Objectives: To assess postoperative hearing level, and factors that may have influence hearing improvement after myringoplasty.Methods: Twenty six cases of successful myringoplasty were included in this prospective st...Objectives: To assess postoperative hearing level, and factors that may have influence hearing improvement after myringoplasty.Methods: Twenty six cases of successful myringoplasty were included in this prospective study. Patient parameters including age, gender, size and site of the perforation, mastoid status, and etiology were evaluated. Hearing levels were assessed as the mean air conduction(AC), and airbone gap(ABG) at 500, 1000, and 2000 Hz, and their relation with aforementioned parameters were analyzed.Results: The mean AC hearing gain was 22.373 dB and mean ABG reduction was 20.733 dB. The maximum AC hearing gain was 25.93 dB for subtotal perforation and 26.24 dB for big central perforation, and the maximum ABG reduction was 25.63 dB for subtotal perforation and 24.20 for big central perforation. Mean AC hearing gain was 23.01 dB, 22.72 dB, and 21.39 dB for 500, 1000, and 2000 Hz, respectively, and mean ABG reduction was 21.52 dB, 20.79 dB, and 19.86 dB for 500, 1000, and 2000 Hz, respectively. Patient age, gender, mastoid status and etiology did not seem to have any bearing on postoperative hearing improvement.Conclusion: While patient parameters do not seem to correlate with hearing improvement following myringoplasty, the size and location of perforation appear to have an impact on postoperative hearing outcomes. Most hearing improvement appears to occur at 500 Hz.展开更多
Objective: To investigate the feasibility of transcanal endoscopic myringoplasty in the hand of young beginner surgeons who had just completed the residency programme.Methods: In a three year period(August 2012 to Aug...Objective: To investigate the feasibility of transcanal endoscopic myringoplasty in the hand of young beginner surgeons who had just completed the residency programme.Methods: In a three year period(August 2012 to August 2015), 44 ears in 42 patients were operated upon by a beginner surgeon through the transcanal endoscopic approach in a subdistrict level hospital located in the north western ranges of the Himalayan region.Results: Of the 42 patient, 19 were male and 23 female. The mean age was 26.23 years(range: 15 e47 years). In 40 ears, complete perforation closure was achieved at six months(success rate: 90.9%). The mean air conduction PTA preoperatively was 40.84 dB HL and improved to 28.06 dB HL postoperatively(p <.001). The mean AB gap preoperatively was 22.40 dB, which improved to 9.1 dB postoperatively(p <.001).Conclusion: Endoscopic transcanal myringoplasty is safe and reliable even in young beginners' hands.Surgeons can consider endoscopic approach early in their careers without the fear of learning curve. The cost of endoscopic equipment is about one tenth as compared to open approach under a operating microscope, and an added advantage.展开更多
Objective/Hypothesis: We have tried to present some of our concerns regarding the usually adopted surgical techniques of Myringoplasty with their possible solutions. Also we have tried to present digital recordings of...Objective/Hypothesis: We have tried to present some of our concerns regarding the usually adopted surgical techniques of Myringoplasty with their possible solutions. Also we have tried to present digital recordings of pre and post-operative findings in reference cases, which have been provided rarely in available literature. Pre- and post-operative pictures and videos of two representative cases are attached. Study design: This prospective study was carried out in MMABM hospital. Forty six (46) ears, 37 patients underwent tympanoplasty by the modified dual grafting technique and the results were analysed. Results: Objectives of tympanic membrane repair, dry ear, closure of AB gap, and stoppage of tinnitus if any, were achieved in all cases. Small residual perforations which healed over time were seen in two cases in cartilage deficient areas. Conclusion: Dual graft modified techniques served as an effective alternative myringoplasty technique.展开更多
The purpose of closure of small dry tympanic membrane perforations is to restore the continuity of the tympanic membrane in order to improve hearing and decrease the incidence of middle ear infections. Small and cost ...The purpose of closure of small dry tympanic membrane perforations is to restore the continuity of the tympanic membrane in order to improve hearing and decrease the incidence of middle ear infections. Small and cost effective procedures like Chemical Cauterization and Fat Plug Myringoplasty have been found to be effective in healing small central perforations with significant hearing improvement. A study was carried out in 69 patients with central perforations in the Department of ENT, Gauhati Medical College & Hospital for the duration of 1 year from August 11 to July 12. Out of 69 patients, 36 underwent Chemical Cauterization and 33 Fat Plug Myringoplasty. Pre-and post-operative hearing assessments of each patient were done and statistically analyzed. The success rate was found to be 83.33% and 90.9% respectively. In both groups, there was statistically significant hearing improvement with a P value 0.01. From our study, it was found that the two procedures are simple, reliable and also lessened the morbidity of the patient. Thus we recommend the use of these two official procedures for the treatment of central perforations of tympanic membrane less than 5 mm.展开更多
