4. Lesions of the Ossicular Chain

2015 ◽  
pp. 72-121 ◽  
Keyword(s):  
Ossicular Chain

Ossicular chain reconstruction: endoscopic or microscopic?

2021 ◽  
pp. 1-7
Author(s):  
E A Guneri ◽  
A Cakir Cetin
Keyword(s):  
Word Recognition ◽  
Middle Ear ◽  
Risk Index ◽  
Ossicular Chain ◽  
Recognition Score ◽  
Reconstruction Surgery ◽  
Ossicular Chain Reconstruction ◽  
Operation Duration ◽  
Air Conduction

Abstract Objective To compare the results of endoscopic and microscopic ossicular chain reconstruction surgery. Methods Patients undergoing ossicular chain reconstruction surgery via an endoscopic (n = 31) or microscopic (n = 34) technique were analysed for age, gender, Middle Ear Risk Index, ossicular chain defect, incision type, ossicular chain reconstruction surgery material, mean air conduction threshold, air–bone gap, air–bone gap gain, word recognition score, mean operation duration and mean post-operative follow up. Results Post-operative air conduction, air–bone gap and word recognition score improved significantly in both groups (within-subject p < 0.001 for air conduction and air–bone gap, and 0.026 for word recognition score); differences between groups were not significant (between-subject p = 0.192 for air conduction, 0.102 for air–bone gap, and 0.709 for word recognition score). Other parameters were similar between groups, except for incision type. However, endoscopic ossicular chain reconstruction surgery was associated with a significantly shorter operation duration (p < 0.001). Conclusion Endoscopic ossicular chain reconstruction surgery can achieve comparable surgical and audiological outcomes to those of microscopic ossicular chain reconstruction surgery in a shorter time.

Ossicular Discontinuity and Exostoses in Proteus Syndrome: A Case Report

2005 ◽  
Vol 114 (3) ◽  
pp. 242-246
Author(s):  
Joni K. Doherty ◽  
Dennis R. Maceri
Keyword(s):  
Hearing Loss ◽  
High Frequency ◽  
Conductive Hearing Loss ◽  
Ossicular Chain ◽  
Typical Feature ◽  
Proteus Syndrome ◽  
Frequency Range ◽  
Pure Tone Average ◽  
Ossicular Chain Reconstruction ◽  
Conductive Hearing

Proteus syndrome (PS) is a rare hamartomatous disorder characterized by mosaic overgrowth of multiple tissues that manifests early in life and is progressive. The presence of unilateral external auditory canal exostoses in a patient who is not a swimmer or surfer is suggestive of PS. However, hearing loss is not a typical feature. Here, we describe exostoses and ossicular discontinuity with conductive hearing loss in a patient with PS. The treatment consisted of canalplasty and ossicular chain reconstruction. A postoperative reduction was demonstrated in the patient's air-bone gap, from 21 dB to 13 dB for the pure tone average (four frequencies) and from 41 dB to 15 dB in the high-frequency range (6,000 to 8,000 Hz). Causes of ossicular discontinuity are discussed. Routine annual audiometric and otolaryngological evaluation should be considered in all patients with temporal bone inyolvement of PS.

Tensa retraction cholesteatoma: treatment and long-term results

1989 ◽  
Vol 103 (2) ◽  
pp. 149-157 ◽  
Author(s):  
T. Lau ◽  
M. Tos
Keyword(s):  
Ossicular Chain ◽  
Observation Time ◽  
Long Term Results ◽  
Mastoid Process ◽  
Canal Wall ◽  
Pars Tensa ◽  
Results Of Treatment ◽  
Acquired Cholesteatoma ◽  
Canal Wall Down

