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Chronic Otitis Media
Published in Raymond W Clarke, Diseases of the Ear, Nose & Throat in Children, 2023
A dry inactive perforation may need no intervention. If the child is symptomatic (i.e. with a significant hearing loss or recurrent troublesome discharge), surgery in the form of tympanoplasty (myringoplasty) to close the perforation, usually with native fascia, may be considered. Children who are especially keen on watersports also warrant consideration of surgery. Several techniques are described, the most popular relying on temporalis fascia harvested from behind the ear and used as an ‘underlay’ to form a scaffold over which new epithelium grows to close the defect. The optimum age for tympanoplasty is debated, but most otologists wait until the child is about 7–8 years old, by which time Eustachian tubal function will have improved making for better long-term outcomes.
Ossiculoplasty and Myringoplasty
Published in R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne, Scott-Brown's Essential Otorhinolaryngology, 2022
Myringoplasty is defined as surgical repair of the tympanic membrane (TM). This can be performed to rectify a persistent perforation or reinforce a thin or retracted drum. Tympanoplasty is defined as surgical repair of defects of the TM and middle ear ossicles. A type 1 tympanoplasty is synonymous with myringoplasty
Stem Cells and Nanotechnology
Published in Stavros Hatzopoulos, Andrea Ciorba, Mark Krumm, Advances in Audiology and Hearing Science, 2020
Reported causes of failure in tympanoplasty can be anatomic or functional (Sellari-Franceschini et al., 1987). Anatomic complications during the healing process, such as the perforation of the newly reconstructed TM and/or extrusion of the prosthesis are infrequent but serious and are often due to the unfavorable biological environment, which may develop in these patients because of chronic inflammation and underlying infections (Beutner and Hüttenbrink, 2009).
Bone-conduction hearing aid is effective in congenital oval window atresia
Published in Acta Oto-Laryngologica, 2021
Mengdie Gao, Chunli Zhao, Jinsong Yang, Peiwei Chen, Yujie Liu, Danni Wang, Shouqin Zhao
Congenital oval window atresia usually present with high rates of missed diagnoses in clinical practice, and require a close examination of medical history, audiology results, and temporal bone CT outcomes. Tympanoplasty cannot improve hearing in some patients, and it may instead increase the incidence of complications such as sensorineural deafness, while conventional surgical methods like stapedectomy do not guarantee long-term benefits. This study showed that BB implantation is beneficial for congenital oval window atresia. Furthermore, the patients were considerably satisfied with the treatment, particularly those with bilateral ear deformities. During the follow-up period, there was an obvious improvement in the patients’ hearing ability and their ability to recognize words and sentences, which can improve the quality of life and confidence. However, BB has several shortcomings. BCI placement is limited by the developmental conditions of the skull and degree of mastoid gasification, due to which a number of children cannot receive surgical treatment at an early stage. Further clinical studies are needed to investigate the causes and solutions of poor sound field hearing improvements at low-frequencies. Nevertheless, bone-conduction hearing aids remain undeniably effective in treating congenital oval window atresia.
Comparison of clinical outcome between endoscopic and postauricular incision microscopic type-1 tympanoplasty
Published in Acta Oto-Laryngologica, 2021
Yonglan Zhang, Wei Wang, Kaixu Xu, Ming Hu, Yuanxu Ma, Peng Lin
The complications of traditional microscopic tympanoplasty are injury to the chorda tympani nerve or facial nerves, TM perforation, dislocation of the ossicular chain, vertigo, tinnitus, hearing loss and secondary cholesteatoma. Of these, injury to the chorda tympani nerve ranks first because: (i) it is difficult to fully expose the chorda tympani nerve in the tympanic groove through the narrow and curved EAC under the direct vision of a microscope; (ii) damaging the chorda tympani nerve can occur when elevating the tympanomeatal flap. However, an endoscopy can pass through the narrow and curved part of the EAC flexibly, expose the chorda tympani nerve, and avoid injuring it. Another common complication of otoendoscopic surgery is the dislocation of the auditory ossicular chain (especially if observing the tympanic cavity structure and the ostium of the eustachian tube with an angled endoscopy). It is very easy for the front of the endoscopy to touch the incus–stapes joint, resulting in the dislocation of auditory ossicular chain or stapes, and severe hearing loss. Close attention must be paid to this potential complication.
Analysis on the correlation between Eustachian tube function and outcomes of type I tympanoplasty for chronic suppurative otitis media
Published in Acta Oto-Laryngologica, 2020
Ruixiang Li, Nan Wu, Jiabing Zhang, Zhaohui Hou, Shiming Yang
From June 2016 to July 2018, 53 patients with a confirmed diagnosis of CSOM in the Department of Otolaryngology at Chinese PLA General Hospital received type I tympanoplasty described by Wullstein (type I–V) [5]. They were aged 16 years old and above. Those with recurrent ear drainage before surgery and preoperative air–bone gap (ABG) above 30 dB or combined with diabetes, hepatitis B and tumors were excluded. Before surgery. All patients received a high-resolution thin-slice CT scan of the temporal bone, hearing test, otoscopy, and ETS evaluation before surgery. All surgeries were performed under general anesthesia by a senior surgeon who had at least 10 years of working experience and had performed tympanoplasty for over 500 cases. Temporalis fascia was used as graft materials under a similar microscopically assisted procedure.