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Tympanoplasty.

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Chronic Disease↗

[Functional results of ossiculoplasty. Apropos of 216 cases].

Results of 219 ossiculoplasties performed during closed technic tympanoplasties over a 7-year period are reviewed. Ossiculoplasty involved the implantation of ossiculo-tympanic plate homografts, ossicular auto- or homo-grafts or Klein type prostheses. Results are analyzed as a function of disease causing the ossicular lysis, types of mounting and number of operations required. From these are determined etiopathogenic factors and technics providing improved results. Absence of residual inflammation, stability of mounting and use of remaining ossicles are conditions that ensure best results. Contact between columella and tympanic membrane should be as wide as possible, with greater preference therefore for stapes-malleus or foot of stapes-malleus than stapes-tympanic plate or foot of stapes-tympanic plate mountings. These former mountings improve functional gain in a homogeneous manner throughout the frequency range.

Cholesteatoma↗

[Tympanic membrane repair with cartilage and double tissue-layered grafts (author's transl)].

This article describes the technique and advantages of a three layered repair of large perforations of the tympanic membrane using a pallisade of tragal cartilage covered by temporalis fascia and pedicled external auditory canal skin. Large defects of the tympanic membrane can be closed by this method and in addition satisfactory sound transmission can be achieved. The correct positioning of the cartilage graft complex requires training and skill, but an experienced otologist should be able to achieve this in a short time. Early or late reperforation of the graft is extremely rare and late perforations due to otitis media close spontaneously since large defects are not expected. The results in respect of graft durability and hearing improvement are very satisfactory.

Cartilage↗

[Progress in microsurgery of the middle ear].

Some advances in middle ear surgery during the last 15 years are discussed, including successful microsurgical methods, those that were more or less abandoned, and new techniques and materials.

Cholesteatoma↗

Tympanic grafts. An ultrastructural study.

Scanning electron microscopy (SEM) was used to investigate the surface architecture of human tympanic membranes. The morphology of the normal eardrum was compared with the surface structure of preserved tympanic membrane (allograft), fresh air-dried fascia temporalis and preserved calf jugular vein (xenograft). The role of the physical structure and composition of the extra-cellular matrix in the restoration of a tympanic graft is discussed.

Animals↗