AbstractTo obtain the best possible results of treatment of acquired cholesteatoma, we made a subdivision of cholesteatoma types into attic and pars tensa cholesteatomas, and subdivided the latter further into tensa retraction cholesteatoma and sinus cholesteatomas. Tensa retraction cholesteatoma is defined as arising from a retraction or perforation of the whole pars tensa, whereas sinus cholesteatoma is defined as arising from a retraction or perforation of the postero-superior part of the tensa. We present the long-term results obtained in tensa retraction cholesteatomas treated with one stage surgery from 1964 to 1980. Median observation time was 9 years, range 2 to 19 years. Sixty-one ears were treated without mastoidectomy, whereas 71 ears had canal wall-up mastoidectomy and 64 ears had canal wall-down mastoidectomy. The total recurrence rate was 13.3 per cent; 17 ears had residual cholesteatoma, and nine ears had recurrent cholesteatoma. The best results were obtained in ears with an intact ossicular chain where mastoidectomy was not performed. In 49 per cent of the cases, the cholesteatoma was confined to the tympanic cavity without reaching the aditus, antrum or mastoid process. About one-third to one-quarter of the ears had tympanoplasty only, with removal of the cholesteatoma through the ear canal.

Soft Impact in a Biomechanical System With Shape Memory Element

2017 ◽  
Vol 12 (6) ◽  
Author(s):  
R. Rusinek ◽  
M. Szymanski ◽  
J. Warminski
Keyword(s):  
Shape Memory ◽  
Middle Ear ◽  
Polynomial Function ◽  
Ossicular Chain ◽  
Excitation Amplitude ◽  
Patient Needs ◽  
Memory Element ◽  
The Impact ◽  
Irregular Behavior ◽  
Two Degree Of Freedom

The analysis of the shape memory prosthesis (SMP) of the middle ear is presented in this paper. The shape memory prosthesis permits the adjustment of its length to individual patient needs, but sometimes the prosthesis cannot be properly fixed to the stapes. In this case, the impact between the prosthesis and stapes is important. Therefore, the reconstructed middle ear is modeled as a two degree-of-freedom system with a nonlinear shape memory element and soft impact to represent its behavior when the prosthesis is not properly placed or fixed. The properties of the shape memory prosthesis, in the form of a helical spring, are represented by a polynomial function. The system exhibits advisable periodic and undesirable aperiodic and irregular behavior depending on the excitation amplitude, the frequency, and the prosthesis length. The prosthesis length can change, resulting in a modification of the distance between the prosthesis and the stapes. The results of this study provide an answer in terms of how the prosthesis length, which produces the ossicular chain tension, influences the system dynamics and its implication in medical practice.

Comparison of the application of artificial ossicles and autologous ossicles in the reconstruction of a damaged ossicular chain

2018 ◽  
Vol 132 (10) ◽  
pp. 885-890
Author(s):  
L Zhao ◽  
J Li ◽  
S Gong
Keyword(s):  
Facial Nerve ◽  
Temporal Bone ◽  
Pure Tone ◽  
Bone Fractures ◽  
Pure Tone Audiometry ◽  
Ossicular Chain ◽  
Facial Nerve Paralysis ◽  
Temporal Bone Fracture ◽  
Nerve Paralysis ◽  
Ossicular Reconstruction

AbstractObjectiveTo evaluate the therapeutic effect that the titanium partial ossicular reconstruction prosthesis and autologous ossicles have on hearing loss after reconstruction of a damaged ossicular chain.MethodsForty-two medical records of treatments carried out from 2013 to 2015 for ossicular chain damage with facial nerve paralysis due to temporal bone fractures were reviewed. The study assessed: causes of damage, pre-operative pure tone audiometry findings, types of intra-operative ossicular chain damage, intra-operative ossicular chain repair methods (titanium partial ossicular reconstruction prosthesis or autologous ossicles) and post-operative pure tone audiometry results.ResultsThe titanium partial ossicular reconstruction prosthesis was used in 26 cases; the average air–bone gap was 32.3 ± 5.3 dB pre-operatively and 12.8 ± 5.3 dB post-operatively. Autologous ossicles were used in 16 cases; the average air–bone gap was 33.4 ± 4.5 dB pre-operatively and 17.8 ± 7.8 dB post-operatively.ConclusionOssicular chain reconstruction is an effective way of improving hearing in patients with ossicular chain damage. The results suggest that repair with either the titanium partial ossicular reconstruction prosthesis or autologous ossicles can improve hearing following ossicular chain injury with facial nerve paralysis caused by a temporal bone fracture.

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