Objective: To determine Eustachian tube function in tubotympanic type of chronic ear disease and to correlate Eustachian tube function with pathological change in middle ear mucosa. Materials and Methods: A prospectiv...Objective: To determine Eustachian tube function in tubotympanic type of chronic ear disease and to correlate Eustachian tube function with pathological change in middle ear mucosa. Materials and Methods: A prospective study of the cases of tubotympanic type of chronic suppurative otitis media was undertaken. Patients were subjected to clinical examination followed by audiometry tests and impedence audiometry to determine eustachian tube functions. Patients were then subjected to myringoplasty and eustachian tube function were then reassessed post operatively. Results: In our study, out of 30 cases who underwent myringoplasty, 21 cases had successful surgical outcome and 9 cases were failed. Out of 24 cases of good Eustachian tube function, 21 cases had successful surgical outcome intends of taking up graft, absence of otorrhea and improvement in hearing. In remaining 3 cases, there was recurrence of otorrhea with central perforation. All the 6 cases with poor Eustachian tube function had surgical failure. Conclusion: The prognosis of the middle ear reconstructive surgery has direct correlation with Eustachian tube functions and Eustachian tube function tests should be a routine investigation in all the cases planned for surgical reconstruction of the middle ear.展开更多
<strong>Background:</strong> Myringoplasty is a technique for the closure of the simple perforation of the tympanic membrane. For the better outcome, myringoplasty combined with cortical mastoidectomy has ...<strong>Background:</strong> Myringoplasty is a technique for the closure of the simple perforation of the tympanic membrane. For the better outcome, myringoplasty combined with cortical mastoidectomy has been tried in many studies. <strong>Objectives:</strong> To compare the outcome of repair of tympanic membrane perforations with myringoplasty alone versus myringoplasty with opening of blocked aditus if any by doing antrostomy. <strong>Methodology:</strong> This was a prospective study. Patients included in the study were randomly allocated into 2 groups, the group I and the group II. The group I included 17 patients undergoing myringoplasty with antrostomy and the group II included 17 patients undergoing only myringoplasty. The blocked aditus was made patent if it was found blocked during antrostomy procedure. Graft uptake rate and improvement in conductive hearing loss were measured as success rate. <strong>Results:</strong> Mean age of the patients in the group I was 23.12 ± 7.55 years. The mean age of patients in the group II was 25.53 ± 8.79 years. In the group I unilateral disease was present in 6 (35%) cases. In the group II unilateral disease was present in 12 (70.5%) cases. In the group I subtotal perforation was present in 9 (52.9%) cases and moderate to large perforation was present in 8 (47%) cases. In the group II subtotal perforation and moderate to large perforation were present in 9 (52.9%) and 8 (47%) cases respectively. Aditus was found to be blocked in eleven (64.7%) patients in the group I. Successful graft uptake was seen in twelve cases (70.58%) in the group I and eleven cases (64.7%) in the group II with all of them showing improvement in hearing. The success rate of the group I was 70.58% while success rate of the group II was 64.7%. The mean of pre-operative and post-operative air-bone gap was 31.94 ± 11.7 dB and 24.8 ± 10.55 dB respectively in the group I with the mean hearing gain of 7.06 ± 3.9 dB. Similarly, the mean of pre-operative and post-operative air-bone gap was 28.24 ± 10.5 dB and 17.9 ± 0.08 dB respectively in the second group with the mean hearing gain of 10.29 ± 4.83 dB. <strong>Conclusion:</strong> There was no difference between success rate of myringoplasty with antrostomy group and myringoplasty alone group in the treatment of mucosal tympanic membrane perforation;however in majority of cases where aditus patency was checked (group I) it was found to be blocked (64.7%).展开更多
