elimination of granulation lesions turned out to be a positive factor for the future improvement of the function of the inner ear. Conclusions: The lack of abnormalities on the mucous of the middle ear (e.g. granulation,) and discharge has a positive impact on improvement of bone conduction after myringoplasty. Adhesions in the tympanic cavity, especially in the niche of the round window, have a negative impact on improvement of bone conduction in patients after myringoplasty.

A new device for real-time peroperative monitoring of ossicular chain reconstruction during middle ear surgery

2019 ◽  
Vol 34 (4) ◽  
pp. 827-832
Author(s):  
Van Son Nguyen ◽  
Didier Rouxel ◽  
Brice Vincent ◽  
Joël Ducourneau ◽  
Cécile Parietti-Winkler
Keyword(s):  
Real Time ◽  
Middle Ear ◽  
Ossicular Chain ◽  
Middle Ear Surgery ◽  
Ear Surgery ◽  
New Device ◽  
Ossicular Chain Reconstruction

Cholesteatoma Medial to an Intact Tympanic Membrane in 34 Young Children

PEDIATRICS ◽  
1984 ◽  
Vol 74 (2) ◽  
pp. 236-240
Author(s):  
Richard H. Schwartz ◽  
Kenneth M. Grundfast ◽  
Bruce Feldman ◽  
Richard E. Linde ◽  
Karen L. Hermansen
Keyword(s):  
Hearing Loss ◽  
Young Children ◽  
Tympanic Membrane ◽  
Otitis Media ◽  
Middle Ear ◽  
Early Stage ◽  
Middle Ear Surgery ◽  
Ear Surgery ◽  
Simple Excision ◽  
Otoscopic Examination

Thirty-five cholesteatomas medial to intact eardrums were treated in 34 children between 1976 and 1982. Six (18%) children had never had a documented episode of otitis media. Seventeen (50%) children, in whom the lesion was diagnosed at an early stage, underwent simple excision of the cholesteatoma without the need for extensive middle ear surgery. Findings from postoperative audiograms were normal for all such children. Cholesteatoma has recurred in eight (23%) children to date. Most recurrences were diagnosed 15 months or less after surgery. Routine careful otoscopic examination is essential in order to discover cholesteatoma at an early stage and to avoid hearing loss and the need for extensive otomastoid surgery. In order to perform an accurate examination of the eardrum, a halogen-illuminated otoscope and pneumo-otoscopy should be used by the pediatrician routinely. Particular attention should be paid to the posterior-superior quadrant of the tympanic membrance where a cholesteatoma is usually located.

Evaluation of Taste Disturbance in Pre and Post Mastoid Surgery Patients

2019 ◽  
Vol 2 (2) ◽  
pp. 4-11
Author(s):  
Sriti Manandhar ◽  
ST Chettri ◽  
DR Kandel
Keyword(s):  
Tympanic Membrane ◽  
Middle Ear ◽  
Analytical Study ◽  
Middle Ear Surgery ◽  
Chorda Tympani ◽  
Chorda Tympani Nerve ◽  
Ear Surgery ◽  
Taste Disturbance ◽  
Duration Of Operation ◽  
Mastoid Surgery

Background: Mastoid surgery is one of the commonest surgeries in Otolaryngology & Head & Neck department. Surgeons are less aware of preserving chorda tympani nerve (CT). Injury to the chord tympani nerve is common in middle ear surgery as the course of CT runs between ossicles and close to tympanic membrane. It makes the surgeon difficult to preserve it during the surgery. The study was done to observe frequency of taste disturbances (TD) in all patients undergoing mastoid surgery and to correlate between intra operative status of CT and type of intra operative status of CT injury with postoperative taste disturbances. Methods: A prospective analytical study was conducted in patients who underwent mastoid surgery. The intra operative status of CT was studied, different forms of injury to the nerve were noticed and its impact on taste disturbances was assessed subjectively with questionnaire. The patients with taste disturbances were followed till twelve weeks. Result: None of the patients had taste disturbances prior to surgery. Out of 65 patients, only 15 patients became symptomatic in second postoperative day and the taste disturbances were in the form of altered taste (26.66%), dry mouth (26.66%) and numbness (46.66%). Symptoms like altered taste and numbness were present till the eighth week of surgery and disappeared by the twelfth week except one patient in whom numbness persisted till twelfth week. The symptoms did not correlate with the intra operative status of CT. The symptoms disappeared with duration of operation and it was significant. Conclusion: None of the patients voluntarily complained regarding taste disturbances until they were specifically asked. Only 15 patients had taste disturbances; 7 had numbness, 4 dryness of mouth and 4altered taste. The taste disturbances did not correlate with the type of intra operative status of CT. CT was not identified in 9 patients and only 3 (33.3%) became symptomatic and CT was cut with micro scissors in 26 patients but only 4 (15.38%) patients were symptomatic.

scholarly journals Robot-Assisted Middle Ear Endoscopic Surgery: Preliminary Results on 37 Patients

