Humans ; Stents ; Tympanic Membrane ; Tympanic Membrane Perforation ; surgery

Endoscopy ; Humans ; Myringoplasty ; Tympanic Membrane ; Tympanic Membrane Perforation ; surgery ; Wound Healing

OBJECTIVETo investigate the feasibility of bilateral same-day myringoplasty and the indications for myringoplasty for patients with bilateral tympanic membrane perforation, and to summarize relevant experience.

METHODSTwenty-two patients underwent bilateral same-day underlay myringoplasty, and all cases were consistent with the indications for myringoplasty. The preoperative hearing and postoperative hearing at three months were compared, and the postoperative symptoms and complications were observed. Forty patients underwent monaural myringoplasty as the control group over the same period. All cases were followed up for 1 - 3 years.

RESULTSThe postoperative hearing was increased by an average of 18 dB, and the rate of closure of tympanic membrane perforation was 93.2% (41/44). There were seven patients with ear fullness after operation in the bilateral myringoplasty group and two patients in the control group (χ(2) = 4.5374, P = 0.0332). There were no differences in the postoperative hearing improvement, the rate of closure and the rates of other discomfort symptoms except for ear fullness between the two groups (P > 0.05).

CONCLUSIONIt was feasible and safe to perform bilateral same-day myringoplasty for bilateral tympanic membrane perforation, but the postoperative temporary discomfort of bilateral ear fullness should be informed the patients in advance.

Hearing ; Hearing Tests ; Humans ; Myringoplasty ; statistics & numerical data ; Postoperative Period ; Treatment Outcome ; Tympanic Membrane ; surgery ; Tympanic Membrane Perforation ; surgery

OBJECTIVE: To investigate the reconstruction method of lateral attic wall with tragal cartilage and temporalis fascia graft. And analyze the postoperative result of its clinical application. METHOD: From Jan 2005 to Jul 2014, 45 patients whose middle ear disease were limited to attic received this surgery in our department. Among 31 cases of cholesteatoma otitis media and 14 cases of external auditory canal cholesteatoma were included. In order to expose the attic fully, we operated epitympanotomy through retroauricular incision and then removed the scutum and lateral attic bone wall. After eliminating the lesions, we reconstructed the lateral attic bone wall with tragal cartilage, covered the cartilage with temporalis fascia and then repaired the tympanic membrane and external ear canal skin. After surgery, all patients were followed up at 10 days, 1 month, 2 months, 6 months and 1 year. RESULT: Two months after surgery, 45 patients' achieved one-stage wound healing. Six months later, all of the patients' operation area had epithelized completely. After 1 year, 37 patients had recovered the normal shapes and stable audition; 7 cases patients have different level tympanic membrane retraction; 1 patient suffered from tympanic membrane retraction and recurrent cholesteatoma. CONCLUSION With regard to the lesion limited to the attic, we can remove it by operating epitympanotomy through retroauricular incision, and then reconstruct the lateral attic wall with tragal cartilage and temporalis fascia. By the support of the cartilage, we can keep the epitympanic aeration, reduce the retraction of pars flaccida membrana tympani, and maintain the fundamental shape of lateral attic wall.
Cartilage ; transplantation ; Cholesteatoma ; surgery ; Ear Auricle ; Ear Canal ; Ear Diseases ; surgery ; Ear, Middle ; pathology ; Fascia ; transplantation ; Humans ; Mastoid ; Otitis Media ; surgery ; Tympanic Membrane ; surgery ; Tympanic Membrane Perforation ; surgery

