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Noise, hearing and vibration
Published in Nicholas Green, Steven Gaydos, Hutchison Ewan, Edward Nicol, Handbook of Aviation and Space Medicine, 2019
Nicholas Green, Steven Gaydos, Hutchison Ewan, Edward Nicol
Conductive: Occurs within outer and/or middle ear.May be amenable to medical or surgical correction.Sound not conducted efficiently through outer/middle ear to inner ear; reduction in sound level heard or ability to hear soft sounds.Causes may include fluid in the middle ear, eardrum perforation, impacted earwax, ear infection or auditory tube dysfunction.
Ears
Published in Marie Lyons, Arvind Singh, Your First ENT Job, 2018
This is an operation to repair an eardrum perforation. The approach depends on the site and size of the perforation. The first part of the operation involves preparation of the edges of the perforation (‘freshening’) (a). This involves scratching the edges of the perforation and getting back to healing eardrum tissue. Tiny perforations in ears with wide canals can be repaired using a fat patch harvested from the lobule of the ear. They are repaired permeatally. Larger or more inaccessible perforations are repaired using temporalis fascia harvested via an endaural or postaural incision. A tympanomeatal flap (eardrum plus ear canal skin) is raised (b) and the graft is placed underneath the eardrum (c).
Preliminary experience and feasibility test using a novel 3D virtual-reality microscope for otologic surgical procedures
Published in Acta Oto-Laryngologica, 2021
Merlin Schär, Christof Röösli, Alexander Huber
The novel microscope was introduced to the surgery after skin incision, flap preparation and incision of the posterior ear canal wall. Notable findings during the procedure included a severely overhanging antero-inferior and inferior canal wall, and a completely fixated but intact ossicular chain. The tympanic membrane, which was retracted in the upper quadrants, was perforated in the anterior and inferior quadrants. After separation of the incudo-stapedial joint (Figure 2(B)), the stapes was found to be mobile. The antrum was noticeably filled with sclerotic material (Figure 2(D)). No cholesteatoma was found. An epitympanectomy with removal of the malleus head and the incus (Figure 2(E)) was performed. The tympanic membrane was reconstructed with temporalis fascia inserted in underlay technique (Figure 2(F)) (Supplemental online material: Intraoperative video recording). No ossicular reconstruction was done in this first stage surgery according to in-house guidelines for eardrum perforation of more than 1/3 of the area. There were no technical difficulties during the procedure related to the use of the novel microscope, and a conversion to the conventional surgical microscope was not necessary at any given point during surgery. No perioperative complications were observed.
The safety of posterior tympanotomy in otitis media with effusion during cochlear implantation: clinical retrospective cohort study
Published in Acta Oto-Laryngologica, 2021
Saad Elzayat, Ihab Nada, Hossam El sherif, Ali Mahrous
As regard major postoperative Mild partial lower motor neuron facial nerve palsy occurred in 1 patient out of 22 (4.5%) OME patient group A postoperatively, with spontaneous recovery after 1 week with none in group B which was insignificant. Swab samples showed no bacterial growth in group A. Acute otitis media were observed during first six months postoperatively in the implanted ear in one patient out of 22 in group A (4.5%) while in 4 patients out of 90 in group B (5%) which was not statistically significant difference. There was no evidence of eardrum perforation, no wound infection or delayed healing was apparent in both groups. Activation was done 3 weeks post-operative after complete wound healing. Follow-up periods ranged from 6 months to one year. Characteristics of both patient groups and their operative details are shown in Tables 1 and 2.
Spontaneous closure of traumatic tympanic membrane perforation following long-term observation
Published in Acta Oto-Laryngologica, 2019
Tomoyasu Tachibana, Shin Kariya, Yorihisa Orita, Takuma Makino, Takenori Haruna, Yuko Matsuyama, Yasutoshi Komatsubara, Yuto Naoi, Michihiro Nakada, Yohei Noda, Yasuharu Sato, Kazunori Nishizaki
Spontaneous closure of TTMP during long-term observation has not been well described in the literature. In the present study, four patients experienced successful spontaneous closure following long-term observation ≥6 months. There have been two previous studies including TTMP cases with spontaneous closure following long-term observation: one reported two successful cases of perforation closure at 5 and 11 months [4]; and the other described two patients who successfully healed at 4 and 9 months, respectively [5]. In the present study, cases 1 and 3 exhibited large-size perforations in contact with the malleus and the annulus, and case 4 exhibited a small-size perforation near the annulus. The larger the perforation, the longer it will take epithelial migration to cover wider tissue defects [4,8]. Perforations involving the malleus or those with umbo damage could lengthen the healing time of perforation [5]. The epithelial generation center was reported to be located near the annulus and the handle of the malleus in an experimental study [2]. In the present study, case 2 exhibited outward and centrifugal migration, and outward epithelial migration may prolong the closure time of traumatic eardrum perforation [3]. Dry perforations have been reported to achieve successful closure only when the proliferating epithelium migrated centripetally, but not centrifugally [16]. In the present study, all four cases had factors that could prolong the spontaneous healing described above.