SEARCH · PubMed Health

Results for “TYMPANOPLASTY”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 55 records · Page 3Linked to original sources

PubMed1986

Homograft (allograft) tympanoplasty update.

If homograft tympanoplasty is to be of value, specific instances in which homograft tympanic membrane, malleus, and incus (TMMI) provide significant hearing and anatomical advantages over standard techniques should be identified. This author has performed 305 homograft tympanoplasties limited to the reconstruction of the severely damaged middle ear. Indications include: previous failure with standard tympanoplasty techniques; high risk of anatomic or hearing failure with standard techniques (total perforation with absent malleus, slag burns); reconstruction of radical mastoidectomy; congenital aural atresia. The first 125 consecutive homograft tympanoplasties were reported in 1982. One hundred eighty additional homograft tympanoplasties have been performed since then. In the past 3 years the anatomic success rate has risen to 97% (174/180) with refinement of surgical techniques. Eighty-five percent of all patients have maintained an average air-bone gap of 25 dB or better. Formalin preserved homograft tympanic membranes with attached malleus offer significant advantages over standard tympanoplasty techniques in these specific indications.

Ear↗

PubMed2003

Cartilage tympanoplasty: indications, techniques, and outcomes in a 1,000-patient series.

OBJECTIVES/HYPOTHESIS: The purpose of this study was to analyze the anatomical and audiologic results in more than 1,000 cartilage tympanoplasties that utilized a logical application of several techniques for the management of the difficult ear (cholesteatoma, recurrent perforation, atelectasis). Our hypothesis was that pathology and status of the ossicular chain should dictate the technique used to achieve optimal outcome. STUDY DESIGN: Retrospective clinical study of patients undergoing cartilage tympanoplasty between July 1994 and July 2001. A computerized otologic database and patient charts were used to obtain the necessary data. METHODS: A modification of the perichondrium/cartilage island flap was utilized for tympanic membrane reconstruction in cases of the atelectatic ear, for high-risk perforation in the presence of an intact ossicular chain, and in association with ossiculoplasty when the malleus was absent. A modification of the palisade technique was utilized for TM reconstruction in cases of cholesteatoma and in association with ossiculoplasty when the malleus was present. Hearing results were reported using a four-frequency (500, 1,000, 2,000, 3,000 Hz) pure-tone average air-bone gap (PTA-ABG). The Student t test was used for statistical comparison. Postoperative complications were recorded. RESULTS: During the study period, cartilage was used for TM reconstruction in more than 1,000 patients, of which 712 had sufficient data available for inclusion. Of these, 636 were available for outcomes analysis. In 220 cholesteatoma cases, the average pre- and postoperative PTA-ABGs were 26.5 +/- 12.6 dB and 14.6 +/- 8.8 dB, respectively (P <.05). Recurrence was seen in 8 cases (3.6%), conductive HL requiring revision in 4 (1.8%), perforation in 3 (1.4%), and post- and intraoperative tube insertion in 11 (5.0%) and 18 ears (8.2%), respectively. In 215 cases of high-risk perforation, the average pre- and postoperative PTA-ABGs were 21.7 +/- 13.5 dB and 11.9 +/- 9.3 dB, respectively (P <.05). Complications included recurrent perforation in 9 ears (4.2%), conductive HL requiring revision in 4 (1.9%), postoperative and intraoperative tube insertion in 4 (1.9%) and 6 ears (2.8%), respectively. In 98 cases of atelectasis, the average pre- and postoperative PTA-ABGs were 20.2 +/- 10.9 dB and 14.2 +/- 10.2 dB, respectively (P <.05). Complications included 1 perforation (1.0%), conductive loss requiring revision in 2 cases (2.0%), and post- and intraoperative tube insertion in 7 (7.1%) and 12 ears (12%), respectively. In 103 cases to improve hearing (audiologic), the average pre- and postoperative PTA-ABGs were 33.6 +/- 9.6 dB and 14.6 +/- 10.1 dB, respectively (P <.05). Complications included 1 perforation (1.0%), conductive loss requiring revision in 11 (11%), and post- and intraoperative tube insertion in 6 (5.8%) and 2 (1.9%), respectively. CONCLUSIONS: Cartilage tympanoplasty achieves good anatomical and audiologic results when pathology and status of the ossicular chain dictate the technique utilized. Significant hearing improvement was realized in each pathological group. In the atelectatic ear, cartilage allowed us to reconstruct the TM with good anatomic results compared to traditional reconstructions, which have shown high rates of retraction and failure. In cholesteatoma, cartilage tympanoplasty using the palisade technique resulted in precise reconstruction of the TM and helped reduce recurrence. In cases of high-risk perforation, reconstruction with cartilage yielded anatomical and functional results that compared favorably to primary tympanoplasty using traditional techniques. We believe the indications for cartilage tympanoplasty (atelectatic ear, cholesteatoma, high-risk perforation) were validated by these results.

