scholarly journals Experimental middle ear surgery in rabbits: a new approach for reconstructing the ossicular chain

2009 ◽  
Vol 43 (2) ◽  
pp. 198-204 ◽  
Author(s):  
M Stieve ◽  
H J Hedrich ◽  
R D Battmer ◽  
P Behrens ◽  
P Müller ◽  
...  
Keyword(s):  
Middle Ear ◽  
Bone Conduction ◽  
Hearing Threshold ◽  
Ossicular Chain ◽  
Ceramic Materials ◽  
Middle Ear Surgery ◽  
Electric Response ◽  
Hearing Level ◽  
Erbium:Yag Laser ◽  
Significant Difference

This experimental animal study aimed at evaluating a new prosthesis to replace the ossicular chain; we developed a new technique for surgical implantation into the middle ear of rabbits. The rabbit middle ear is, owing to the relative anatomical dimensions involved, an ideal environment for implantation procedures involving the ossicles, as the surgical conditions are similar to those of the human middle ear. This study included a total of 34 approximately six-month-old female white rabbits (New Zealand) weighing between 3.2 and 4.4 kg. The implants used were constructed of ceramic materials (titania, TiO2) of various pore sizes. Directly prior to implanting the total ossicular reconstruction prostheses (TORPs), as well as at 28, 84 and 300 days after implantation, electric response audiometry was used to determine the hearing thresholds of the animals (bone conduction; click stimulus nHL). An erbium:YAG laser was used to excise the original ossicular chain. Following implantation, we were unable to detect any stenosis of the outer ear canal or perforation of the tympanic membrane. The conductive hearing threshold was in the range of 4.21 ± 6.68 dB nHL ( n = 131). The hearing level showed no significant difference before and after surgery ( P < 0.05).

scholarly journals Factors that have an influence on bone conduction thresholds changes after otosurgery in the patients operated on due to the perforation of the tympanic membrane with the preserved ossicular chain

2017 ◽  
Vol 71 (4) ◽  
pp. 26-33
Author(s):  
Maciej Wiatr ◽  
Agnieszka Wiatr ◽  
Sebastian Kocoń ◽  
Jacek Składzień
Keyword(s):  
Tympanic Membrane ◽  
Middle Ear ◽  
Negative Impact ◽  
Positive Impact ◽  
Round Window ◽  
Bone Conduction ◽  
Ossicular Chain ◽  
Middle Ear Surgery ◽  
Ear Surgery ◽  
Study Objective

Introduction: The aim of the middle ear surgery is to eliminate abnormalities from the mucous, ensure the due airing of the postoperative cavity and reconstruct the sound-conducting system in the middle ear. Numerous reports can be found in literature on the changes to bone conduction as a consequence of middle ear surgery. Study objective: The aim of the work is to define the factors that affect bone conduction in the patients operated on due to the perforation of the tympanic membrane with the preserved and normal mobile ossicular chain. Material and method: A prospective analysis of patients operated on due to diseases of the middle ear in 2009–2012 was carried out. The cases of patients operated on for the first time due to chronic otitis media were taken into consideration. The analysis encompassed the patients who had undergone myringoplasty. The patients were divided into several groups taking into account the abnormalities of the mucous observed during otosurgery. Results: A significant improvement of bone conduction was observed in the patients with dry perforation, without other lesions in the middle ear. The appropriate pharmacological treatment before otosurgery in patients with permanent discharge from the ear resulted in significant bone conduction improvement. The elimination of granulation lesions turned out to be a positive factor for the future improvement of the function of the inner ear. Conclusions: The lack of abnormalities on the mucous of the middle ear (e.g. granulation,) and discharge has a positive impact on improvement of bone conduction after myringoplasty. Adhesions in the tympanic cavity, especially in the niche of the round window, have a negative impact on improvement of bone conduction in patients after myringoplasty.

scholarly journals Transcanal endoscopic treatment for congenital middle ear cholesteatoma in children

2021 ◽  
Author(s):  
Nan Zeng ◽  
Meng Liang ◽  
Shang Yan ◽  
Lue Zhang ◽  
Qiong Yang ◽  
...  
Keyword(s):  
Middle Ear ◽  
Endoscopic Treatment ◽  
Bone Conduction ◽  
Hearing Threshold ◽  
Sensorineural Deafness ◽  
Ossicular Chain ◽  
Surgical Trauma ◽  
Process Comparison ◽  
Middle Ear Cholesteatoma ◽  
The Mean