2021 ◽  
Vol 8 ◽  
Author(s):  
Marine Veleur ◽  
Ghizlene Lahlou ◽  
Renato Torres ◽  
Hannah Daoudi ◽  
Isabelle Mosnier ◽  
...  
Keyword(s):  
Middle Ear ◽  
Bone Conduction ◽  
Case Series ◽  
Petrous Apex ◽  
Middle Ear Surgery ◽  
Type I ◽  
Type Ii ◽  
Robot Assisted ◽  
Ear Surgery ◽  
Type Iii

Background: Endoscopy during middle ear surgery is advantageous for better exploration of middle ear structures. However, using an endoscope has some weaknesses as surgical gestures are performed with one hand. This may trouble surgeons accustomed to using two-handed surgery, and may affect accuracy. A robot-based holder may combine the benefits from endoscopic exposure with a two-handed technique. The purpose of this study was to assess the safety and value of an endoscope held by a teleoperated system.Patients and Methods: A case series of 37 consecutive patients operated using endoscopic exposure with robot-based assistance was analyzed retrospectively. The RobOtol® system (Collin, France) was teleoperated as an endoscope holder in combination with a microscope. The following data were collected: patient characteristics, etiology, procedure type, complications, mean air and bone conduction thresholds, and speech performance at 3 months postoperatively. Patients had type I (myringoplasty), II (partial ossiculoplasty), and III (total ossiculoplasty) tympanoplasties in 15, 14, and 4 cases, respectively. Three patients had partial petrosectomies for cholesteatomas extending to the petrous apex. Finally, one case underwent resection of a tympanic paraganglioma. Ambulatory procedures were performed in 25 of the 37 patients (68%).Results: Complete healing with no perforation of the tympanic membrane was noted postoperatively in all patients. No complications relating to robotic manipulation occurred during surgery or postoperatively. The mean air conduction gain was 3.8 ± 12.6 dB for type I (n = 15), 7.9 ± 11.4 dB for type II (n = 14), and −0.9 ± 10.8 for type III tympanoplasties (n = 4), and the postoperative air-bone conduction gap was 13.8 ± 13.3 dB for type I, 19.7 ± 11.7 dB for type II and 31.6 ± 13.0 dB for type III tympanoplasty. They was no relapse of cholesteatoma or paraganglioma during the short follow-up period (<1 year).Conclusion: This study indicates that robot-assisted endoscopy is a safe and trustworthy tool for several categories of middle ear procedures. It combines the benefits of endoscopic exposure with a two-handed technique in middle ear surgery. It can be used as a standalone tool for pathology limited to the middle ear cleft or in combination with a microscope in lesions extending to the mastoid or petrous apex.

scholarly journals Experimental middle ear surgery in rabbits: a new approach for reconstructing the ossicular chain

2009 ◽  
Vol 43 (2) ◽  
pp. 198-204 ◽  
Author(s):  
M Stieve ◽  
H J Hedrich ◽  
R D Battmer ◽  
P Behrens ◽  
P Müller ◽  
...  
Keyword(s):  
Middle Ear ◽  
Bone Conduction ◽  
Hearing Threshold ◽  
Ossicular Chain ◽  
Ceramic Materials ◽  
Middle Ear Surgery ◽  
Electric Response ◽  
Hearing Level ◽  
Erbium:Yag Laser ◽  
Significant Difference

This experimental animal study aimed at evaluating a new prosthesis to replace the ossicular chain; we developed a new technique for surgical implantation into the middle ear of rabbits. The rabbit middle ear is, owing to the relative anatomical dimensions involved, an ideal environment for implantation procedures involving the ossicles, as the surgical conditions are similar to those of the human middle ear. This study included a total of 34 approximately six-month-old female white rabbits (New Zealand) weighing between 3.2 and 4.4 kg. The implants used were constructed of ceramic materials (titania, TiO2) of various pore sizes. Directly prior to implanting the total ossicular reconstruction prostheses (TORPs), as well as at 28, 84 and 300 days after implantation, electric response audiometry was used to determine the hearing thresholds of the animals (bone conduction; click stimulus nHL). An erbium:YAG laser was used to excise the original ossicular chain. Following implantation, we were unable to detect any stenosis of the outer ear canal or perforation of the tympanic membrane. The conductive hearing threshold was in the range of 4.21 ± 6.68 dB nHL ( n = 131). The hearing level showed no significant difference before and after surgery ( P < 0.05).

