Intact-Bridge Tympanomastoidectomy

1984 ◽  
Vol 92 (3) ◽  
pp. 334-338 ◽  
Author(s):  
Michael M. Paparella ◽  
Timothy T.K. Jung
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Chronic Otitis Media ◽  
Primary Objective ◽  
Open Cavity ◽  
Mastoid Obliteration ◽  
Closed Cavity ◽  
One Stage ◽  
Secondary Objective ◽  
Good Exposure

In recent years closed-cavity (intact wall) tympanomastoidectomy has been described and recommended by many. The pendulum now is swinging back to open-cavity tympanomastoidectomy. The literature in this regard is reviewed. In all patients with chronic otitis media and mastoiditis with intractable tissue pathology, the primary objective is total eradication of disease with a dry, safe ear; a concomitant but secondary objective is hearing retention and restoration with tympanoplasty techniques. Over a 3-year period we have used a one-stage procedure called intact-bridge tympanomastoidectomy (IBM) that fulfills the desirable objectives of both open-and closed-cavity tympanomastoidectomy. The salient features include (1) good exposure as in open-cavity tympanomastoidectomy, (2) maintenance and widening of the middle ear space by bony bridge retention and facial buttress sculpturing to enhance grafting and ossiculoplasty such as TORP or PORP as in canal-up tympanomastoidectomy, and (3) enhancement of mastoid obliteration for large cavities by blocking the aditus with bone paté or cartilage and by providing a separation between middle ear and mastoid. Specific methods, techniques, and results will be presented and discussed.

Intact bridge tympanomastoidectomy (I.B.M.)—combining essential features of open vs. closed procedures

1983 ◽  
Vol 97 (7) ◽  
pp. 579-585 ◽  
Author(s):  
Michael M. Paparella ◽  
Timothy T. K. Jung
Keyword(s):  
Middle Ear ◽  
Chronic Otitis Media ◽  
Primary Objective ◽  
Open Cavity ◽  
Mastoid Obliteration ◽  
Closed Cavity ◽  
One Stage ◽  
Third Stage ◽  
Secondary Objective ◽  
The Cost

AbstractIn recent years, closed cavity intact wall tympanomastoidectomy or combined approached tympanoplasty—(CAT)—has been described and recommended by many. The pendulum now appears to be swinging back again to open cavity tympanomastoidectomy. Pertinent literature in this regard is reviewed. In all patients with chronic otitis media and mastoiditis with intractable tissue pathology, the primary objective is total eradication of disease with the achievement of a dry safe ear while a concomitant but secondary objective is hearing retention and restoration utilizing tympanoplasty techniques. Over a three-and-a-half year period we have utilized a one-stage procedure which provides the desirable objectives of both open and closed cavity tympanomastoidectomy called intact bridge tympanomastoidectomy (I.B.M.). The salient features include: (1) good exposure, as in open cavity tympanomastoidectomy; (2) maintaining and widening the middle-ear space by bony bridge retention and facial buttress sculpturing, to enhance grafting and ossiculoplasty such as TORP or PORP, as in canal up tympanomastoidectomy; (3) enhancement of mastoid obliteration for large cavities, by blocking the aditus with bone pate or cartilage and by providing a separation between middle ear and mastoid. Specific methods, techniques and results are presented and discussed. The results have been gratifying to date. In comparison to intact wall tympanomastoidectomy, this one-stage operation avoids the cost and discomfort of a second and sometimes third stage; surgery for recurrent pathology has been avoided and hearing results have been at least comparable if not improved.

scholarly journals Multiple Osteomas in Middle Ear

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Yongxin Li ◽  
Qiuhuan Li ◽  
Shusheng Gong ◽  
Honggang Liu ◽  
Zilong Yu ◽  
...  
Keyword(s):  
Otitis Media ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Semicircular Canal ◽  
Chronic Otitis Media ◽  
Lateral Semicircular Canal ◽  
Type Iii ◽  
One Stage ◽  
Tensor Tympani Muscle

Since the first description of middle ear osteomas by Thomas in 1964, only few reports were published within the English literatures (Greinwalid et al., 1998; Shimizu et al., 2003; Cho et al., 2005; and Jang et al., 2009), and only one case of the multiple osteomas in middle ear was described by Kim et al., 2006, which arose from the promontory, lateral semicircular canal, and epitympanum. Here we describe a patient with multiple middle ear osteomas arising from the promontory, incus, Eustachian tube, and bony semicanal of tensor tympani muscle. This patient also contracted the chronic otitis media in the ipsilateral ear. The osteomas were successfully removed by performing type III tympanoplasty in one stage.

