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Results for “MYRINGOPLASTY”

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At least 505 records · Page 28Linked to original sources

PubMed1995

[Chronic otitis media].

Results of middle ear operations performed between 1984-1989 were analyzed. The operations included 139 simple mastoidectomies, 68 radical mastoidectomies, and 41 simple mastoidectomies with tympanoplasty. 342 tympanoplasties were also performed, 51 in children up to 14 years old and 291 in those over 14. We conclude that the Schuller view and CT are not conclusive as to the presence of cholesteatoma, and cannot be relied on without other confirmation in planning the type of operation. Of patients with cholesteatoma who underwent simple mastoidectomy, in 21.1% the cholesteatoma recurred and revision or radical mastoidectomy was necessary. When the Eustachian tube was patent, the graft took in more than 90% of cases. Fibrin glue did not affect the results of tympanoplasty or myringoplasty. Graft take was similar in those under and over the age of 14. Tympanoplasty in children has a good chance of succeeding, and enables most to return to a normal life (including swimming).

Adolescent↗

PubMed1995

[Nineteenth century physicians against drum perforation].

The trials of "organic" closure of drum perforation are described. The achievements of Adam Politzer, Hermann Schwartze, Joseph Gruber are presented. The first who used term "myringoplasty" was Emil Berthold. The "epochal" method of Wasilij Okuniew and achievements of Beniamin Gomperz are also depicted. The scientific activities of Polish otologists: Ludwik Guranowski and Rafai Spira were presented.

History, 19th Century↗

PubMed1996

[Problems in cochlear implant surgery].

In cochlear implant surgery, major complications, requiring revision procedures, do not exceed 5% of cases reported. Less frequent are problems that call for specific technical solutions. In 44 multichannel implantations (out of 54 cases) adverse conditions occurred and were successfully resolved in 6 patients: 1) delayed wound breakdown (one case); 2) chronic otitis media (three cases); 3) cochlear obliteration (two cases). Problem 1 was managed with the excision of an ellipse of skin including the devitalized areas under local anesthesia. The electronic package was left untouched, and the freshly cutaneous edges were mobilized and layer-sutured. Problem 2 was solved through a two-stage procedure. The chronic ear was dealt with as usual (myringoplasty, tympanoplasty, revision of a radical mastoidectomy). In the second stage the cochleotomy and device implantation were carried out. Problem 3 is a major issue for the surgeon. Following the Lehnhardt technique we drilled along the basal cochlear turn using the sharp line between the yellowish otic bone and the white newly formed bone as a landmark, until a patent s.tympani was found at the ascending part of the 1st or at the beginning of the 2nd turn.

Cochlear Implants↗

PubMed1996

[Tympanoplasty in clinical practice: use and results].

The halt in the use of allografts has resulted in the use in clinical practice in humans of a product that has been known for at least thirty years: collagen. Interesting experimental animal studies have been performed with the type I and type III collagen currently used: the Tympanoplast. This collagen, already used in numerous medical fields (digestive, renal and neuro-surgery) is of bovine origin. It is purified, and comes in the form of a reticulated plate. It is known for its qualities of reepithelialisation. We have been using it for more than a year for the reconstruction of the tympanic membrane. We use Tympanoplast 100 microns thick. All the cases of myringoplasties have been performed on dry ears, and essentially on partial perforations in reinforcement surgery. The results are most encouraging and depend on the surgical technique employed. On the other hand, the grafts performed on total perforations failed to produce the expected results. The paper presents work of the School, with the anatomical results and comments on the precautions to be taken when using Tympanoplast.

Audiometry↗

PubMed1997

Middle ear surgery under local anaesthesia and sedation.

