1.Analysis of medium and long term efficacy of ossicle chain bypass technique in treatment of tympanosclerosis.
Ningyu FENG ; Ying ZHANG ; Pei DONG ; Xueliang SHEN ; Ming LIU ; Yaxin WANG ; Ruixia MA
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2023;37(10):815-818
Objective:For tympanosclerosis patients with ossicular chain fixation, we use ossicular chain bypass technique and evaluate its long-term effects. Methods:From June 2017 to June 2019, 147 patients with tympanosclerosis who underwent middle ear surgery with otoscopy in Yinchuan First People's Hospital were reviewed. The subjects were divided into three groups according to the implemented operation plan, 51 cases in the ossicular chain mobilization group(OCM), 56 cases in the ossicular chain bypass reconstruction group(OCB), and 40 cases in the malleus-incus complex resection reconstruction group(MICR). Through a three-year follow-up, the medium and long-term effects of different operation plans were compared and analyzed. Results:There was no significant difference among the three groups in the incidence of tympanic membrane perforation, delayed facial nerve palsy, and the dispatch and displacement of PORP. The incidence of tympanic membrane retraction pocket or cholesteatoma after operation in OCB group(0) was significantly lower than that in OCM group(11.76%) and MICR group(7.5%)(P<0.05). At 12 months after operation, ΔABG of OCB group and MICR group were better than that in the OCM group(P<0.05). At 36 months after operation, ΔABG of OCB group was better than that in the OCM group(P<0.05), and there was no significant difference between OCB group and MICR group. The audiological performance of patients with epitympanic sclerosis(ETS) at 12, 24 and 36 months after operation was better than that of patients with posterior tympanosclerosis(PTS) and total tympanosclerosis(TTS)(P<0.05). Conclusion:Compared with patients undergoing ossicular chain mobilization and malleus-incus complex resection for ossicular chain reconstruction, patients with tympanosclerosis undergoing bypass technique have better and stable hearing prognosis in medium and long term. This technique can effectively prevent the formation of retracted pocket and cholesteatoma in patients with tympanosclerosis after operation.
Humans
;
Tympanosclerosis
;
Ear Ossicles/surgery*
;
Ear, Middle
;
Malleus/surgery*
;
Cholesteatoma
;
Retrospective Studies
;
Ossicular Prosthesis
;
Treatment Outcome
2.Advances in research on treatment of tympanosclerosis.
Xin WANG ; Lingyun MEI ; Lu JIANG
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2024;38(1):86-90
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
3.Do All Antioxidant Supplements Have the Same Potential Effect on Preventing Myringosclerosis?.
Seden AKDAGLI ; Arzu TUZUNER ; Sule DEMIRCI ; Hatice KARADAS ; Kamil Gokce TULACI ; Mehmet DOGAN ; Refik CAYLAN
Clinical and Experimental Otorhinolaryngology 2015;8(1):1-6
OBJECTIVES: Myringosclerosis is an irreversible pathological healing mechanism of the tympanic membrane which can result in the formation of sclerotic plaques. Antioxidant treatment is a recognised prevention therapy and coenzyme Q10 (CoQ10), lycopene, and grape seed extract (GSE), were used in this manner. METHODS: Forty-four Wistar rats were used in this experiment, and, following myringotomies, the animals were randomly divided into four groups. CoQ10, lycopene or GSE was administered orally to the respective groups, starting from the day of surgery. Otomicroscopy examination was performed on the 14th day. All tympanic membrane lesions were evaluated and compared otomicroscopically and histopathologically. RESULTS: The otomicroscopy and histopathological findings, compared against a control (saline) group, showed the CoQ10, lycopene, and GSE groups had statistically significant differences of degree of sclerosis (P<0.001). CONCLUSION: CoQ10, lycopene, and GSE were compared against a saline group and their antioxidative and anti-inflammatory effects were similar. The formation of myringosclerotic plagues after experimental myringotomy in rats significantly decreased and diminished after systemic administration of the three different antioxidant supplements.
Animals
;
Grape Seed Extract
;
Myringosclerosis*
;
Rats
;
Rats, Wistar
;
Sclerosis
;
Tympanic Membrane
4.Effectiveness of Stapes Mobilization in Tympanosclerotic Stapes Fixation.