Preliminary outcomes of endoscopic middle-ear surgery in 103 cases: a UK experience

2018 ◽  
Vol 132 (06) ◽  
pp. 493-496 ◽  
Author(s):  
C P Yiannakis ◽  
R Sproat ◽  
A Iyer
Keyword(s):  
Tympanic Membrane ◽  
Middle Ear ◽  
Middle Ear Surgery ◽  
Endoscopic Ear Surgery ◽  
Short Term ◽  
Ear Surgery ◽  
Sinus Tympani ◽  
New Concepts ◽  
The Uk ◽  
External Incisions

AbstractBackgroundTotally endoscopic ear surgery and endoscope-assisted microsurgery are still new concepts, with relatively few centres in the UK performing them. Advantages include better visualisation of difficult to reach areas, such as the sinus tympani, and limited external incisions. This paper reports our short-term outcomes for endoscopic middle-ear surgery.MethodsA prospective review was conducted of the first 103 consecutive patients undergoing totally endoscopic ear surgery or endoscope-assisted microsurgery in 1 centre performed by 1 operator. The outcomes assessed were: tympanic membrane healing, audiological data and complications.ResultsTwenty-five patients underwent endoscope-assisted microsurgery, while 78 had totally endoscopic ear surgery. There were no reported cases of dead ear or permanent facial nerve palsy. The average air–bone gap following stapedectomy was 7.38 dB. The tympanic membrane healing rate was 89 per cent.ConclusionOur results confirm that endoscopic middle-ear surgery is safe, and the short-term outcomes are comparable with conventional surgery.

Auditory Brain Stem Response Monitoring during Middle Ear Surgery

1989 ◽  
Vol 98 (8) ◽  
pp. 605-610 ◽  
Author(s):  
Jobst von Scheel ◽  
Dieter Mrowinski ◽  
Günther Gerull ◽  
Josef Thoma
Keyword(s):  
Brain Stem ◽  
Middle Ear ◽  
Ossicular Chain ◽  
Simultaneous Recording ◽  
Response Monitoring ◽  
Middle Ear Surgery ◽  
Ear Surgery ◽  
Auditory Brain Stem Response ◽  
Auditory Brain Stem ◽  
Conductive Hearing

Conductive hearing loss can be determined in the course of middle ear surgery by sound probe stimulation and simultaneous recording of auditory brain stem responses. Mechanical properties of the ossicular chain, usually judged subjectively by the surgeon's visual and tactile senses, can be quantified objectively. Thus, disarticulation of ossicles can be localized precisely, and fixation of the head of the malleus can be differentiated from stapes fixation. Moreover, the function of the reconstructed ossicular chain or prosthesis may be ascertained.

A new adhesive bone conduction hearing system as a treatment option for transient hearing loss after middle ear surgery

2019 ◽  
Vol 277 (3) ◽  
pp. 751-759 ◽  
Author(s):  
Roxanne Weiss ◽  
Andreas Loth ◽  
Martin Leinung ◽  
Sven Balster ◽  
Daniel Hirth ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Treatment Option ◽  
Middle Ear ◽  
Bone Conduction ◽  
Middle Ear Surgery ◽  
Ear Surgery ◽  
Bone Conduction Hearing ◽  
Hearing System

scholarly journals Microendoscopic Surgery of Middle Ear and Petrous Bone: Benefits Analysis

2020 ◽  
pp. 014556132093001 ◽  
Author(s):  
Arturo Mario Poletti ◽  
Lorenzo Salvatore Solimeno ◽  
Giovanni Cugini ◽  
Stefano Miceli ◽  
Giovanni Colombo
Keyword(s):  
Middle Ear ◽  
Chronic Otitis Media ◽  
Ossicular Chain ◽  
Petrous Bone ◽  
Tertiary Hospital ◽  
Middle Ear Surgery ◽  
Microscopic Approach ◽  
Ear Surgery ◽  
Glomus Tympanicum ◽  
Double Technique

Objectives: Endoscopy has become routinely used in middle ear surgery. The aim of this study is to analyze where this tool may complement the traditional microscopic approach. This is a retrospective study done in single tertiary hospital. Methods: We reviewed 342 middle ear/petrous bone surgical procedures performed between 2005 and 2015. Only cases in which both microscopic and endoscope-assisted techniques were used have been included. Sixty-six patients received this double-technique surgery: 51 (77.2%) had middle ear/mastoid and petrous bone cholesteatomas (46 middle ear and mastoid and 5 acquired/congenital petrous bone cholesteatomas), 5 (7.5%) had glomus tympanicum tumors (GTT), 4 (6%) had an ossicular chain dislocation, 3 (4.5%) had purulent chronic otitis media, 2 (3%) had tympanosclerosis, and 1 (1.5%) had an ossicular chain malformation. Results: The endoscope was helpful to remove disease remnants not accessible by microscope in 41 (62%) of the cases; 37 (90%) were cholesteatomas, 3 (7%) were GTT, and only 1 (3%) was an open tympanosclerosis. In the remaining 25 (37.8%) cases, the endoscope was useful only to visualize the cavity since the microscope had already been successful in removing the entire lesion. Conclusions: The endoscopy can add valuable information and support to the usual microscope approach alone. The consensus of a single best technique does not yet exist, but the physician should choose the best modality or combination of modalities in order to cure the patient and prevent any possible complications or recurrence of the pathology.

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