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At least 649 records · Page 36Linked to original sources
PubMed1978

Tympanoplasty: the fundamentals of the concept.

The development of tympanoplasty based on a fundamental understanding of the mechanisms of the middle ear in health and disease is described as it evolved. As a consequence of problems arising from the creation of an open cavity further developments led to the concept of a 'closed' operation which in turn has its own disadvantages. These are principally concerned with aeration of the tubotympanic cleft. The most recent phase of tympanoplasty is concerned with limiting the extent of the procedure to what is required to expose the disease process and re-establish function.

Anti-Bacterial Agents↗
PubMed1983

Tympanoplasty with mastoidectomy: present status.

There are many problem areas in tympanoplasty surgery. For the most part the extent of the problems relates directly to how vigorously one pursues a good functional result: the harder the surgeon tries, the more problems he may have. There are also many controversial areas in tympanoplasty, most of which relate to technique. In regard to tympanic membrane grafting and management of the sound pressure transfer mechanism, how well the surgeon performs the operation is far more important than which of the variety of techniques he uses. In relation to obtaining an air-containing mucous membrane-lined middle ear space and the management of the mastoid, there are many philosophical and emotional factors. There are many ways to manage the mastoid in cholesteatoma surgery, all of which can be successful if properly performed. We use all procedures but prefer the intact canal wall technique. The major advantage of the intact canal wall procedure is that the surgeon may avoid a post-operative mastoid cavity. The main disadvantages of this technique are the problems of recurrent and residual cholesteatoma, problems that necessitate a two-stage procedure in the majority of patients.

Cholesteatoma↗
PubMed1988

The fasciaform graft: a technique for the repair of large perforations of the tympanic membrane.

Our experience with the fasciaform graft, designed specifically for the repair of subtotal or total perforations of the tympanic membrane, is presented. The technique which utilizes a total tympanic graft of formalized autologous temporalis fascia is described in detail. We have employed this method in 29 patients with total closure of the defect being achieved in 93% of cases. The fasciaform graft is therefore recommended as a successful method of repair for subtotal and total perforations of the tympanic membrane for which the conventional grafting techniques currently available are much less effective.

Adolescent↗
PubMed1989

Tympanic membrane perforation following the removal of ventilation tubes in the presence of persistent aural discharge.

This study considers the effect of the removal of a ventilation tube from the tympanic membrane of an ear which has been affected with persistent mucopurulent discharge for at least 3 months. The records of 332 patients were reviewed. Thirty-three patients with 34 ears satisfied the entry criteria. Tube removal cured 27 out of 34 ears (79%) of aural discharge within 1 month. The tympanic membrane healing rates were: at 1 month, 14 (41%); at 3 months, 23 (68%); at 6 months, 24 (71%); and at 1 year, 28 (82%). A table is presented comparing perforation rates from different ventilation tube studies.

Adolescent↗
PubMed1994

Validity of a patient-administered questionnaire for routine otolaryngology admissions.

In this study the accuracy of a questionnaire filled in by 109 parents of children admitted for routine ENT surgery was compared with the well recognized verbal clerking. A major problem in communication between doctors and parents was highlighted, as just 44% of the parents were able to state the operation their children were admitted for. The study also showed that it is impossible to rely on parents to give the information required in the form of replies to questionnaires as the sensitivity of the questions designed to recognize risk factors was poor.

Adenoidectomy↗
PubMed1995

Long-term post-operative follow-up of patients with chronic otitis media. Does it make sense?

Complications ('events') encountered during long-term post-operative follow-up (on average, 6.5 years) of 493 patients undergoing surgery for chronic otitis media or its sequelae were evaluated. After the immediate post-operative period (of 30 days), in 44% of the patients at least one event was detected, infection being the most common, followed by graft failure, hearing impairment and recurrence of cholesteatoma. It was concluded that post-operative follow-up is necessary in all patients with chronic otitis media. The suitable length of follow-up was estimated to be 8 years for patients with cholesteatoma, 7 years for patients with granulating otitis media and 5 years for patients operated on for the sequelae of otitis.

Cholesteatoma↗
PubMed1980

Functional middle ear reconstruction: experience with prostheses and tissue graft.