Objective:Assess the long-term outcome of pediatric myringoplasty.Methods:Tympanoplasty type I,myringoplasty,was performed on 85 children(91 consecutive operations,74 primary and 17 revisions)under 16 years of age.The...Objective:Assess the long-term outcome of pediatric myringoplasty.Methods:Tympanoplasty type I,myringoplasty,was performed on 85 children(91 consecutive operations,74 primary and 17 revisions)under 16 years of age.The perforations were sequela either to acute or chronic inflammatory middle ear disease.Medial grafting technique was employed with temporalis fascia.Adenoidectomy was performed earlier on all but five children.The preoperative observation period exceeded one year for all patients.The mean follow-up was 5.4(SD 3.6)years.Results:The long-term graft take rate was 84%for primary myringoplasty,and 53%for revision operations.The re-perforations were associated with postoperative discharge,subtotal or total perforation and revision surgery.In the cohort,sixty ears(66%)were completely healthy(intact tympanic membrane in normal position without adhesions and with good mobility)after follow-up.Spontaneous healing took place in 37%after re-perforation.The preoperative ventilation tube treatment did not affect the outcome and there were no differences between age groups.Preoperative sonotubometry or Valsalva test results did not correlate with outcome.Four ears needed a ventilation tube during the follow-up due to poor ventilation.The mean pure tone thresholds improved significantly after operation.Conclusions:Myringoplasty in children is a reliable procedure without age restrictions.One year of preoperative observation excludes most unstable ears,and high tendency of spontaneous healing after re-perforation suggests the need for a lengthy follow-up before revision surgery.展开更多
Purpose:Myringoplasty aims to improve hearing and prevent otorrhea,making graft uptake rates and hearing crucial considerations.This study analyzed the factors associated with unsuccessful graft uptake and hearing imp...Purpose:Myringoplasty aims to improve hearing and prevent otorrhea,making graft uptake rates and hearing crucial considerations.This study analyzed the factors associated with unsuccessful graft uptake and hearing improvement to guide the selection of optimal surgical approaches for myringoplasty.Methods:We retrospectively reviewed 56 ears with chronic otitis media.All patients were followed up for>6 months after tympanic membrane closure surgery.We compared the underlay method using the transcanal approach with the inlay method using the retroauricular approach for myringoplasty in patients with chronic otitis media.The underlay and inlay methods were used for 23 and 33 ears,respectively.The primary outcomes were graft uptake rate and hearing improvement.Additionally,factors such as the location of tympanic membrane perforation,patient age,and the degree of mastoid development were evaluated.Results:The perforation rate was high when the transcanal underlay method was employed to repair perforations in the anterior inferior quadrant.Both the underlay and inlay methods significantly improved hearing.However,the success rate of the inlay method was lower.Within the cases performed using the inlay method,outcomes tended to be poorer in older age groups.There were no significant differences in surgical success rates related to mastoid development.Conclusion:The inlay method using the retroauricular approach is a favorable option for repairing perforations involving the anterior inferior quadrant.However,older patients presented lower rates of hearing improvement when the inlay method was used.展开更多
Middle ear surgery is usually performed using a surgical microscope. Initially, in otorhinolaryngology practice, endoscopes were used for paranasal sinus surgeries. It was only later that they were applied in the area...Middle ear surgery is usually performed using a surgical microscope. Initially, in otorhinolaryngology practice, endoscopes were used for paranasal sinus surgeries. It was only later that they were applied in the area of otology. In otologic surgeries, endoscopes were first used to visualize the middle ear, before being used to assist with visualization of instruments during cholesteatoma surgeries, although they are still not used alone in various otologic surgeries. As in other surgical fields, there is also a trend towards minimally invasive intervention in the field of otorhinolaryngology. Smaller incisions performed under the guidance of endoscopes are preferred over conventional large incisions. Using this approach, improved outcomes can be achieved and postoperative morbidities can be reduced. In addition, the outcomes of grafts performed using the endoscopic approach are similar to that achieved by the microscopic approach. Therefore, endoscopic ear surgery implementations are becoming increasingly popular.展开更多