Adolescent↗

PubMed2006

Revision tympanoplasty using scar tissue graft.

OBJECTIVE: To evaluate the success rate of subcutaneous postsurgical scar tissue as graft material for revision tympanoplasty operations. STUDY DESIGN: Retrospective case review. SETTING: Tertiary referral center. PATIENTS: Thirty-five patients who underwent revision tympanoplasty with or without mastoidectomy procedures and 36 patients undergoing primary operations who had all the data necessary for the study and a minimum follow-up of 6 months. The mean follow-up period was 12 months (range, 6-18 mo). Mean age, perforation size, cholesteatoma presence, time required for harvesting, and adjunctive mastoidectomies were similar between the two groups. INTERVENTION: The patients undergoing revision tympanoplasty had graft material harvested from the subcutaneous scar tissue. In the control group, temporalis fascia graft was used as graft tissue. MAIN OUTCOME MEASURES: The rate of perforation closure and postoperative hearing change was measured. RESULTS: In the scar tissue tympanoplasty group, 32 of 35 patients (91%) had successful closure of the tympanic membrane perforation, whereas in the control group, the success rate was 92% (p > 0.05). Mean postoperative pure-tone average improvement was 21 dB in the scar tissue tympanoplasty group and 18 dB in the control group (p > 0.05). CONCLUSION: Subcutaneous scar tissue is as successful in perforation closure and hearing improvement as temporalis fascia graft. The use of subcutaneous scar tissue graft is advantageous to other graft materials used in revision tympanoplasty operations in that it can be harvested through the same incision, does not add to the operative time, and does not carry the cost or risk of acellular dermis.

Adolescent↗

PubMed2005

"Window shade" tympanoplasty for anterior marginal perforations.

OBJECTIVES/HYPOTHESIS: Anterior marginal perforations of the tympanic membrane often present a reconstructive challenge to the otolaryngologist. Poor surgical outcomes are often due to inadequate exposure, a lack of residual tympanic membrane, impaired vascular supply, and delayed healing. This study reports on the success of the "window shade" technique, combining aspects of both the traditional underlay and overlay tympanoplasty techniques, for the management of anterior marginal tympanic membrane perforations. STUDY DESIGN: Retrospective review of patients undergoing window shade tympanoplasty from July 1, 1994, to July 1, 2003, at a tertiary care referral center. METHODS: Only patients found to have anterior tympanic membrane perforations and who underwent a window shade tympanoplasty were included in the study. Tympanoplasty success rate was studied by examining postoperative complications of recurrent perforation, tympanic membrane lateralization, or anterior blunting. RESULTS: The authors identified 164 patients who underwent window shade tympanoplasty during the study period. The overall success rate for tympanic membrane repair was 94.5%. There were no cases of tympanic membrane lateralization or significant blunting. The average healing time was 4 weeks. The surgical technique is described in detail. CONCLUSION: The window shade tympanoplasty is an excellent surgical option for repair of anterior marginal perforations of the tympanic membrane.

Adolescent↗

PubMedDate not supplied

Twenty-five years of tympanoplasty: a critical evaluation.

Twenty-five years of experience with tympanoplasty have demonstrated that the operation is not as safe as it is generally thought. Serious complications do occur. Many problems of middle ear reconstruction remain unsolved and more often than not results have not withstood the test of time. This paper attempts to answer the following questions. 1) What are the hazards in tympanoplasty surgery? 2) What are the complications of tympanoplasty? 3) What can tympanoplasty do for the welfare of the patient with reasonable certainty? 4) What has tympanoplasty been unable to do in spite of continued attempts and experimentation? 5) Why is tympanoplasty successful or unsuccessful in seemingly similar cases?

Cholesteatoma↗

PubMedDate not supplied

Fenestration tympanoplasty: an adjunctive technique for hearing restoration.