The transmission of sound to the internal ear passes across the tympanic membrane to vibrate the ossicle chain formed by the malleus, incus and stapes. Movements of the stapes footplate set up complex wave formation within the cochlear fluids to excite the sensory nerve endings of the organ of Corti. Microsurgery for the relief of middle ear deafness has been progressively developed since 1946 and is concerned with the restoration of this collection of sound by an intact flexible ear drum and transmission of oscillation across the middle ear by a free, mobile chain of ossicles. Otosclerosis is a deafness of genetic origin caused by bony overgrowth immobilizing the stapes footplate and is treated with a 95% success rate by selective stapedectomy and fenestration of the footplate. A prosthesis or one limb of the stapes is attached on to the incus and inserted into the fenestration, often with the use of using a tissue graft as a sealing membrane. Over twenty years' experience has originated many differing contours and materials for the stapes prosthesis--in scale some 4 mm or 5 mm in length and 0.3 mm to 0.8 mm in diameter--which will be illustrated and discussed. These prostheses lie deep within a healthy tympanic cavity, and it is most exceptional for a prosthesis to detach or extrude. In our large series subsequent reexploration usually reveals a prosthesis sheathed in mucosa without visible foreign body reaction.

Ear Ossicles↗
PubMed2006

How we do it: laser reduction of peri-tubal adenoids in selected patients with otitis media with effusion.

. The literature supports the benefit of adenoidectomy in patients with otitis media with effusion (OME). . It is difficult to clear adenoid tissue from around the Eustachian tubes using curettes and this conventional method of adenoidectomy is contra-indicated in patients with cleft palates. . Laser reduction of peri-Eustachian adenoid tissue without myringotomies or grommet insertion was performed in three patients with OME. Two patients had previous adenoidectomies performed with curettes and one patient had a cleft palate. . In all three patients, the OME resolved and all had closure of the air-bone gap that was maintained during long-term follow-up (14 months-4 years). . This technique resolved OME without the need for myringotomies or grommet insertion and should be considered particularly in patients who have peri-tubal recurrence of adenoidal tissue following conventional adenoidectomy or in patients with cleft palate where there is concern with regards to palatal incompetence.

Acoustic Impedance Tests↗
PubMed1978

Hazards of ventilation tubes.

Ventilation tubes are not the treatment of choice in serous otitis media. Conservative measures should be tried first, with simple myringotomy for the evacuation of thick, rubbery fluids. Autoinflation, well tolerated by most children above 3 years of age, should be practiced daily for months to years, under periodic check-ups. Tube insertion should be reserved for younger children, as well as for recurrent and non-responsive cases. These are the cases in which a calculated risk is worth taking, as otherwise the patient is on an ineffective treatment. In those hard-to-manage ears, tubes seem to be justified, as their potential hazards are apparently outnumbered by the complication of untreated or maltreated serous otitis media.

Atrophy↗
PubMed2001

Failure of grommet insertion in post-irradiation otitis media with effusion.

Nasopharyngeal carcinoma (NPC) survivors with post-irradiation otitis media with effusion (OME; 100 ears) were divided into 2 groups. One group underwent grommet insertion, and the other group was treated by repeated myringotomies plus aspiration to evaluate the outcome of the OME. Computed tomography, magnetic resonance imaging, audiometry, and local checks of the ear, nose, and nasopharyngeal fields were performed to evaluate the sinus and middle ear conditions over a long-term (more than 10 years) follow-up period. The results in these NPC survivors with OME indicated that the prevalence of middle ear complications in the myringotomized group (33%) was less than that in the grommeted group (90%). Grommets alone cannot eradicate inflammation outside the middle ear cavity, but rather, they can aggravate it by superinfection. We therefore recommend that controlling the radiation-induced inflammation in areas such as the ears, nose, sinuses, and nasopharynx is most important. In conclusion, post-irradiation OME should be treated in a different way from conventional OME. Restated, grommet insertion is contraindicated in post-irradiation OME.

Adult↗
PubMedDate not supplied

Malleus handle probe: a middle ear diagnostic procedure.

Manual probing of the malleus handle (MH) of 477 patients suggests a protective middle ear reflex with a variable tonic contraction of the tensor tympani muscle (TTM). The degree and type of MH retraction suggests three stages of progressive middle ear inflammation. Prediction accuracy of 250 myringotomy findings was 60% with impedance audiometry and 92% with MH probing. Mechanical pressure gauge readings (grams) of 202 ears correlated with finger pressure estimations. The TTM tendons were sectioned in ten children with persisting otitis media with effusion (OME) and seven obtained benefit. The three diagnostic methods, pneumatic otoscopy, impedance audiometry and MH probing, assess similar and separate perimeters and are complementary. Malleus handle probing alone detects attic loculation of OME, 54 of 954 ears (5.6%). it extends the diagnostic range to the TTM activities.

Adolescent↗
PubMedDate not supplied

Molded tympanic heterografts. Histologic evaluation.

The histologic appearance of the molded tympanic heterograft developed at the ENT Clinic of the University of Parma, Italy, is investigated with light and electron microscopy. Evaluation of the graft before insertion disclosed a unique structure of interwoven collagen bundles. Examination of grafted tympanic membrane showed a structure closely resembling the normal human tympanic membrane. The fate of the heterologous material and the host reaction to it are discussed in relation to histologic findings.

Bioprosthesis↗