Abstract Background To investigate the feasibility and efficacy of transcanal endoscopic treatment for congenital middle ear cholesteatoma in children. Methods Eleven children diagnosed with congenital middle ear cholesteatoma were collected at Huazhong University of Science and Technology Union Shenzhen Hospital from January 2016 to December 2020. The retrospective study of their operation process, comparison of pre- and post-operative hearing result, surgical complications through the surgical video. Results Eleven children received total ear endoscopic surgery under general anesthesia. One of them received planned second operation to reconstruct the ossicular chain. At six months after operation, 11 children underwent re-examination. The mean bone conduction hearing threshold had no significant change (P>0.05), the mean air conduction hearing threshold was significantly decreased (P<0.05), and the air-bone conduction difference was significantly reduced (P<0.05). In 11 children, the air-bone conduction difference were all reduced to less than 20 dB, and 7 cases were reduced to less than 10 dB. All the children were followed up so far without sensorineural deafness, facial paralysis and other serious complications, as well as no recurrence. Conclusion Otoendoscope can provide a wide-angle field of vision and advantages in small surgical trauma, quick healing, avoiding repeated dressing changes and high acceptance of secondary surgery. Intraoperative application of 30° and 45° otoendoscope can effectively reduce residuals. Otoendoscope is widely used as a surgical method in the treatment of congenital middle ear cholesteatoma in children.

scholarly journals A study of occurrence of postoperative sensorineural hearing loss after middle ear surgeries

2017 ◽  
Vol 3 (3) ◽  
pp. 510
Author(s):  
Md. Shafiuddin Mazhar ◽  
Shrikrishna B. H.
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Middle Ear ◽  
Pure Tone ◽  
Bone Conduction ◽  
Hearing Threshold ◽  
Sensorineural Hearing ◽  
Middle Ear Surgery ◽  
Post Surgery ◽  
Duration Of Surgery

<p class="abstract"><strong>Background:</strong> Chronic otitis media is the most common middle ear disease that is encountered in our hospital. There are various surgical procedures that are performed in cases of COM and other similar conditions of the middle ear. Any type of otosurgical procedure involves the risk of inner ear damage. As middle ear surgery is also performed for functional reasons this risk should be taken into consideration. There have been some studies mentioning many insults to the cochlea during middle ear surgeries. Some studies claim that sensorineural hearing loss post-surgery is not significant at all. In view of these contradictory studies, further study is essential on this subject<span lang="EN-IN">. </span></p><p class="abstract"><strong>Methods:</strong> All patients undergoing middle ear surgeries are subjected to pure tone audiometry pre-operatively and tenth day, one month and three months postoperatively. Hearing assessment done with pure tone audiometer. The hearing threshold for pure tone audiometer was determined in a sound treated room at frequencies ranging from 125-8000 Hz for air conduction and 250-4000 Hz for bone conduction<span lang="EN-IN">.  </span></p><p class="abstract"><strong>Results:</strong> Sensorineural hearing loss was not found in any of the patients postoperatively on 10th day 1st month and 3rd month<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> There was no significant variation between preoperative and postoperative bone conduction levels.  Therefore middle ear surgeries have not resulted in any SNHL. Duration of ear discharge, duration of surgery, type of surgery had no bearing on postoperative sensory neural hearing levels<span lang="EN-IN">.</span></p>

A new device for real-time peroperative monitoring of ossicular chain reconstruction during middle ear surgery

2019 ◽  
Vol 34 (4) ◽  
pp. 827-832
Author(s):  
Van Son Nguyen ◽  
Didier Rouxel ◽  
Brice Vincent ◽  
Joël Ducourneau ◽  
Cécile Parietti-Winkler
Keyword(s):  
Real Time ◽  
Middle Ear ◽  
Ossicular Chain ◽  
Middle Ear Surgery ◽  
Ear Surgery ◽  
New Device ◽  
Ossicular Chain Reconstruction

Eosinophilic Inflammation in the Middle Ear Induces Deterioration of Bone-Conduction Hearing Level in Patients With Eosinophilic Otitis Media

2010 ◽  
Vol 31 (1) ◽  
pp. 100-104 ◽  
Author(s):  
Yukiko Iino ◽  
Hajime Usubuchi ◽  
Kozue Kodama ◽  
Hiromi Kanazawa ◽  
Katsumi Takizawa ◽  
...  
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Bone Conduction ◽  
Hearing Level ◽  
Eosinophilic Inflammation ◽  
Bone Conduction Hearing

Standard Anesthetic Technique for Middle Ear Surgical Procedures: A Comparison of Desflurane and Sevoflurane

2005 ◽  
Vol 133 (2) ◽  
pp. 269-274 ◽  
Author(s):  
W. Scott Jellish ◽  
Kevin Owen ◽  
Steven Edelstein ◽  
Elaine Fluder ◽  
John P. Leonetti
Keyword(s):  
Middle Ear ◽  
Operating Conditions ◽  
Anesthetic Technique ◽  
Middle Ear Surgery ◽  
Pain Scores ◽  
Significant Difference ◽  
Discharge Readiness ◽  
History Of ◽  
Blood Pressures ◽  
To Receive

