Humans ; Microsurgery ; Otologic Surgical Procedures

Ear, Middle ; surgery ; Humans ; Otologic Surgical Procedures

Ear, Middle ; surgery ; Otologic Surgical Procedures

Objectives: 1) To present a technique for implanting the Med-EI Combi 40+™ using a small incision with minimal access. 2) To describe the short term postsurgical outcomes in these patients. Methods: Two patients (1 child and 1 adult) underwent a novel small incision technique for implantation of the Med-EI Combi 40+™ cochlear implant device. The short term outcomes in these two patients were described and compared with previous experience using the standard implantation technique citing advantages and possible limitations. As these two patients had bilateral implantation utilizing different techniques on the two sides interesting comparisons could be made on the same individuals. Results: The preliminary experience with a novel small incision technique for the Med-EI Combi 40+™ implantation shows encouraging results in terms of healing and initial performance of these patients. Conclusion: This small incision technique may be offered to patients especially to those who wish to have bilateral implantations as this allows a less invasive approach, good cosmesis without sacrificing the safety and performance outcomes at least in the short term. (Author)
COCHLEAR IMPLANTATION SURGERY OTOLOGIC SURGICAL PROCEDURES

Objective: To determine the relationship of the surgeon handedness and operative site laterality on operative duration and hearing improvement in otologic surgery, and to further explore whether this relationship may be related to surgeon experience. Methods: Design: Retrospective Cohort Setting: Tertiary Private Teaching Hospital Participants: Seventy-three (73) patients aged 18 to 65 years old who underwent primary ear surgery under general anesthesia between January 2016 and December 2019 were retrospectively divided into two groups: 39 contralateral and 34 ipsilateral. The operative durations and hearing improvements were compared using independent t-tests, with consideration of surgeon experience in years further stratifying patients. Results: There was no significant difference in operative duration, t(71) = 1.14, p = .26, between the contralateral (M = 281.95 minutes, SD = 71.82) and ipsilateral (M = 261.15, SD = 79.26) groups. This same pattern was more pronounced among surgeons with 10+ years of experience although there was also no significant difference in operative time, t(33) = 1.31, p = .19 for both ipsilateral and contralateral surgeries There was no statistically significant difference, t(36) = -0.72, p = .47, in overall mean hearing gain among patients in the contralateral (M = +2.22 dB, SD = 10.54) and ipsilateral (M = +5.12 dB, SD = 14.26) groups. Although the difference was also not statistically significant, t(16) = -1.94, p = .07 for contralateral (M = 0.00, SD = 5.43) and ipsilateral (M = +7.95 dB, SD = 11.52) procedures performed by surgeons with experience of 10 years or more, a mean hearing gain of +7 dB in the ipsilateral group compared to 0 dB in the contralateral group was notable. Conclusion: This study did not prove that regardless of surgeon experience, right-handed surgeons operating on the right ear and left-handed surgeons operating on the left ear have better ear surgery outcomes of operative duration and hearing improvement compared to right- handed surgeons operating on the left ear and left-handed surgeons operating on the right ear. Future studies on larger samples with more complete data may yet demonstrate this effect.
Functional Laterality ; otologic surgical procedures ; hearing ; operative time

OBJECTIVETo explore the surgical treatment and pathologic mechanism of polyotia.

METHODSThe operative methods for polyotia were flexible. The main procedures were aimed at the remodeling of tragus with the redundant tissue. Tissue transplantation was used to correct the depression deformity. Compound auricular tissue transplantation and Z-plasty were used for correction of the malformation at the posterior part of polyotia.

RESULTSFrom 2003 to 2008, 9 patients with polyotia were treated. The tragus was reconstructed after resection of redundant tissue. The depression deformity was corrected with tissue infilling in 6 cases. The compound auricular tissue transplantation was performed in 4 cases. Z-plasty at the lower ear lobe was performed in 2 cases. The appearance and the location of the reconstructed ears looked symmetric to the healthy ear.

CONCLUSIONSNatural and symmetric appearance of reconstructed ear can be achieved in polyotia. The abnormal migration of neural crest cell might be the pathologic mechanism of polyotia.