Surgical Advances in Treating Otitis Media

1994 ◽  
Vol 103 (5_suppl) ◽  
pp. 49-53 ◽  
Author(s):  
Michael M. Paparella ◽  
Oleg Froymovich
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Chronic Otitis Media ◽  
Combined Approach ◽  
Radical Mastoidectomy ◽  
Closed Cavity ◽  
Surgical Methods ◽  
Ventilation Tubes

Surgical methods of treating otitis media and its sequelae are discussed, according to the classification of otitis media presented in an earlier report Surgical management of otitis media with effusion and recurrent purulent otitis media includes myringotomy and use of ventilation tubes. Occasionally, otitis media with effusion will lead to structural and other pathologic changes in the middle ear, and conservative treatments such as use of medication or tubes will not suffice. Indications and methods for exploratory tympanotomy and reconstruction of the middle ear are discussed. In such instances, tympanoplasty can be used to the patient's benefit Chronic otitis media with mastoiditis, defined by the presence of intractable pathologic tissue, generally requires surgical correction. Classic methods include simple mastoidectomy, modified radical (Bondy) mastoidectomy, and radical mastoidectomy. Current classifications of procedures would also include closed-cavity tympanomastoidectomy, open-cavity tympanomastoidectomy, and intact-bridge tyrnpanomastoidectomy (a combined approach). The diagnostic and surgical approach to silent or subclinical otitis media is discussed. Diagnosis and treatment of sequelae of otitis media, including sequelae in the middle ear and, less commonly, in the inner ear, are discussed.

S229 – One-Stage Tympanoplasty with or without Mastoid Obliteration

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P152-P152
Author(s):  
Ken Hayashi ◽  
Atsushi Shinkawa
Keyword(s):  
Success Rate ◽  
Otitis Media ◽  
Chronic Otitis Media ◽  
Ossicular Chain ◽  
Mastoid Obliteration ◽  
Type Iii ◽  
One Stage ◽  
Type Iv ◽  
Canal Wall Down ◽  
P Type

Objectives To confirm the efficacy of one-stage tympanoplasty with mastoid obliteration and a tymapanoplasty by transcanal approach using ceramic prosthesis. Methods Our surgical procedure was performed on 163 patients with cholesteatoma and 545 patients with chronic otitis media in Shinkawa Clinic. The operative method was classified into 2 groups. We use one-stage tympanoplasty with mastoid obliteration, a canal wall down procedure for chronic otitis media with cholesteatoma and chronic otomastoiditis. On the other hand, we use a tympanoplasty by an endaural approach for chronic otitis media without chronic otomastoiditis. The ossicular chain was reconstructed using the ceramic ossicular prosthesis (P-type and T-type). We performed modified Type III tympanoplasty using the P-type ceramic when the superstructure of the stapes could be utilized, while we performed modified Type IV tympanoplasty using the T-type ceramic when the superstructure of the stapes could not be used. Results In chronic otitis media with cholesteatoma or chronic otomastoiditis, the success rate of modified Type III tympanoplasty using ceramic P type was 77.8%; on the contrary, that of modified Type IV tympanoplasty using ceramic T type was 70.6%. In chronic otitis media without chronic otomastoiditis, the success rate of modified Type III tympanoplasty using ceramic P-Type was 69.8%, while that of modified Type IV tympanoplasty using ceramic T was 69.1%. Conclusions Our results show that there are no significant differences of success rate between these 2 procedures. We confirmed that the use of ceramic implant was satisfactory for both one-stage tympanoplasty with mastoid obliteration and a tympanoplasty by an endaural approach.

Comparison of the Aditus ad Antrum Diameter on CT between Patients with Chronic Otitis Media and Healthy Individuals

2019 ◽  
Vol 15 (10) ◽  
pp. 990-993 ◽  
Author(s):  
Elif Gündoğdu ◽  
Uğur Toprak
Keyword(s):  
Computed Tomography ◽  
Otitis Media ◽  
Middle Ear ◽  
Healthy Subjects ◽  
Normal Values ◽  
Chronic Otitis Media ◽  
Healthy Individuals ◽  
Inner Diameter ◽  
Male Patients ◽  
The Right