Two-staged fenestration tympanoplasty is a form of total tympanoplasty type V that incorporates the mastoidotympanomastoidectomy (radical mastoidectomy) and revives the Lempert horizontal semicircular canal fenestration operation. It is valuable when the usual and customary single or two-staged tympanoplasty procedures fail to conserve or restore hearing in the operative management of otitic disease. Two-staged fenestration tympanoplasty is also indicated in audiometric failure tympanoplasties, in oval window surgery failures in the absence of supporting ossicles and in the presence of a fibrosed or sclerosed oval window, and in severe otitic oval window-round window-posterior tympanic recess-tympanic orifice eustachian tube infection, which can only be completely removed by the mastoidotympanectomy. Total tympanoplasty type V as described here has produced serviceable hearing for human conversation and the speech frequencies to the 15-dB to 25-dB levels, and a 20 dB average in 19 of 21 patients operated on for a 90% success rate.

Adolescent↗

PubMed2001

Success rates in paediatric tympanoplasty.

OBJECTIVE: To determine if the success of paediatric tympanoplasty is dependent on certain criteria, which are determinable prior to surgery. DESIGN: Retrospective chart review. SETTING: An academic paediatric otolaryngology department. PATIENTS: Seventy-seven patients who had undergone tympanoplasty with or without ossicular reconstruction, but without mastoidectomy, between April 1997 and May 1999. MAIN OUTCOME MEASURES: Status of the repaired tympanic membrane at last follow-up visit measured by otoscopic examination and with tympanometry. RESULTS: Eighty-nine tympanoplasties were performed during this period. The age range was 2.9 to 22 years. The success rate was 75% overall. For patients younger than 11 years (n = 43), the success rate was 82%, and for those 11 to 18 years (n = 44), it was 74%, which was not significantly different. In 18 patients 7.5 years or younger, the success rate was 79%. Perforation location, size, presence of myringosclerosis, status of the other ear or nose, history of the perforation, surgical approach, middle ear findings, canal packing, and gender were not shown to be significantly different between successful and unsuccessful tympanoplasty groups. CONCLUSION: These young patients had a good success rate post-tympanoplasty, which we believe reflects less severe disease. These results mitigate against delaying tympanoplasty in young children.

Adolescent↗

PubMed1989

[Contralateral hearing and tympanoplasty].

The relationship between the contralateral hearing threshold in the operated ear and the type of tympanoplasty and the hearing threshold in the operated ear was investigated in this report. The subjects of analysis were 863 ears that received tympanoplasty during the past nine years at the Nippon Medical School Main Hospital. Patients who had good hearing in the contralateral ear received type I tympanoplasty more frequently than did those who had poor hearing on the contralateral ear. On the other hand, patients who had poor hearing in the contralateral ear received a modified type III tympanoplasty more frequently. Patients who had good hearing in the contralateral ear tended to have better hearing in the operated ear compared to those who had poor hearing in the contralateral ear. The hearing threshold in patients who had normal contralateral hearing on the average had 20 dB better hearing than did those who had profound hearing loss in the contralateral ear. More than one third of the patients whose hearing thresholds were worse than 30 dB in the operated ear also had a contralateral hearing loss of 30 dB or more. The decision to perform tympanoplasty in cases of the better hearing ear or the only hearing ear must be made very carefully. The contralateral hearing in patients with chronic otitis media, however, is frequently not normal as was evidenced in this investigation. Also, patients who had poor hearing or were deaf in the contralateral ear received more benefit by tympanoplasty than did those who had good hearing in the contralateral ear.(ABSTRACT TRUNCATED AT 250 WORDS)

Auditory Threshold↗

PubMed1999

Anterior subannular T-tube for long-term middle ear ventilation during tympanoplasty.