BACKGROUND: Middle ear surgical procedures such as myringoplasty, stapedectomy and tympanolasty are traditionally performed under general anaesthesia, with induced hypotension. METHODS: We performed middle ear surgery in 73 patients, without induced hypotension, under local anaesthesia with sedation, and assessed feasibility, safety and acceptability. RESULTS: The operating conditions achieved were good and the complications were minor. None required conversion to general anaesthesia. CONCLUSION: Middle ear surgery under local anaesthesia and sedation is safe and feasible. Prospective trials are needed to fully assess the advantages of this technique over general anaesthesia.

Adolescent↗

PubMed1998

Prognostic factors in tympanoplasty.

OBJECTIVE: To assess the prognostic value of pathologic and technical variables influencing the functional outcome of tympanoplasty. PATIENTS AND STUDY DESIGN: Retrospective review of the records of 544 patients affected by chronic otitis with or without cholesteatoma, operated on by the senior author in a city hospital ENT department. Follow-up was provided systematically by the same institution. INTERVENTIONS: These included tympanoplasty without mastoidectomy in 339 cases, canal wall up technique in 134 cases, and canal wall down in 71 cases. Three hundred twenty-six (60%) were primary, and 218 (40%) were revision procedures. Myringoplasty was performed with autologous temporalis fascia, ossiculoplasty with incus interposition, or partial or total ossicular prostheses. Mean follow-up was 14 months (range, 12-50 months). MAIN OUTCOME MEASURES: Hearing results were defined according to the Committee on Hearing and Equilibrium Guidelines. A one-way analysis of variance was used to determine group differences. Multiple logistic regression analysis was subsequently carried out on the different pathology groups via the hierarchical log linear model. A probability value of p < 0.05 was the level of significance. RESULTS: The status of the mucosal lining, the mastoidectomy, the availability of the malleus handle, and the tympanic membrane perforation were all significantly predictive of the hearing outcome but with differing weight according to the pathologic condition. CONCLUSIONS: Anatomic and technical factors diversely affect the functional outcome of tympanoplasty. A better knowledge of their predictive roles and weights may be useful in both the surgeon's judgment and in the information given to the patient.

Adolescent↗

PubMed1998

Growth factors in tympanic membrane perforations.

OBJECTIVE: Little is known about the arrested healing of chronic central tympanic membrane perforations and the mechanism involved in this process. Some authors have traced the failure to a growth factor deficiency at the perforation margin. In addition, recently, several growth factors have been tried out to improve tympanic membrane (TM) closure in animals. The authors sought to determine the expression of some well-known growth factor peptides in normal human TM and in TMs with a chronic central perforation. MATERIALS AND METHODS: Total TM specimens were obtained from patients with a normal TM (N = 10) soon after death and from patients with a chronic perforation (N = 20) undergoing myringoplasty with use of an allograft TM. Formaldehyde solution-fixed TMs were analyzed after immunohistochemical staining using highly purified monoclonal antibodies to determine whether epidermal growth factor receptor (EGF-r), transforming growth factor-alpha (TGF-alpha), basic fibroblast growth factor (b-FGF), or transforming growth factor-beta 1 (TGF-beta 1) was expressed in the TMs. RESULTS: The distribution pattern for EGF-r, TGF-alpha, and b-FGF was similar in perforated and nonperforated TMs. In contrast to this, TGF-beta 1 staining was markedly different in perforated and nonperforated TMs. No or minimal TGF-beta 1 was observed in normal TMs, whereas TGF-beta 1 staining was prominent in perforated membranes, mostly at the perforation border. CONCLUSIONS: The authors experimental findings imply that EGF-r, b-FGF, and TGF-alpha expression are not significantly different in TMs with and without a central chronic perforation. However, for TGF-beta 1, the authors found an increased staining pattern in perforated TMs when compared with that of normal TMs, and staining at the fibrotic and scarred perforation margin was pronounced. Based on these findings, the authors speculate on the possible role of TGF-beta 1 in the development of the fibrotic scar at the perforation margin explaining the deficient healing pattern of tympanic membranes in chronic otitis media. Possible clinical implications for the future, including growth factor therapy, are discussed.

Antibodies, Monoclonal↗

PubMed1965