Hun Yi PARK ; Hyung Jin JUN ; Yun Hoon CHOUNG ; Keehyun PARK
Korean Journal of Audiology 2011;15(1):19-24
BACKGROUND AND OBJECTIVES: Tympanosclerosis is a nonspecific and irreversible result of chronic inflammation or infection of the middle ear. However, there remains disagreement about how best to surgically treat tympanosclerotic ossicular fixation, with the controversy over its management when stapes is involved. The aim of this study was to evaluate operative findings and hearing results of tympanosclerosis involving the ossicular chain, which in turn would establish better surgical treatment of tympanosclerotic ossicular fixation. SUBJECTS AND METHODS: In this prospective study conducted from Mar 2000 to Dec 2007, 38 patients with tympanosclerosis who had undergone surgical treatment were evaluated. The clinical and operational records and pre- and postoperative pure tone audiograms were reviewed. RESULTS: Operative findings showed stapes fixation is the most common. In 8 patients (21.1%), stapes was mobile, while, in the remaining 30 patients (78.9%), stapes fixation was found. In all cases with stapes fixation, stapes mobilization was possible. Following hearing result reporting guideline by the Korean Otological Society, the success rate of middle ear surgery was 68.4% (26 of 38 patients). In cases with stapes fixation, the success rate was 66.6% (20 of 30 patients), while, in cases with no stapes fixation, the success rate was 75.0% (6 of 8 patients). However, there was no statistical significance between the two groups. CONCLUSION: Stapes fixation was found in 78.9% of tympanosclerotic ossicular fixation. In management of tympanosclerotic stapes fixation, meticulous excision of tympanosclerotic plaques and removal of new bone formation around stapes footplate after adequate exposure could achieve a relatively good hearing result without stapes surgery.
Ear, Middle
;
Hearing
;
Humans
;
Inflammation
;
Myringosclerosis
;
Ossicular Replacement
;
Osteogenesis
;
Prospective Studies
;
Stapes
;
Stapes Mobilization
;
Stapes Surgery
5.Grommet Cholesteatoma.
Hoon Young WOO ; Young Sam YOO ; Chan CHOI ; Jung Hyeob SOHN
Korean Journal of Otolaryngology - Head and Neck Surgery 2007;50(6):545-547
There are occasional complications after tympanostomy tube insertion due either to the operative procedure itself or to the anato-mical or physiological effects of the tubes. Hearing loss, persisting perforation, tympanosclerosis, atrophy, atelectasis, and the development of cholesteatoma have all been attributed to the tympanostomy tubes. The development of a secondary cholesteatoma at the site of the tube placement Grommet cholesteatoma- is a very uncommon complication. We report one case of cholesteatoma associated with tympanostomy tube insertion.
Atrophy
;
Cholesteatoma*
;
Hearing Loss
;
Middle Ear Ventilation
;
Myringosclerosis
;
Pulmonary Atelectasis
;
Surgical Procedures, Operative
6.Tympanosclerosis of the Middle Ear: Radiologic-Surgical Correlation.
Woo Jin MOON ; Dong Woo PARK ; Seung Ro LEE ; Jin Yong SEONG ; Soon Young SONG ; Chang Kok HAHM ; Yong Soo KIM ; Choong Ki PARK ; Kyung TAE
Journal of the Korean Radiological Society 1998;38(2):211-216
PURPOSE: Tympanosclerosis is a common problem causing conductive hearing loss accompanied by chronic otitismedia. The purpose of this study was to evaluate the CT findings of tympanosclerosis, and correlate them with thesurgical findings. MATERIALS AND METHODS: The CT scans of 17 patients with surgically-proven tympanosclerosis andthose of a control group of 34 patients with nontympanosclerotic chronic otitis media were reviewed. According totheir location, they were assigned to one of three groups; tympanic membrane, epitympanum, or ossicles. RESULTS: Tympanosclerosis was found during surgery to be located in the tympanic membrane (n=11), the epitympanum (n=6), oraround the ossicles(n=8). Calcification of the tympanic membrane, ossicular thickening, narrowing of theepitympanum and calcification of the tympanic cavity occurred to a significant extent, and were more often afeature of tympanosclerosis than of nontympanosclerotic chronic otitis media (p <0.05). As an indicater of tympanicmembrane involvement, sensitivity and specificity of calcification of the tympanic membrane were 73% and 83%,respectively. As an indicator of ossicular involvement, the corresponding figures for ossicular thickening were50% and 93% ; as an indicator of involvement of the tympanic cavity (especially the epitympanum) the figures fornarrowing of the epitympanum and calcification of the tympanic cavity were 50% and 50% (respective sensitivities),and 89% and 93%(respective specificities). CONCLUSION: Tympanosclerosis usually appears on CT as ossicularthickening, narrowing of the epitympanum, calcification of the tympanic membrane and/or tympanic cavity. CT isvery helpful in evaluating ossicular involvement and determining the appropriate surgical treatment oftympanosclerosis.
Ear, Middle*
;
Hearing Loss, Conductive
;
Humans
;
Myringosclerosis*
;
Otitis Media
;
Sensitivity and Specificity
;
Tomography, X-Ray Computed
;
Tympanic Membrane
7.The impact of malleus processing in ossicular chain reconstruction on the therapeutic effect in patients with tympanosclerosis.
Fan SHU ; Menghe GUO ; Nanping XIE ; Hongzheng ZHANG ; Liangcai WAN
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2013;27(10):455-457
OBJECTIVE:
To investigate the effect of different malleus treatments on the postoperative efficacy in the tympanosclerosis patients receiving ossicular chain reconstruction.