OBJECTIVE: A technique for providing long-term ventilation of the middle ear (ME) during tympanoplasty is described, and the results using this technique in 20 patients with chronic Eustachian tube dysfunction (ETD) are reported. STUDY DESIGN: This study was a retrospective, nonrandomized case review. SETTING: This study was conducted at an otology clinic in a tertiary referral center. PATIENTS: Twenty consecutive patients who underwent tympanoplasty with ETD, adhesive otitis media, or chronic otitis media with perforation were included in this study. INTERVENTION: All patients had a subannular T-tube placed anteriorly at the time of tympanoplasty for long-term ventilation of the ME space. MAIN OUTCOME MEASURES: The two main outcome measures were tube position and patency. Preoperative and postoperative hearing levels were also tested in most patients, and any complications were documented. RESULTS: Twenty patients (20 ears) received anterior subannular T-tubes at the time of tympanoplasty. Fourteen females and 6 males were evaluated (median age, 36 years; range, 7 to 72 years). All patients had ETD; 7 had adhesive otitis media, 10 had chronic otitis media, 8 had cholesteatoma, and 2 had cleft palate. All patients had conductive hearing loss and previous surgery. All patients underwent tympanoplasty; 11 had concomitant ossiculoplasty, and 5 had mastoidectomy. Follow-up ranged from 8 to 22 months (mean, 13.4 months). One patient was lost to follow-up. One tube extruded after 16 months. Two patients had persistent mild retraction of the tympanic membrane. All other tubes are patent and have not migrated or plugged. There has been no evidence of anterior blunting or ingrowth of epithelium around the tube. CONCLUSIONS: Anterior subannular T-tube placement is a simple, safe, and effective alternative for long-term ME ventilation in patients in whom standard transtympanic sites are not available. At their last follow-up visit, all but one patient had a patent tube. All MEs were aerated. This technique offers the advantage of ease of placement during simultaneous tympanoplasty, mastoidectomy, or ossiculoplasty. Longer follow-up is necessary to confirm these initial findings.

Adolescent↗

PubMed2005

[Clinical study of combined approach of tympanoplasty and mastoidectomy with close technique].

OBJECTIVE: To improve the surgery results and living quality of patients following the operation of the combined approach of tympanoplasty and mastoidectomy with close technique. METHODS: The clinical data and following-up results of 49 patients treated with combined approach of tympanoplasty and mastoidectomy with close technique and 82 patients treated with open mastoidectomy with tympanoplasty were retrospective analyzed. RESULTS: In the group treated with combined approach tympanoplasty, all patients got dry ear in 20 days and 31 patients' hearing level enhanced over 15 dB after the operation; but in the group treated with open mastoidectomy with tympanoplasty, only 13 patients got dry ear in 20 days and no patients' hearing level enhance over 15 dB after the operation. Although the recurrence rates between two groups were not significant difference, the patients of former group not only took a shorter recovery time and got a better hearing recovery, but also kept a normal external auditory meatus, at the same time, they need not to clear scab at fixed period all life long. CONCLUSIONS: When performed on carefully selected patients, combined approach tympanoplasty was a feasible surgical method to improve the surgery results and living quality of patients following the operation, however, the advanced equipment and perfect operation skill are necessary.

Adolescent↗

PubMed1988

Cholesteatoma surgery: open vs closed tympanoplasty.

The purpose of this report is to compare closed tympanoplasty (canal wall up) and open tympanoplasty (canal wall down) performed in ears with extensive cholesteatoma operated on and followed up during the past 11 years. The study has demonstrated that there are no significant differences between open and closed tympanoplasties in terms of both postoperative subjective problems and auditory results. The only definite difference relates to recurring cholesteatoma: canal wall-up operations are complicated by recurrence of cholesteatoma in a not insignificant number of ears and require a planned two-stage procedure in all the cases. By contrast, the postoperative clinical course of open tympanoplasties has been only rarely affected by cholesteatomatous complications. It is concluded that reduction of cholesteatoma recurrence to the greatest degree possible necessitates removal of the canal wall. Open tympanoplasty is an effective alternative for closed tympanoplasty in all cases in which there is a contraindication to preserving the canal wall and in all patients whose medical or social conditions prevent scheduling an operation in more stages.

Adolescent↗

PubMed1993

[Contralateral hearing and tympanoplasty].

The contralateral hearing level of the operated ear is closely related to its preoperative hearing level, and is an important index to the success of tympanoplasty. We analysed 146 cases of chronic otitis media who had received tympanoplasty by the same surgeon at Kaohsiung Medical College Hospital. From the results of pure tone audiometry, we divided the hearing acuity into the following 5 categories: normal hearing, mild hearing loss, moderate hearing loss, severe hearing loss, and deafness. Referring to the categories of contralateral hearing, we discuss the preoperative hearing level of the operated ear, the occurrence of cholesteatoma, the type of the tympanoplasty, and the auditory gain of the operation. While 23.97% cases had moderate or severe loss of contralateral hearing, their hearing acuity of the operated ear was also poor. Most of cases with normal contralateral hearing received type I tympanoplasty. Compared to the above group, half of the cases with moderate or severe contralateral hearing loss received type III or type IV operations to reconstruct the ossicle chain. Though the type I cases had more hearing gains than the type III cases, those with moderate contralateral hearing loss had good results from the type III tympanoplasty. We also found the cases with cholesteatoma in the operated ear had better contralateral hearing in the contralateral ear than the cases without cholesteatoma. The decision to perform tympanoplasty in cases of the better hearing ear with poor contralateral hearing should be very carefully made so as to improve the postoperative social life of the patients.

