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Results for “MYRINGOPLASTY”

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At least 73 records · Page 4Linked to original sources

PubMed2004

[The effectiveness of otoendoscopy in myringoplasty using adipose graft].

OBJECTIVE: The aim of this study was to present our results of endoscopic-guided myringoplasty using adipose graft tissue. Due to its simplicity and reliability, this technique seems be as efficient as other classical graft techniques (fascia temporalis, perichondrium...). PATIENTS AND METHODS: We analyzed data from 81 patients operated on for a tympanic perforation between 1993 and 2002 using an endoscopic-guided technique with adipose graft. Patients were evaluated postoperatively at seven days, one month and three months. Criteria of success were complete closure of the tympanic membrane, absence of lateralization of the tympanic membrane and no audiometric impairment. RESULTS: Treatment was successful in 920f patients with at least two years follow-up. The failures occurred in patients with contraindications such as myringosclerosis, myringitis and perforation size greater than 500f the tympanic surface. CONCLUSION: Endoscopic-guided myringoplasty using an adipose tissue graft is a rapid, safe, reliable and efficient procedure that should be performed in first intention for selected indications.

Adipose Tissue↗

PubMed1992

Interlay method for myringoplasty.

Sixty-nine ears with perforation of the tympanic membrane were reviewed. All had undergone myringoplasty by the interlay method. The average period for complete epithelization was 16.1 days after surgery. Neither blunting of the anterior tympanomeatal angle nor lateralization of the tympanic membrane was observed. The success rate was 94.2% for the initial surgery, when "success" is defined as closure of the perforation and complete epithelization (dry ear). The surgical technique and various advantages of the interlay method of myringoplasty are described.

Adolescent↗

PubMed1983

Myringoplasty: hearing gain in relation to perforation site.

One hundred perforations of the tympanic membrane with successful myringoplasties have been reviewed. A partially reversible impairment of bone conduction was noted, being more obvious in posterior and subtotal perforations. It was also shown that the site of perforation affects the degree of hearing loss and the degree of subsequent improvement after myringoplasty; marginal and malleolar perforations had a greater hearing loss and less post-operative hearing improvement than central and non-malleolar perforations. It was also shown that posterior perforations had a greater hearing loss than anterior perforations.

Adult↗

PubMed1997

Fat graft myringoplasty in children--a safe and successful day-stay procedure.

The surgical closure of dry tympanic membrane perforations in children remains a controversial issue due to conflicting opinions on the appropriate technique, graft material and success rate. We present a review of 342 children who underwent fat graft myringoplasty as a day-stay procedure over a six-year period. Successful closure of the tympanic membrane perforation was achieved in 92 per cent of ears. Subsequent recurrent otitis media with effusion required insertion of ventilation tubes in 12 per cent. No relationship was observed between the age of the child and a successful outcome. We conclude that day-stay fat graft myringoplasty is a safe and successful procedure which results in a dry and safe ear in the majority of children.

Adipose Tissue↗

PubMed1999

Myringoplasty: a prospective audit study.

Seventy-three surgeons participated in a prospective audit of myringoplasty. They returned data on 1070 individual patients. Up to 12 months follow-up information was obtained. The mean number of myringoplasties performed per consultant in 1 year (1995) was 14.7 (95% confidence intervals (CI) 12.1 17.2). The main indication for performing the operation was to achieve an intact tympanic membrane. The mean graft take rate was 82.2%. When hearing improvement was the main indication for surgery it was improved in 67%. The use, or not, of an antibiotic had no significant influence on the graft take rate or the complication rate. Most complications reported were minor in nature.

Ear Diseases↗

PubMed2001

Revision myringoplasty with solvent-dehydrated human dura mater (Tutoplast).

OBJECTIVES: Several grafting materials have been used in the reconstruction of the perforations of the tympanic membrane. The use of dehydrated dura homografts as a substitute for the tympanic membrane has not been fully documented. On the other hand, revision surgery is more critical in terms of patients' expectations. The aim of this study is to determine the tissue stiffness, the compliance, and the wound healing rate of dura homografts in revision surgery of perforations of the tympanic membrane. STUDY DESIGN AND SETTING: The charts of 45 patients who have received dura grafts because of re-perforation or failure of the myringoplasty have been reviewed retrospectively. The healing process of the myringoplasty, graft take rate, pure-tone hearing level, and tympanogram were reviewed. RESULTS AND CONCLUSION: It has been concluded that dura homografts, which have excellent tissue-compatibility, stability, and an 86.7% graft success rate, are preferred in patients in whom their own temporalis fascia cannot be used because of previous operations. It has been demonstrated by tympanometric analysis that the compliance of the graft during various pressure applications is as good as the normal eardrum.