Objective: To explore the clinical characteristics, intervention and treatment of tympanic osteoma at different locations. Methods: The medical history, audiological and imaging examination, operation and follow-up results of two patients with tympanic osteoma at different sites were reviewed and summarized. Furthermore, the clinical characteristics and interventions of 36 patients reported in literatures with tympanic osteomas were also summarized and analyzed. Results: Osteoma of the two patients collected in this study located at promontory and incus respectively;both of them presented with intact tympanum and conductive deafness, without obvious etiology or predisposing factor. Both of them underwent surgeries and the hearing improved significantly. For patient one, the ossicular chain was intact and restored to activity after removed the osteoma. For patient two, an artificial ossicle was implanted after removed the osteoma and incus. In the 36 patients reported in literatures, the average age was 26.5 years, and 39.47% of them located at promontory; in addition, the main symptoms of them were progressive hearing loss, tinnitus and ear stuffy. Conclusions: Patients with tympanic osteoma are characterized by conduction deafness with intact tympanic membrane, and the most common lesion is promontory. Hearing can be restored by excision of the osteoma and maintenance or reconstruction of the ossicle chain.
Adult ; Ear Ossicles/surgery* ; Ear, Middle/surgery* ; Hearing Loss, Conductive/surgery* ; Humans ; Osteoma/surgery* ; Tympanic Membrane

Patients with patulous Eustachian tubes(PET) usually suffer from annoying symptoms, such as tinnitus, autophony and aural fullness, due to the excessive opening of the Eustachian tube. There is no uniform standard of treatment, and conservative therapy combined with"Stepup"surgical intervention strategy is the main treatment. In this article, we reviewed various surgical treatments of patulous Eustachian tube in recent years, including key points of surgical operation, effectiveness, safety and complications. Full communication and evaluation are needed to establish appropriate patients' expectations preoperatively. A "Stepup" treatment strategy will be carried out, including conservative treatment, tympanic membrane surgery, Eustachian tube pharyngeal orifice constriction surgery, Eustachian tube tympanic orifice plug surgery and Eustachian tube muscle surgery, which aims to maintain normal Eustachian tube function and good middle ear ventilation.
Humans ; Eustachian Tube/surgery* ; Ear Diseases/diagnosis* ; Ear, Middle ; Tympanic Membrane/surgery* ; Tinnitus ; Otitis Media

Tympanosclerosis is the hyaline degeneration and calcium deposition of the lamina propria of tympanic membrane and the submucosa of middle ear under long-term chronic inflammatory stimulation. At present, treatment primarily involves the surgical removal of sclerotic foci and reconstruction of auditory ossicular chain. However, excision of sclerotic lesions near critical structures like the facial nerve canal and vestibular window may result in complications like facial paralysis, vertigo, and sensorineural hearing loss. Developing safer and more effective treatments for tympanosclerosis has become an international research focus. Recent years have seen novel explorations in the treatment of tympanosclerosis. Therefore, this article reviews the latest advancements in research on the treatment of tympanosclerosis.
Humans ; Tympanoplasty ; Ear, Middle ; Ear Ossicles/surgery* ; Tympanic Membrane/surgery* ; Tympanosclerosis

OBJECTIVETo study the efficiency of using autogenous temporalis fascia which was formed and shaped by formaldehyde cross-linking with special fasciaform molds in the repair of large tympanic membrane perforations.

METHODSBase on machine technique and published data, the molds was designed according to the shape of tympanic membrane (TM), autologous fascia graft shaped by 4% formaldehyde (pH 5.6) was cross-linked on the mold to resemble the natural TM more closely repairing the large perforations of tympanic membrane with the formed fascia. Sixty-one operations were performed to close large perforations in patients with intact ossicular chain in fifty-seven patients from November 2006 to April 2009. The follow up was done from one month to thirty months; the average follow up period was eleven months. Statistical analysis was performed using a SPSS 13.0 software.

RESULTSThe repairing of the perforations were successfully with rate of 95.1% (58/61). Three ears were remained small remnant perforations after the surgery, but all hearing had been improved except one patient with biauricular total sensorineural hearing loss within the group. The air bone gap (ABG) of preoperative average (x ± s) hearing level of fifty-nine ears was (31.5 ± 6.1) dB, and the ABG of postoperative average hearing level of same group was (14.2 ± 4.4) dB, the difference was significant (t = 21.3, P < 0.01). During the early stage of using this technique, six ears were found to have graft lateralization recovery, but one case was slightly blunting recovery. No pearl tumor and epicyst had been found during the follow-up period.