Adult↗

PubMed1998

Type IV tympanoplasty revisited.

OBJECTIVE: There has been a great improvement in the material and design of prosthesis used for total ossicular reconstruction in recent years. As a result, the indication for type IV tympanoplasty has become more restricted. The long-term follow-up of type IV tympanoplasties performed by the author is presented. STUDY DESIGN AND SETTING: This is a retrospective study of 31 patients who had type IV tympanoplasties performed by the author at the ear, nose, and throat clinic of a district general hospital. PATIENTS: All the patients had chronic active otitis media with total loss of ossicles that were unsuitable for ossicular reconstruction. INTERVENTION AND MAIN OUTCOME MEASURES: The preoperative and postoperative air and bone conduction thresholds of all the patients who underwent type IV tympanoplasty were measured. RESULTS: Twenty-six percent of the patients had a postoperative hearing level <40 dB and 58% had an air-bone gap <30 dB. The indication for type IV tympanoplasty can be categorized into four groups: severe atelectasis, patients with cleft palate, erosion of the footplate, and surgery on the better-only hearing ear. CONCLUSION: There still is a place for type IV tympanoplasty in modern otology.

Audiometry, Pure-Tone↗

PubMed1998

Results of tympanoplasty in children with primary ciliary dyskinesia.

OBJECTIVE: To assess the results of tympanoplasty in children with primary ciliary dyskinesia complicated by tympanic perforation or cholesteatoma with hearing loss and/or recurrent otorrhea. DESIGN: Retrospective study. Postoperative follow-up of 26.3 months in the type 1 tympanoplasty group and 46 months in the child with cholesteatoma. SETTING: Hospitalized care, referral center. PATIENTS: Seven children with primary ciliary dyskinesia, complicated in 6 children by 9 tympanic perforations (3 bilateral perforations) and in 1 child by an attical cholesteatoma. RESULTS: After 9 type 1 tympanoplasties, the grafts were intact in 9 ears, with no recurrence of otorrhea, but serous otitis media was present in 6 of the 9 ears. Auditory improvement was significant, with an average gain of 17-dB hearing level in speech frequencies. After a canal wall-down tympanoplasty with mastoidectomy for attic cholesteatoma in 1 ear, the cavity that was operated on showed no signs of otorrhea or residual cholesteatoma after a follow-up of 46 months. CONCLUSION: In children with primary ciliary dyskinesia, tympanoplasty has a high probability of graft success and auditory improvement, despite the frequent recurrence of serous otitis media.

Adolescent↗

PubMed1999

Meta-analysis of pediatric tympanoplasty.

OBJECTIVE: To determine which preoperative conditions or surgical techniques may influence the success of tympanoplasty in the pediatric population. DATA SOURCES: A MEDLINE search of the English-language literature from 1966 to May 1997 was conducted using the search terms pediatric or child and tympanoplasty or myringoplasty. STUDY SELECTION: Articles that provided age-specific data on tympanoplasty or myringoplasty were included. Of the original 651 studies retrieved, 30 were accepted for inclusion. The principal reason for exclusion was inability to separate adult and pediatric results in series that combined both patient populations. DATA EXTRACTION: Success was defined as an intact tympanic membrane for the purpose of this review. Data were tabulated by consensus of 2 reviewers. DATA SYNTHESIS: The effect of surgical technique, prior adenoidectomy, presence of active infection, size of perforation, status of the contralateral ear, age, and eustachian tube function on healing of the tympanic membrane after surgery was assessed. Only those studies providing data on a given parameter of interest could be included when comparing each variable. Weighted means were compared and subjected to sensitivity analysis. Simple linear regression analysis was used to assess the effect of age on outcome. CONCLUSIONS: Greater success in healing of the tympanic membrane following tympanoplasty in children is seen with advancing age. None of the other parameters studied was shown to be a significant predictor of success. Guidelines for reporting results of tympanoplasty are presented.

Child↗

PubMed2003

Pediatric tympanoplasty: effect of contralateral ear status on outcomes.