Audiometry, Pure-Tone↗

PubMed2003

Adipose graft: an original option in myringoplasty.

OBJECTIVE: To describe the fat graft as a reconstructive material in myringoplasty. METHOD: In a review of 45 patients conducted between 1993 and 1999, the authors analyzed their patients' outcomes after having myringoplasties with fat graft. Median follow-up was 2.5 years (range, 6 mo-6 yr). RESULTS: We achieved a success rate of 91.1%. Different features of the patient and the tympanic perforation were studied to demonstrate their role in the quality of the surgical closing. A review of the literature was done to compare our results with the results of other series using this type of graft as well as with studies of the temporalis fascia as a graft material. CONCLUSION: The high reliability of the fat graft and the technical simplicity of this procedure in anterior perforations, especially with the use of intraoperative endoscopy, make it an attractive technique.

Adipose Tissue↗

PubMed1992

Myringoplasty under local anaesthesia: day case surgery.

Eleven patients underwent fat graft myringoplasty, using EMLA cream local anaesthetic, as day cases. 10 of them were followed up, and 3 months post-operatively, 8/10 (80%) of the perforations were completely closed, with an average improvement of the hearing threshold of 11 dB. All the patients were satisfied with the procedure and it is concluded that fat graft myringoplasty under local anaesthesia as a day case is safe, simple, reliable and cost effective. It should be considered for closure of small perforations (30% or less) of the tympanic membrane.

Adolescent↗

PubMed1995

Day case myringoplasty using tragal perichondrium.

Day surgery has an ever-increasing role to play in otology. In this study of myringoplasty, tragal perichondrial grafts were placed permeatally as a day case procedure in 32 patients. These are compared with a control group, matched for age and for the size of their perforations, in whom temporalis fascia was grafted via an endaural or postaural incision. The success rate was 94% in the perichondrial group as compared with 84% in the control group (no significant difference P > 0.05). Day case myringoplasty produced less morbidity for the patients and a 40% reduction in theatre time as well as the more obvious savings resulting from a shorter hospital stay.

Adolescent↗

PubMed1995

Myringoplasty for subtotal perforation.

It is often reported that the repair of subtotal perforations is less successful than that of smaller perforations, mainly because it is technically more difficult. The author's surgical technique for subtotal perforations is presented and the results compared with that of myringoplasty for smaller perforations. The study shows that subtotal perforations are associated with a higher incidence of abnormal middle ear mucosa (chi 2 = 11.75, d.f. = 2) and damage to the malleus (chi 2 = 5.60, d.f. = 1) than smaller perforations. However, the success rate of subtotal perforation closure (92.5%) is as good as the closure rate for smaller perforations (94.1%). It is concluded that the size of the perforation is not a major factor in determining whether the graft will be successful in myringoplasty.

Ear Ossicles↗

PubMed2004

Myringoplasty using a subcutaneous soft tissue graft.

A retrospective study was performed on patients who underwent myringoplasty using an autologous subcutaneous soft tissue graft over a 5-year period. Details including age, site and size of perforation, grade of surgeon, surgical approach, postoperative dressings, overnight stay, complications and outcome were recorded and analysed. Fifty-two patients underwent myringoplasty using a subcutaneous soft tissue graft. Their ages ranged from 4 to 78 years (median = 36 years). The mean follow-up period was 19 months. Successful closure to give an intact tympanic membrane was obtained in 82.7% of patients. Thresholds improved on pure tone audiometry in 57.1% and deteriorated in only one patient. There was no case of dead ear as a result of surgery. Subcutaneous tissue graft has comparable outcomes with temporalis fascia graft with additional advantages of a smaller incision, minimum dissection and a lower risk of bleeding.

Adolescent↗

PubMedDate not supplied

Air conduction thresholds after myringoplasty and stapes surgery: a conventional and high frequency audiometric comparison.

A comparison has been made of air conduction thresholds after myringoplasty and stapes surgery for otosclerosis in both the conventional (0.25 to 8 kHz) and high frequency (8 to 20 kHz) ranges. Significant threshold losses occurred in the high frequencies following both procedures. Threshold improvement was significantly greater at the lower frequencies following stapes surgery, while high frequency threshold deterioration was significantly less in the myringoplasty group. High frequency audiometry may prove to be a sensitive monitor of middle ear surgical techniques.

Adolescent↗

PubMed1998

Myringoplasty in children: factors influencing surgical outcome.