METHOD:
Fifty-nine patients (62 ears) with tympanosclerosis were treated by ossicular chain reconstruction. All the patients were divided into three groups, including malleus removal group (A, 24 ears), retaining only the malleus handle group (B, 18 ears) and the intact malleus group (C, 20 ears). All the patients were followed up 3 months pre-operation, 3 months and 1 year post-operation by audiometric measurement (the average hearing threshold at 0.5, 1.0, 2.0 kHz HI). Tympanic membrane was examined by ear endoscope.
RESULT:
The pre-operation mean air bone gap (ABG) in these groups were 40.07 +/- 77.56 dB, 37.31 +/- 76.45 dB, and 36.75 +/- 76.72 dB, among which the difference had no statistical significance (P > 0.05). At 3 months after operation, the ABG in all cases was improved at 0.5, 1 and 2 kHz. The difference of ABG improvement among these three groups had no statistical significance (P > 0.05). One year after surgery, the ABG of the three groups were decreased by 17.92 +/- 9.28 dB, 16.76 +/- 5.19 dB and 10.58 +/- 7.38 dB respectively. The hearing improvement in group C is less than the other two groups (P = 0.03, P = 0.016). The difference of hearing improvement between group A and group B had no statistical significance(P > 0.05). Group A and group B each have one case of tympanic membrane perforation and artificial ossicle falling off.
CONCLUSION
The operating processes of malleus in ossicular chain reconstruction of patients with tympanosclerosis were introduced. In terms of short-term efficacy, the three groups showed no significant difference. However, the long-term efficacy of the patients in the group A and group B were better compared with the group C.
Adolescent
;
Adult
;
Female
;
Humans
;
Male
;
Malleus
;
surgery
;
Middle Aged
;
Myringosclerosis
;
surgery
;
Ossicular Replacement
;
methods
;
Retrospective Studies
;
Treatment Outcome
;
Young Adult
8.Tympanosclerosis etiology and treatment.
Xueling JIN ; Jian ZHANG ; Wugen LUO
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2014;28(22):1811-1814
Tympanosclerosis is the middle ear tissue hyalinization and calcification caused by chronic middle ear inflammation, which mainly results in conductive deafness with unobvious clinical symptom. Etiology is unclear. The treatment is given priority to surgical treatment at present, while long-term effect reported mostly poor. This article analyzed etiology and treatment of the tympanic cavity sclerosis.
Calcinosis
;
Chronic Disease
;
Ear, Middle
;
Hearing Loss, Conductive
;
etiology
;
Humans
;
Myringosclerosis
;
complications
;
etiology
;
therapy
;
Otitis Media
;
Sclerosis
9.A Case of Kartagener's syndrome combined with congenital nystagmus.
Jun Sun RYU ; Dong Woo JEONG ; Yoon Keun PARK ; Ki Sik KIM
Korean Journal of Otolaryngology - Head and Neck Surgery 2001;44(6):657-661
Primary ciliary dyskinesia results in characteristic clinical symptoms, including chronic pansinusitis, recurrent infections of the respiratory tract, and infertility. Kartagener's syndrome is clinically distinguishable by the presence of situs inversus from this group of diseases. Other otolaryngological manifestations of primary ciliary dyskinesia which have been reported include otitis media with effusion, tympanosclerosis, keratosis obturans, and chronic cholesteatoma. Congenital nystagmus is another otological symptom characterized by ocular oscillation, which usually appears in the early infancy, and is often associated with visuosensory abnormalities. Recently, we experienced a 13 year-old boy with congenital nystagmus in addition to all other manifestations of Kartagener's syndrome. Although the clinical implication is not clear, it is possible that two diseases share the same developmental abnormality.
Adolescent
;
Cholesteatoma
;
Humans
;
Infertility
;
Kartagener Syndrome*
;
Keratosis
;
Male
;
Myringosclerosis
;
Nystagmus, Congenital*
;
Otitis Media with Effusion
;
Respiratory System
;
Situs Inversus
10.Neuroglial Choristoma of the Middle Ear with Massive Tympanosclerosis: A Case Report and Literature Review.
Hyun Joon SHIM ; Yong Kyung KANG ; Yong Hwi AN ; Young Ok HONG
Journal of Audiology & Otology 2016;20(3):179-182
Neuroglialchoristoma is a rare cerebral heterotopia typically involving extracranial midline structures of the head and neck, including the nose, nasopharynx and oral cavity. It rarely involves non-midline structures, such as the middle ear, mastoid and orbit. We report the case of a 63-year-old woman with right-sided hearing loss and aural fullness who was diagnosed with neuroglialchoristoma of the middle ear and mastoid. To our knowledge, this is the first report on neuroglialchoristomawith massive tympanosclerosis. The presence of combination supported the inhalation theory of neuroglialchoristoma, given that tympanosclerosis is typically caused by Eustachian tube dysfunction.
Choristoma*
;
Ear, Middle*
;
Encephalocele
;
Eustachian Tube
;
Female
;
Head
;
Hearing Loss
;
Humans
;
Inhalation
;
Mastoid
;
Middle Aged
;
Mouth
;
Myringosclerosis*
;
Nasopharynx
;
Neck
;
Neuroglia
;
Nose
;
Orbit