OBJECTIVE: To assess the prognostic value of different variables on the outcome of pediatric type I tympanoplasty. DESIGN: Retrospective review of medical records. SETTING: An otolaryngology department in a large urban tertiary care medical center. PATIENTS: We reviewed 72 ears in 60 patients who had undergone a type I tympanoplasty from 1987 to 2000. Patient ages ranged from 3 to 18 years. INTERVENTIONS: Type I tympanoplasty. MAIN OUTCOME MEASURES: We identified the following 3 criteria for success: (1) healing of the neotympanic graft; (2) healing of the graft with a postoperative air-bone gap of no greater than 20 dB; and (3) healing of the graft with aeration of the middle ear space. RESULTS: Healing occurred in 59 (82%) of the 72 neotympanic grafts; 39 (83%) of the 47 healed ears for which a postoperative audiogram was available had an air-bone gap of no greater than 20 dB; and 49 (83%) of the 59 healed ears had a normally aerated middle ear space. A statistically significant difference in the rate of graft healing was identified for large perforations (76%), as well as for creation of an aerated middle ear space, when there was evidence of ongoing contralateral eustachian tube dysfunction (ie, otitis media with effusion or negative middle ear pressure, but not a perforation). CONCLUSIONS: Pediatric type I tympanoplasty can offer reasonably good chances for postoperative graft healing, serviceable hearing, and creation of an air-containing middle ear space if performed in carefully selected patients. Caution should be exercised in performing tympanoplasty in children with evidence of ongoing eustachian tube dysfunction, as evidenced by otitis media with effusion and negative middle ear pressure, but not perforations, in the contralateral ear.

Adolescent↗

PubMed1995

Pediatric tympanoplasty. A 10-year experience.

OBJECTIVES: To determine if the age of the child is a factor in healing after tympanoplasty and to find other factors that affect the outcome in these patients. DESIGN: Case series by retrospective otological chart review. SETTING: A group private practice otology and neuro-otology referral center. PATIENTS AND OTHER PARTICIPANTS: A consecutive sample of all patients younger than 20 years who had tympanoplasty performed at the House Ear Clinic between January 1, 1983, and January 1, 1993. The 318 patients, who had had 381 ears operated on, were separated into four age groups: younger than 7 years, 7 to 8 years, 9 to 12 years, and 13 to 19 years. The 268 patients who had follow-up examinations for 6 months or longer after tympanoplasty are grouped in the same age categories for outcomes analysis. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Preoperative and postoperative audiometric data and otologic examination at the final follow-up examination. Results are reported for hearing, healing, and "success," which combines hearing and healing and is defined as an intact graft with a postoperative air-bone gap of less than 25 dB. RESULTS: The operation resulted in an intact graft in 92.5% of ears and a postoperative air-bone gap less than 25 dB in 84% of ears. Success was achieved in 81% of ears. No difference in outcome was observed among the four age groups. Success was negatively affected by mastoidectomy, previous tympanoplasty, and use of total ossicular replacement prosthesis ossiculoplasty; perhaps by the number of previous myringotomy and tubes; but not by age, status of the contralateral ear, middle ear discharge, or fellow as primary surgeon. CONCLUSION: Tympanoplasty can be safely and effectively performed in children.

Adolescent↗

PubMed1997

[New methods of type II tympanoplasty in erosion of the long incus process].

Reliable methods of reconstruction of the ossicular chain in the situation of an isolated errosion of the long process of the incus using a tympanoplasty type II have not been available until recently. Instead, the tympanoplasty type III has been generally performed with the interposition of an autologous incus. In this presentation, we are describing two methods for reconstruction of the ossicular chain between the in-situ residing incus and the stapes on the other side so that the direct connection eventually will result in a tympanoplasty type II. In the first case, we used ionomeric cement in a way that features two characteristics: the direct connection between the stapes and the long process of the incus could be achieved as well as an articulation that was created on the head of the stapes. Hence, a too stiff connection between the head of the stapes and the long process of the incus could be avoided. In addition, a new method for precise microapplication of cooled bone cement (IONOCAP LV) with a syringe will be presented. In the second method titanium-gold-angle prostheses have been crimped to the long process of the incus and positioned onto the head of the stapes in the way of an articulation. So far, comparison of the audiological results of those two methods of a tympanoplasty type II reveal in average better results than postoperative conductive hearing thresholds of the conventional tympanoplasty type III. If the achieved results can be reproduced on a larger number of patients, the expected audiological results are likely to resemble those of stapes surgery.

Auditory Threshold↗