Objective: This study was designed to compare desflurane and sevoflurane anesthesia for middle ear microsurgery. Study Design: One hundred healthy adults undergoing middle ear surgery were assigned to receive either desflurane or sevoflurane as their anesthetic. Intraoperative hemodynamics and BIS numbers were recorded. Hemodynamics, pain, nausea/vomiting, discharge readiness, and other parameters were compared postoperatively and 24 hours later. Results: No intraoperative differences were noted except in BIS scores which trended lower with desflurane. PACU blood pressures were higher after desflurane but pain scores, nausea/vomiting, rescue anti-emetics, recovery scores, and discharge times were similar. A significant difference was noted in anesthetic costs (desflurane > sevoflurane), and in patients with the lowest BIS scores associated with more nausea/vomiting. Conclusions: Both anesthetics may be used for ototic surgery but propofol anesthesia should still be considered in patients with a history of emetic sequelae. Significance: Short-acting inhalational anesthetics produce excellent operating conditions and reduce costs for otologic surgery.

Effect of Changes in Mass on Middle Ear Function

1993 ◽  
Vol 109 (5) ◽  
pp. 899-910 ◽  
Author(s):  
Shinsei Nishihara ◽  
Hiroshi Aritomo ◽  
Richard L. Goode
Keyword(s):  
Middle Ear ◽  
Hearing Threshold ◽  
Laser Doppler Vibrometer ◽  
Ossicular Chain ◽  
High Frequencies ◽  
Before And After ◽  
Ventilation Tubes ◽  
Temporal Bones ◽  
Middle Ear Transfer Function ◽  
Vibrating Systems

Vibrating systems such as the middle ear are affected by changes in mass. After disease or ear surgery, significant changes in mass may contribute positively or negatively to the postoperative hearing threshold. This article describes experiments in 15 human temporal bones of the addition or reduction of mass on the middle ear transfer function. Measurement of stapes and umbo vibration was performed using a Laser Doppler Vibrometer before and after the addition of different masses at several sites on the tympanic membrane (TM) and ossicular chain. The input was 61 pure tones swept from 147 to 19433 Hz at 80 dB SPL. The addition of mass onto the TM produced varying detrimental effects on sound transmission, depending on the location and amount of mass. The insertion of ventilation tubes, weighing 12 to 17 mg each, produced losses at 1.5 to 5.0 kHz compared with tympanotomy alone. Addition of mass to the umbo and malleus head produced a loss at mid and high frequencies, whereas addition of mass on the incus long process and stapes also produced a high-frequency decrease in stapes displacement. Reduction of TM mass by removal of the epithelium produced an increase, especially at 2.0 to 4.0 kHz.

scholarly journals The Effect of Dexmedetomidine and Esmolol on Early Postoperative Cognitive Dysfunction After Middle Ear Surgery Under Hypotensive Technique: A Comparative, Randomized, Double-blind Study

2020 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Mahmoud Hussein Bahr ◽  
Samaa A Kasem Rashwan ◽  
Doaa Abu Elkassim Rashwan
Keyword(s):  
Cognitive Dysfunction ◽  
Middle Ear ◽  
Postoperative Cognitive Dysfunction ◽  
Adult Patients ◽  
Cerebral Injury ◽  
Middle Ear Surgery ◽  
Double Blind Study ◽  
Arterial Blood ◽  
Hypotensive Anesthesia ◽  
Significant Difference

Objectives: Postoperative cognitive dysfunction (POCD) is multifactorial, which may be caused by anesthetic and surgical causes or cerebral injury. This study aimed to evaluate the effect of dexmedetomidine as a neuroprotective drug compared to esmolol on the prevalence of POCD in adult patients undergoing middle ear surgeries under hypotensive anesthesia. Methods: This study included male and female adult patients, according to American Society of Anesthesiology physical status (ASA) I, the patients who underwent middle ear surgeries under hypotensive anesthesia were randomly assigned to two groups that received esmolol and dexmedetomidine. The demographic data, heart rate, mean arterial blood pressure, duration of the surgery, evaluation of the surgical field, and the Mini-Mental State Examination (MMSE) (preoperatively and at 1, 6 and 24 hours postoperatively) were recorded. Results: There was a significant difference between the numbers of patients who had POCD in MMSE1: 12 cases in the esmolol group (41.37%) compared to three cases in the dexmedetomidine group (10.34%) (P = 0.016), in MMSE6: 10 cases in the esmolol group (34.48%) compared with two cases in the dexmedetomidine group (6.89%) (P = 0.023) and in MMSE24: seven cases in the esmolol group (24.13%) compared with one case in the dexmedetomidine group (3.44%) (P = 0.022), while the median and range of MMSE score were comparable between the two groups (P > 0.05). Conclusions: This study suggests that intraoperative use of dexmedetomidine as an adjuvant to hypotensive anesthesia reduces the incidence of POCD compared to esmolol.