Objective: To study the clinical and therapeutic epidemiological profile of chronic purulent otorrhea in the ENT and CCF departments of the Gabriel Touré university hospital. Materials and Method: This was a retr...Objective: To study the clinical and therapeutic epidemiological profile of chronic purulent otorrhea in the ENT and CCF departments of the Gabriel Touré university hospital. Materials and Method: This was a retrospective study from May 2019 to April 2021. We made an exhaustive sampling of all patients who consulted for chronic purulent otorrhea with a complete medical file. All ages were included (except from 0 to - 5 years), and all sexes combined. The data medium was the patient records and the department’s operating report register. The non-inclusion criteria were patients with incomplete files and patients who were less than 5 years old. Results: In total, we collected 135 cases. The average age of our patients was 29.27 years. The most represented age group was 16 to 25 years old. We noted a male predominance in 60.7%. The associated signs found were hearing loss, earache, tinnitus, ear pruritus, vertigo, headache and facial paralysis. The main pathology involved is chronic otitis media (CMO) in 55.5%, the most serious of which is dangerous chronic otitis (8.1%). All of our patients have received medical treatment. The treatment was surgical in 64% of patients after medical treatment. With the mean follow-up of 6 months, tinnitus and reperforation were the most common complications found in 6.2% and 3.1% respectively. Conclusion: Chronic purulent otorrhea is the most common ear discharge in ENT consultation. The main pathology involved is CMO, the most formidable of which is cholesteatoma. Medico-surgical treatment.展开更多
Approximately 740 million symptomatic patients are affected by otitis media every year.Being an inflammatory disease affecting the middle ear,it is one of the primary causes of tympanic membrane(TM)perforations,often ...Approximately 740 million symptomatic patients are affected by otitis media every year.Being an inflammatory disease affecting the middle ear,it is one of the primary causes of tympanic membrane(TM)perforations,often resulting in impaired hearing abilities.Antibiotic therapy using broad-spectrum fluoroquinolones,such as ciprofloxacin(CIP),is frequently employed and considered the optimal route to treat otitis media.However,patients often get exposed to high dosages to compensate for the low drug concentration reaching the affected site.Therefore,this study aims to integrate tissue engineering with drug delivery strategies to create biomimetic scaffolds promoting TM regeneration while facilitating a localized release of CIP.Distinct electrospinning(ES)modalities were designed in this regard either by blending CIP into the polymer ES solution or by incorporating nanoparticles-based co-ES/electrospraying.The combination of these modalities was investigated as well.A broad range of release kinetic profiles was achieved from the fabricated scaffolds,thereby offering a wide spectrum of antibiotic concentrations that could serve patients with diverse therapeutic needs.Furthermore,the incorporation of CIP into the TM patches demonstrated a favorable influence on their resultant mechanical properties.Biological studies performed with human mesenchymal stromal cells confirmed the absence of any cytotoxic or anti-proliferative effects from the released antibiotic.Finally,antibacterial assays validated the efficacy of CIP-loaded scaffolds in suppressing bacterial infections,highlighting their promising relevance for TM applications.展开更多
文摘Objectives: To assess postoperative hearing level, and factors that may have influence hearing improvement after myringoplasty.Methods: Twenty six cases of successful myringoplasty were included in this prospective study. Patient parameters including age, gender, size and site of the perforation, mastoid status, and etiology were evaluated. Hearing levels were assessed as the mean air conduction(AC), and airbone gap(ABG) at 500, 1000, and 2000 Hz, and their relation with aforementioned parameters were analyzed.Results: The mean AC hearing gain was 22.373 dB and mean ABG reduction was 20.733 dB. The maximum AC hearing gain was 25.93 dB for subtotal perforation and 26.24 dB for big central perforation, and the maximum ABG reduction was 25.63 dB for subtotal perforation and 24.20 for big central perforation. Mean AC hearing gain was 23.01 dB, 22.72 dB, and 21.39 dB for 500, 1000, and 2000 Hz, respectively, and mean ABG reduction was 21.52 dB, 20.79 dB, and 19.86 dB for 500, 1000, and 2000 Hz, respectively. Patient age, gender, mastoid status and etiology did not seem to have any bearing on postoperative hearing improvement.Conclusion: While patient parameters do not seem to correlate with hearing improvement following myringoplasty, the size and location of perforation appear to have an impact on postoperative hearing outcomes. Most hearing improvement appears to occur at 500 Hz.