CONCLUSIONSThe formaldehyde fasciaform technique produces consistent, reliable as well as reproducible results for repairing large tympanic membrane perforations with minimal complications.

Adolescent ; Adult ; Fascia ; transplantation ; Female ; Humans ; Male ; Middle Aged ; Models, Anatomic ; Transplantation, Autologous ; Tympanic Membrane ; transplantation ; Tympanic Membrane Perforation ; surgery ; Tympanoplasty ; methods ; Young Adult

OBJECTIVE: To evaluate effectiveness of endoscopic tragus cartilage-perichondrium in the treatment of large tympanic membrane perforations. METHOD: Patients with large tympanic membrane perfortations who had underwent cartilage-perichondrium myringoplasty were retrospectively retrieved from our department. Those with a follow-up of equal to or greater than 12 months after surgery were included in the study. Hearing test results were reported using a four-frequency air conduction and bone-air conduction gap. Patients were labeled as treatment success if the tympanic membrane was intact without lateralization or anterior blunting after surgery. RESULT: Of the 35 patients with large tympanic membrane perforations treated by endoscopic tragus cartilage-perichondrium, 33 (94.3%) were treatment success. There was no graft lateralization, anterior blunting, neocholesteatoma, and sensorineural hearing loss in these patients after surgery. The air conduction and bone-air conduction gap before surgery in the study cohort were (43.8 ± 5.7) dB and (28.5 ± 3.1) dB, respectively. Postoperative air conduction and bone-air conduction gap of the cohort were (31.4 ± 6.4) dB HL and (16.2 ± 4.1) dB, respectively. The postoperative air conduction and bone-air conduction gap decreased significantly after surgery (P < 0.01). Overall postoperative air-bone gap in 27 of the 35 patients (77%) were less than 20 dB after surgery. CONCLUSION Endoscopic cartilage-perichondrium myringoplasty is an effective procedure in the treatment of large tympanic membrane perforations.
Bone Conduction ; Cartilage ; Cohort Studies ; Ear Auricle ; Endoscopy ; Hearing ; Hearing Tests ; Humans ; Myringoplasty ; Postoperative Period ; Retrospective Studies ; Treatment Outcome ; Tympanic Membrane ; Tympanic Membrane Perforation ; surgery ; Tympanoplasty

Because wide swings in temperature can occur during cardiac anesthesia all patients undergoing cardiac anesthesia should have their temperatures monitered. This is especially true in situations where deliberate hypothermia during cardiopulmonary surgery is an area of controversy. This study of 20 cases of open heart surgery was undertaken to compare the changes in tympanic membrane, nasopharyngeal, rectal and great toe temperatures and of to evaluate their correlation during the induction, cardiopulmonary bypass, rewarming and post-cardiopulmonary bypass periods. The temperature at each site was monitored every 10 minutes for 60 minutes of each period. The results were as follows, During the induction period, the temperature of the tympanic membrane, nasopharynx and rectum decreased significantly(p<0.05~p<0.01), but the temperatures of the great toe temperatures increased for 20 minutes and then slowly decreased during the next 30 to 60 minutes. During the cardiopulmonary bypass period, the sympanic membrane temperatures which were best correlated with the nasopharyngeal temperatures(p<0.05~p<0.01), decreased faster than the rectal, nasopharyngeal and great toe temperatures. During the rewarming period, the tympanic membrane temperatures increased most quickly and were significantly correlated with the nasopharyngeal temperatures(p<0.05) only at 0 and 10 minutes. During the post-cardiopulmonary bypass period, the tympanic membrane and nasopharyngeal temperatures decreased slowly and were significantly correlated with each other(p<0.01), but the rectal and the great toe temperatures increased slowly.
Anesthesia* ; Cardiopulmonary Bypass ; Heart* ; Humans ; Hypothermia ; Membranes ; Nasopharynx ; Rectum ; Rewarming ; Thoracic Surgery* ; Toes ; Tympanic Membrane