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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
Other techniques include the following: ‘Push-through’ technique: Variant of the underlay technique, avoids elevation of the TM, and is used for small perforations. A dissolvable dressing is placed through the perforation into the middle ear; the graft is then pushed through the perforation so that it is held laterally against the TM.‘Butterfly’ technique: Utilises a disc of cartilage with a circumferential groove cut into it; this splays the edges of the cartilage, which ‘snaps’ into place within the perforation. Suitable for smaller perforations <6 mm in size. Mild myringitis occurs in 11%, resolving within 3 months.‘Overlay’ technique: Steps similar to the underlay technique, except that the epithelial layer of the TM alone is elevated, with placement of the graft between the collagen (unelevated) and epithelial (elevated) layers. Repair outcomes are similar for overlay and underlay techniques.
The Special Sense Organs and Their Disorders
Published in Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss, Understanding Medical Terms, 2020
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss
Problems with any of the structures involved in sound transmission from the body surface to the brain may impair hearing. External otitis is an inflammation of the outer ear and may block the progress of sound waves. Impacted cerumen is an accumulation of cerumen or earwax that blocks the ear canal and prevents sound waves from reaching the tympanic membrane. Inflammation of the tympanic membrane is known as myringitis or tympanitis and may prevent the tympanic membrane from vibrating appropriately. Eustachian tube dysfunction is a general term used to describe any condition in which the ability of the eustachian tube to equilibrate ambient and middle ear pressure is impeded.
Acute otitis externa
Published in S. Musheer Hussain, Paul White, Kim W Ah-See, Patrick Spielmann, Mary-Louise Montague, ENT Head & Neck Emergencies, 2018
Myringitis means inflammation of the tympanic membrane. Primary myringitis can be due to trauma, infection or sudden pressure changes. Granular myringitis (Figure 12.4), due to infection, is seen as bubbles filled with blood on the surface of the tympanic membrane that can burst; however, the tympanic membrane itself is not perforated. Secondary myringitis occurs as a result of adjacent inflammation of the middle ear or the external canal. Bullous myringitis (Figure 12.5) is sometimes seen after there has been loss of the epidermal layer of the tympanic membrane.
Relapsing polychondritis: state-of-the-art review with three case presentations
Published in Postgraduate Medicine, 2021
Bogna Grygiel-Górniak, Hamza Tariq, Jacob Mitchell, Azad Mohammed, Włodzimierz Samborski
The first and most commonly observed clinical symptom in relapsing polychondritis is mono or bilateral auricular chondritis [23,24]. (Table 1) illustrates the prevalence of symptoms in RPC patients. This manifestation, known informally as the ‘cauliflower ear,’ causes the upper ear’s external inflammation without affecting the lobule. This usually occurs abruptly, with red and painful erythema and edema. Recurring bouts of chondritis can lead to extended calcification, causing permanent damage [3,25]. Acute attacks usually resolve within weeks, recurring in variable intervals. In addition to the above symptoms, RPC can also cause hearing loss and tinnitus that is separate from the conductive hearing loss resulting from inflammation of the external auditory meatus [23,26,27]. The hearing loss is prevalent in 46% of cases[28]. In addition to the above symptoms, patients have also experienced auricular cartilage collapse, edema of the canal, closure of the external auditory meatus causing otitis media, stapedial footplate fixation, and inflammation of the vestibular structures causing sensorineural hearing loss[28]. Less common are tinnitus, chronic myringitis, and otitis externa[23].
Comparison of bilateral same-day and sequential endoscopic cartilage myringoplasty for bilateral chronic tympanic membrane perforation
Published in Acta Oto-Laryngologica, 2020
At 3 months, in the same-day group, of the 52 ears, two (4%) had residual small perforations, three (5.8%) exhibited myringitis with otorrhea after 14 and 21 days and 2 months, respectively, two (4%) developed secondary purulent otorrhea because of a middle ear infection. However, of the three patients with myringitis with otorrhea, the three cases of myringitis-related otorrhea were improved by treatment with topical ofloxacin, cartilage grafts were healed by the next visit, and no otorrhea was observed. Of the two ears with secondary purulent otorrhea, Nasopore packing was liquefied in the middle ear, fungal otitis externa occurred without healing of the cartilage grafts, the cartilage graft collapsed, resulting in a gap between the cartilage graft and residual eardrum. In the sequential group, of the 68 ears, one ear (1.5%) had residual small perforations, three (4.4%) developed secondary purulent otorrhea and resulted in displaced grafts. The overall graft success rate at 3 months was 92.3% (48/52) in the same-day group and 94.1% (64/68) in the sequential group, the difference was not significant among two groups (p = .35).
Acquired stenosis of the external auditory canal – long-term results and patient satisfaction
Published in Acta Oto-Laryngologica, 2018
David Schwarz, Jan Christoffer Luers, Karl Bernd Huttenbrink, Konrad Johannes Stuermer
Acquired non-osseous atresia or high-grade stenosis of the external auditory canal (EAC) is a rare disease with less than 0.6 cases per 100,000 inhabitants per year [1]. In most cases, the atresia (canal lumen obliterated to 100%) is preceded by a chronic myringitis with a granulomatous EAC [2]. The presence of severe canal stenosis or atresia causes associated morbidity, like chronic discharge and hearing loss [3]. In the absence of conservative treatment options, surgical therapy remains the only curative option [4], while hearing aids might at least be of symptomatic help. Surgical treatment aims to produce a dry widened meatus with self-cleaning skin and without an air-bone gap (ABG). However, surgical treatment is challenging due to the risk of the restenosis and postoperative blunting of the anterior tympanomeatal angle [5]. Moreover, the surgical steps are still controversial.