Age, size, and site of perforation, condition of the ear, status of the contralateral ear, grafting materials, and more are considered factors influencing the success rates in myringoplasties in children. The ambivalence in results is mainly due to nonhomogeneous patient groups. In an effort to compose groups as homogeneous as possible for analysis of influencing factors, a retrospective study of 51 pediatric myringoplasty cases (51 ears) was undertaken. All patients had perforations caused by simple chronic otitis media. The overall surgical success rate was 82.3% at 18 months, and for young (5 to 10 years) and older (11 to 16 years) children it was 77.2% and 86.2%, respectively. Anterior, central, and total perforations healed without significant differences. Outcome in unilateral perforations was better than bilateral: 96.9% and 55%, respectively (p < 0.01). Discharging ears (100%) healed better compared with dry ears (75%) (p < 0.05). Analysis of the literature also revealed significant difference in success rates of discharging and dry ears: 92.5% and 80.6%, respectively (p < 0.01). We conclude that, contrary to comments in the literature, discharging ears in children favor good outcome and they should be operated on regardless of age and site of perforation. However, in bilateral perforations results may not be so rewarding.

Adolescent↗

PubMed2000

Myringoplasty: update on onlay pedicle skin flap and temporalis fascia sandwich graft.

The technique of onlay sandwich grafting of tympanic membrane perforations fashioned by the use of pedicle flap raised from the posterior deep meatal skin and autologous temporalis fascia is described. The results of a series of 124 ears operated between 1987 and 1999 are the basis of this report. Of these 106 patients had myringoplasty for the first time. The operation was successful in 102 (96.23 per cent) patients. Eighteen patients had revision myringoplasty, with a successful result in 14 (77.78 per cent). None of the patients developed complications usually associated with onlay grafting. A preliminary report of this work was presented at the XVI World Congress of Otolaryngology Head and Neck Surgery at Sydney in 1997.

Female↗

PubMed2002

Paediatric revision myringoplasty: outcomes and prospects.

Paediatric revision myringoplasty has received little attention. This study addressed the issue exclusively and reviewed the short- and long-term results of surgery in children between the ages of five and 15. Twenty-six out of 38 operated ears (68.4 per cent) were initially intact. The causes of immediate failure in decreasing order were: infection with graft necrosis, complete no-take of the graft and poor anterior adaptation of the graft. Age, size and site of perforation and surgeon's experience did not significantly affect the initial outcome of surgery. Six ears developed delayed re-perforations, thus decreasing the overall sucess rate to 52.6 per cent. The latter were attributable to either episodes of acute otitis media or to insidious atrophy of the tympanic membrane. Notably, none developed post-operative sensorineural hearing loss. It is concluded that the results of paediatric revision myringoplasty are rather disappointing, yet arguments encouraging its practice are favourably presented.

Adolescent↗

PubMed2003

Comparative study of the underlay and overlay techniques of myringoplasty in large and subtotal perforations of the tympanic membrane.

Myringoplasty is an established procedure. However, the quest is on to improve the results further by studying the different influencing factors, that could possibly affect the outcome. In the present randomized prospective study of one year's duration, 60 patients having dry, large and subtotal perforations of the tympanic membrane were subjected to myringoplasty, 30 by the overlay technique and 30 by the underlay technique keeping all other influencing factors constant. The graft take-up rate was found to be the same (93.3 per cent) in both techniques but the underlay technique was judged to be better because of its technical ease, better assessment of ossicular chain integrity and mobility, less time consumption (55 minutes vs 90 minutes), earlier healing of graft (four to six weeks vs six to eight weeks), hearing gain in more patients (92.8 per cent vs 57.1 per cent) and fewer minor complications (6.6 per cent vs 33.3 per cent).

Adolescent↗

PubMed2006

Myringoplasty results in a district hospital in Botswana.

This was a prospective study to determine the success rate of myringoplasty in a low-resource setting. Myringoplasty was performed on 85 patients and follow-up done for 6 months in order to determine the incidence of closure of the repaired tympanic membrane. The eardrum closure rate at 3 months was 88% and at 6 months 84%. There was a 62% positive change of more than 10 dB in the pure tone averages of air conduction at frequencies 500, 1000 and 2000 Hz and a 24% improvement of less than 10 dB. This compares favourably with results from other studies.

Adolescent↗

PubMedDate not supplied

Pitfalls in myringoplasty.

The results of myringoplasty on 172 ears examined after an average follow-up time of 1.5 years are reported. The fascial underlay technique with swing-door plasty was employed in 78% of the cases. The graft take was successful in 150 ears (87%), three of which (2%) later revealed adhesive changes in the middle ear. Three ears were reoperated, the percentage of healed perforations being 89. A high tone hearing loss occurred in two ears and a moderate flat sensorineural hearing loss in another two (2%). Successful graft take was obtained in 92% of the operations performed by specialists and in 59% of the ears operated upon by residents. Successful myringoplasty presupposes acquisition of a faultless surgical technique and strict adherence to it at all phases of surgery.

Hearing Loss, High-Frequency↗