scholarly journals Effect of Dexmeditomidine on Isofluorane Consumption in Middle Ear Surgery

2020 ◽  
Vol 5 (2) ◽  
pp. 14-19
Author(s):  
Smriti Bandhu ◽  
Arunabh Mukharjee
Keyword(s):  
Heart Rate ◽  
Middle Ear ◽  
Normal Saline ◽  
Middle Ear Surgery ◽  
Ear Surgery ◽  
Mean Values ◽  
Isoflurane Concentration ◽  
Significant Difference ◽  
Surgical Field ◽  
End Tidal

Background: With the introduction of intentional hypotensive anesthesia in the surgical field to achieve a relatively bloodless surgical field along with the use of the operative microscope, it has revolutionized the middle ear surgery practice. Dexmedetomidine is a relatively new and potent α2 agonist prototype found efficient in rendering bloodless intra-surgical field and inducing controlled hypotension during the surgeries of the middle ear. The objective is to present prospective study was aimed at evaluating with and without dexmedetomidine infusion effect on end-tidal isoflurane concentration for lowering blood pressure by 30%, awakening time and quality of bloodless surgical field during middle ear surgical procedure. Subjects and Methods:54 patients who were to undergo middle ear surgery and had ASA I and II were randomly divided into the two groups. In Group I Dexmedetomidine was used and in Group II Normal saline. Effect of Dexmedetomidine infusion on end-tidal isoflurane concentration for lowering blood pressure by 30%, awakening time, quality of bloodless surgical field during middle ear surgical procedure, heart rate was evaluated. The data collected were statistically analyzed. Results: The mean values of the heart rate were statistically non-significant between the groups when recorded at the baseline, whereas, a statistically significant difference was seen in the values for heart rate intra-operatively. The mean values for heart rates were significantly higher for the placebo group. A significant difference in Isoflurane concentration was found with dexmedetomidine requiring a percentage of 0.6 0.4 and normal saline 1.8 0.5. Less bleeding was seen with dexmedetomidine. Conclusion:  Dexmedetomidine is a potent hypotensive agent which also reduces the requirement of Isoflurane compared  to the normal saline placebo. The use of dexmedetomidine is relatively safe and provide a relatively bloodless surgical field, hence, increasing efficacy, and improving visibility at the surgical site.

Temporalis Fascia and Cartilage-Perichondrium Composite Shield Grafts for Reconstruction of the Tympanic Membrane

2009 ◽  
Vol 118 (8) ◽  
pp. 570-574 ◽  
Author(s):  
Sertac Yetiser ◽  
Yusuf Hidir
Keyword(s):  
Tympanic Membrane ◽  
Bone Conduction ◽  
Hearing Threshold ◽  
Functional Results ◽  
Mean Value ◽  
Acoustic Energy ◽  
Type I ◽  
Temporalis Fascia ◽  
Significant Difference ◽  
And Cartilage

Objectives We sought to compare the long-term functional results of tympanic membrane reconstruction with temporalis fascia and cartilage shield grafting. Methods This study includes 113 patients who had tympanoplasty type I tympanic membrane reconstruction between 1997 and 2007, 47 with tragal cartilage and 66 with temporalis fascia. Fourteen patients in the cartilage group and 9 patients in the temporalis fascia group also had mastoidectomy. The average follow-up was 3.2 years. The hearing threshold was calculated as the mean value of the thresholds for 500, 1,000, 2,000, and 3,000 Hz. A paired-samples t-est was used for comparison of the preoperative and postoperative air and bone conduction hearing thresholds and air-bone gaps. Results Significant recovery was found in the postoperative air conduction threshold and air-bone gap in both the temporalis fascia and cartilage groups as compared to those before surgery (p < 0.001). However, the average air and bone conduction thresholds and air-bone gap were found to be statistically different after surgery in the cartilage group as compared to those in the temporalis fascia group. There was no significant difference in hearing parameters before and after surgery in patients with or without mastoidectomy in either the cartilage group or the temporalis fascia group. Conclusions The hearing gain in patients with cartilage shield grafting was better than that in those who had temporalis fascia tympanoplasty, although experimental analysis shows loss of acoustic energy for thick and large shield cartilage grafts.

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