Background: The middle ear cavity is ventilated through the aditus ad antrum. Aditus blockage contributes to the pathology of otitis media. Objective: To determine the normal values of the aditus ad antrum diameter on computed tomography and to investigate its relationship with chronic otitis media and related pathologies (tympanosclerosis and myringosclerosis). Methods: The temporal CT images of 162 individuals were evaluated retrospectively. In the axial sections, the inner diameter of the aditus was measured at the narrowest point at the cortex. The differences in diameter were compared between diseased and healthy ears. Results: In healthy individuals, the diameter was narrower in women. There was no difference between the right and left ears in healthy subjects. No correlation was found between age and diameter. In male patients with myringosclerosis, the diameter was slightly narrower on both sides but more marked on the left. In female patients with myringosclerosis, the diameter in both ears was slightly narrower. In cases of otitis media and tympanosclerosis, the diameter was less than that of healthy individuals, despite the lack of statistically significant result in all cases. Conclusion: The aditus ad antrum was narrower in diseased ears, indicating that a blocked aditus may contribute to the development of otitis media, as well as mucosal diseases.

scholarly journals Tissue Concentrations of Enoxacin in the Middle Ear of Patients with Chronic Otitis Media.

1992 ◽  
Vol 85 (1) ◽  
pp. 131-135
Author(s):  
Nozomu Mori ◽  
Akio Shugyo ◽  
Hiroshi Furuta ◽  
Yasuki Watanabe ◽  
Takafumi Kawahara ◽  
...  
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Chronic Otitis Media ◽  
Tissue Concentrations

Medical tactics in chronic otitis media

1995 ◽  
Vol 76 (1) ◽  
pp. 23-25
Author(s):  
R. M. Nursaitova ◽  
O. A. Guryanov
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Chronic Otitis Media ◽  
Potential Danger

It is advisable to perform cautious radical operations at the same time with plasty elements. The early surgicai sanation of the middle ear is recommended allowing to preserve its elements, to increase the possibilities of reconstruction and consequently, to decrease a potential danger for acoustic function of a patient as well as for his life as a whole.

scholarly journals Clinical analysis on surgery of middle ear cholesteatoma and chronic otitis media

2016 ◽  
Vol 130 (S3) ◽  
pp. S221-S221
Author(s):  
Ayiheng Qukuerhan ◽  
Nilipaer Alimu ◽  
Halimulati Muertiza ◽  
Pilidong Kuyaxi
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Chronic Otitis Media ◽  
Clinical Analysis ◽  
Middle Ear Cholesteatoma

Comparison of Hearing Results by Type of Tympanoplasty with Mastoid Obliteration during Chronic Otitis Media Surgery

2009 ◽  
Vol 45 (2) ◽  
pp. 122
Author(s):  
Jeong Uk Choi ◽  
Seung Eun Oh ◽  
Dong Hoon Lee ◽  
Yong Bum Cho ◽  
Hyong Ho Cho
Keyword(s):  
Otitis Media ◽  
Chronic Otitis Media ◽  
Mastoid Obliteration ◽  
Hearing Results

Determining Otitis Media Severity from Middle Ear Fluid Analysis

1994 ◽  
Vol 103 (5_suppl) ◽  
pp. 43-45 ◽  
Author(s):  
Steven K. Juhn ◽  
William J. Garvis ◽  
Chap T. Le ◽  
Chris J. Lees ◽  
C. S. Kim
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Chronic Otitis Media ◽  
Complex Nature ◽  
Fluid Analysis ◽  
Factor Α ◽  
Necrosis Factor ◽  
Ear Effusion ◽  
Chemical Mediators

Otitis media has a complex multifactorial pathogenesis, and the middle ear inflammatory response is typified by the accumulation of cellular and chemical mediators in middle ear effusion. However, specific biochemical and immunochemical factors that may be responsible for the severity or chronicity of otitis media have not been identified. Identification of factors involved in chronicity appears to be an essential step in the treatment and ultimate prevention of chronic otitis media. We analyzed 70 effusion samples from patients 1 to 10 years of age who had chronic otitis media with effusion for two cytokines (interleukrn-1β and tumor necrosis factor α) and total collagenase. The highest concentrations of all three inflammatory mediators were found in purulent otitis media, and concentrations were higher in younger than in older patients. Mediator concentrations were similar in samples obtained from patients having their first myringotomy for otitis media with effusion and in those who had had multiple previous myringotomies. The multiresponse star, which incorporates several biochemical parameters in one graphic illustration, may best characterize the complex nature of middle ear inflammation.

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