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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
M+S− Autologous incus (TM to footplate)Total ossicular replacement prosthesis (TORP) TM to footplate ± footplate shoe for stability, long-term stability and hearing difficult to achieve
Stem Cells and Nanotechnology
Published in Stavros Hatzopoulos, Andrea Ciorba, Mark Krumm, Advances in Audiology and Hearing Science, 2020
The first studies by tissue engineering on design, fabrication, and characterization of scaffolds for ossiculoplasty concerned a partial ossicular replacement prosthesis (PORP). This prosthesis was cultured in vitro with human MSC and osteoinductive factors (Danti et al., 2009, 2010; D’Alessandro et al., 2012). This 3D porous scaffold of the PORP, made of poly(propylene fumarate)/poly(propylene fumarate)-diacrylate (PPF/PPF-DA), a rigid polymer biodegradable in the long term, was designed by a photo-crosslinking particulate-leaching technique with pore size and porosity suitable to support human MSC differentiation into osteoblasts. The PORP scaffolds were cultured with osteoinduced human MSC to generate in vitro bone extracellular matrix (ECM) within the scaffold porosity. After 12 days, an early bone matrix was detected, consisting of collagen type I fibers and calcium phosphate nodules (Danti et al., 2010). After decellularization, these scaffolds were used for a short term in vitro cultures of undifferentiated human MSC. The results of this process showed cellular viability, distribution, and quality of extracellular collagen type I and high mineralization (Danti et al., 2009; D’Alessandro et al., 2012). These concepts are summarized in Figure 9.2.
Ossiculoplasty
Published in John C Watkinson, Raymond W Clarke, Christopher P Aldren, Doris-Eva Bamiou, Raymond W Clarke, Richard M Irving, Haytham Kubba, Shakeel R Saeed, Paediatrics, The Ear, Skull Base, 2018
Daniel Moualed, Alison Hunt, Christopher P. Aldren
Selecting an appropriate ossicular replacement prosthesis requires careful consideration of the anatomical configuration of the middle ear and ossicles. The two main options for prosthesis placement are stapes to malleus or stapes to tympanic membrane.
Repair effect of xenogeneic acellular dermal matrix during external auditory canal reconstruction after canal wall down mastoidectomy
Published in Acta Oto-Laryngologica, 2020
Jian Zang, Bo Yang, Shuai Feng, Xuejun Jiang
A total of 28 patients (11 males and 17 females) were included in the study, with an average age of 48.8 ± 13.8 years (range, 21–72 years). There were 16 cases of left ear and 12 cases of right ear. Among these patients, there were three (10.7%) cases of chronic otitis media, 14 (50%) cases of middle ear cholesteatoma (nine cases of first episode, five cases of recurrence), three (10.7%) cases of EAC cholesteatoma, and eight (28.6%) cases of cavity-related problems after CWD mastoidectomy (no cholesteatoma). A tympanoplasty, with or without ossiculoplasty, was performed without staging, including type I tympanoplasty in one case whose ossicles was retained, partial ossicular replacement prosthesis (PROP) in 18 cases, total ossicular replacement prosthesis (TROP) in seven cases, and without ossicular chain reconstruction in two cases due to severe sensorineural deafness (Table 1).
Transcanal endoscopic ear surgery for traumatic ossicular injury
Published in Acta Oto-Laryngologica, 2020
Min-Su Kim, Jaein Chung, Jae-Yoon Kang, Jin Woong Choi
All procedures were performed under general anesthesia. Exploratory tympanotomy was conducted via the transcanal approach using 0-degree and 30-degree rigid endoscopes (outer diameter: 2.7 mm or 3 mm and length: 14 cm) (KarlStorz, Germany). Ossicular chain abnormalities were evaluated after tympanomeatal flap elevation. Reconstruction of the ossicular chain was then performed according to the specific abnormality. For patients with a mobile stapes footplate and intact suprastructure, ossiculoplasty was performed using a partial titanium ossicular replacement prosthesis (PORP). For patients with a mobile stapes footplate and fracture of the suprastructure, ossiculoplasty using total titanium ossicular replacement prosthesis (TORP) or stapedotomy using a Teflon-platinum piston prosthesis was performed. Cartilage harvested from the tragus or cymba was placed between the titanium prosthesis and the tympanic membrane. In cases where the tympanic membrane was perforated, myringoplasty was performed using the temporalis fascia or tragal perichondrium. In case the incudomalleolar joint was separated minimally, ossicular repositioning (incus repositioning) was performed.
Polymeric middle ear prosthesis enriched with silver nanoparticles – first clinical results
Published in Expert Review of Medical Devices, 2019
Magdalena Ziąbka, Katarzyna Malec
The study was approved by the Local Bioethics Committee at the Regional Chamber of Physicians and Dentists in Krakow (No. 157/KBL/OIL2016, date of approval: 13.09.2016) and the Registration Office for Medicinal Products, Medical Devices and Biocidal Products in Warsaw (No. UR.D.WM.DNB.4.2017, date of approval 24.01.2017). Three patients underwent ossicular chain replacement with Otoimplant – a partial ossicular replacement prosthesis (PORP). The patients were aged from 58 to 68 years (the mean – 64 years). The patients’ medical background, operative reports, and audiometric data were reviewed. The disease category was chronic otitis media. Patients were operated on by two experienced senior ear surgeons in the following manner. The postauricular approach under local anesthesia was employed. The middle ear cavity was exposed. The tympanomeatal flap was raised and tympanic membrane detached. The middle ear cavity and ossicular chain were evaluated. The prosthesis was placed between the stapes head and tympanic membrane with cartilage interposition (Figure 2).The tympanomeatal flap and tympanic membrane were returned to its original position. The external ear canal was packed with Spongostan particles, silastic stripes and gauze dressing. The wound was closed in layers. Subsequently, the patients’ recovery was investigated according to the study protocol on the 7th day and 1, 3, 6 and 12 months after the surgery.