Adult ; Child ; Ear, External ; abnormalities ; Female ; Humans ; Male ; Otologic Surgical Procedures ; Reconstructive Surgical Procedures

BACKGROUNDSuperior semicircular canal dehiscence (SSCD) is gradually recognized by otologists in recent years. The patients with SSCD have a syndrome comprising a series of vestibular symptoms and hearing function disorders which can be cured by the operation. In this study, we evaluated the characteristics of patients with SSCD and determined the effectiveness of treating this syndrome by resurfacing the canal via the transmastoid approach using a dumpling structure.

METHODSPatients with SSCD, confirmed by high-resolution computed tomography and hospitalized at Beijing Tongren Hospital between November 2009 and October 2012, were included in the study. All of the patients underwent the unilateral transmastoid approach for resurfacing the canal, and received regular follow-up after surgery. Data from preoperative medical records and postoperative follow-up were comparatively analyzed to evaluate the effect of surgery.

RESULTSIn total, 10 patients and 13 ears (three left ears, four right ears, three bilateral ears) were evaluated in the study, which included 7 men and 3 women. Different symptoms and distinctive manifestations of vestibular evoked myogenic potential were found in these patients. After surgery, 4 patients had complete resolution, 5 had partial resolution, and 1 patient, with bilateral SSCD, had aggravation. None of the patients suffered from serious complications such as sensorineural hearing loss, facial paralysis, cerebrospinal fluid leakage, or intracranial hypertension.

CONCLUSIONSIn patients with unilateral SSCD, resurfacing the canal via the transmastoid approach using a dumpling structure is an effective and safe technique. However, more consideration is needed for patients with bilateral SSCD.

Adult ; Female ; Humans ; Male ; Middle Aged ; Otologic Surgical Procedures ; methods ; Retrospective Studies ; Semicircular Canals ; abnormalities ; surgery

BACKGROUND AND OBJECTIVES: The aim of this study is to evaluate the clinical outcomes of two surgical techniques-modified Bondy technique and canal wall up mastoidectomy with tympanoplasty type I and scutumplasty (CWUM/T1)-to remove attic cholesteatoma while preserving ossicular chain intact. SUBJECTS AND METHOD: A retrospective study was performed on 23 surgical cases for the attic cholesteatoma with postoperative audiometry data of more than six months after surgery. The patients' postoperative clinical features and audiometric results were compared between the two surgical groups. RESULTS: Out of 23 patients, CWUM/T1 was performed in 13 cases and modified Bondy technique was used in 10 cases. There were no significant differences for the preoperative and postoperative audiograms between the two groups. But air-bone gap increased significantly after CWUM/T1 while it decreased after modified Bondy technique. Three cases with postoperative problems were seen after CWUM/T1 (recurrent cholesteatoma, pars tensa adhesion, recurrent otitis media with effusion). Two cases with postoperative problems were found after modified Bondy technique (mild attic retraction, pars tensa retraction). CONCLUSION: Both surgical techniques seem to be adequate to treat attic cholesteatoma while preserving intact ossicular chain. Given good postoperative hearing results and stability of open cavity against recidivism, the modified Bondy technique seems to be a good choice for the attic cholesteatoma with intact ossicular chain when mastoid is not highly pneumatized.
Audiometry ; Cholesteatoma* ; Hearing ; Humans ; Mastoid ; Methods ; Otitis Media ; Otologic Surgical Procedures ; Retrospective Studies ; Tympanoplasty*

The otoplasty or auriculoplasty is characterized by the correction of morphological deformity of auricle including its accessory tissue and covering skin to normal or satisfying level to patient. The indication of this surgery is classified as congenital anomaly and secondary deformity caused by trauma and inflammation. Of these, the congenital auricular deformities are closely associated with the anatomical development of auricular muscle as well as cartilage malformation. In addition, the correction of secondary deformities should be based upon complete anatomical understanding of the auricle, so otolaryngologists have more superior accessibility to patients than plastic surgeons and can easily correct the deformity. In this paper, we investigated the types of each auricular deformity, the methods of surgical correction, and results through case reports commonly found in the field of otolaryngology with literature review.
Cartilage ; Congenital Abnormalities* ; Ear, External ; Humans ; Inflammation ; Otolaryngology ; Otologic Surgical Procedures ; Skin ; Surgery, Plastic

Ear, Inner ; surgery ; Humans ; Neuroma, Acoustic ; surgery ; Otologic Surgical Procedures ; methods