文摘Objective: To investigate the feasibility of transcanal endoscopic myringoplasty in the hand of young beginner surgeons who had just completed the residency programme.Methods: In a three year period(August 2012 to August 2015), 44 ears in 42 patients were operated upon by a beginner surgeon through the transcanal endoscopic approach in a subdistrict level hospital located in the north western ranges of the Himalayan region.Results: Of the 42 patient, 19 were male and 23 female. The mean age was 26.23 years(range: 15 e47 years). In 40 ears, complete perforation closure was achieved at six months(success rate: 90.9%). The mean air conduction PTA preoperatively was 40.84 dB HL and improved to 28.06 dB HL postoperatively(p <.001). The mean AB gap preoperatively was 22.40 dB, which improved to 9.1 dB postoperatively(p <.001).Conclusion: Endoscopic transcanal myringoplasty is safe and reliable even in young beginners' hands.Surgeons can consider endoscopic approach early in their careers without the fear of learning curve. The cost of endoscopic equipment is about one tenth as compared to open approach under a operating microscope, and an added advantage.
文摘Objective/Hypothesis: We have tried to present some of our concerns regarding the usually adopted surgical techniques of Myringoplasty with their possible solutions. Also we have tried to present digital recordings of pre and post-operative findings in reference cases, which have been provided rarely in available literature. Pre- and post-operative pictures and videos of two representative cases are attached. Study design: This prospective study was carried out in MMABM hospital. Forty six (46) ears, 37 patients underwent tympanoplasty by the modified dual grafting technique and the results were analysed. Results: Objectives of tympanic membrane repair, dry ear, closure of AB gap, and stoppage of tinnitus if any, were achieved in all cases. Small residual perforations which healed over time were seen in two cases in cartilage deficient areas. Conclusion: Dual graft modified techniques served as an effective alternative myringoplasty technique.
文摘The purpose of closure of small dry tympanic membrane perforations is to restore the continuity of the tympanic membrane in order to improve hearing and decrease the incidence of middle ear infections. Small and cost effective procedures like Chemical Cauterization and Fat Plug Myringoplasty have been found to be effective in healing small central perforations with significant hearing improvement. A study was carried out in 69 patients with central perforations in the Department of ENT, Gauhati Medical College & Hospital for the duration of 1 year from August 11 to July 12. Out of 69 patients, 36 underwent Chemical Cauterization and 33 Fat Plug Myringoplasty. Pre-and post-operative hearing assessments of each patient were done and statistically analyzed. The success rate was found to be 83.33% and 90.9% respectively. In both groups, there was statistically significant hearing improvement with a P value 0.01. From our study, it was found that the two procedures are simple, reliable and also lessened the morbidity of the patient. Thus we recommend the use of these two official procedures for the treatment of central perforations of tympanic membrane less than 5 mm.
文摘Objective: To determine Eustachian tube function in tubotympanic type of chronic ear disease and to correlate Eustachian tube function with pathological change in middle ear mucosa. Materials and Methods: A prospective study of the cases of tubotympanic type of chronic suppurative otitis media was undertaken. Patients were subjected to clinical examination followed by audiometry tests and impedence audiometry to determine eustachian tube functions. Patients were then subjected to myringoplasty and eustachian tube function were then reassessed post operatively. Results: In our study, out of 30 cases who underwent myringoplasty, 21 cases had successful surgical outcome and 9 cases were failed. Out of 24 cases of good Eustachian tube function, 21 cases had successful surgical outcome intends of taking up graft, absence of otorrhea and improvement in hearing. In remaining 3 cases, there was recurrence of otorrhea with central perforation. All the 6 cases with poor Eustachian tube function had surgical failure. Conclusion: The prognosis of the middle ear reconstructive surgery has direct correlation with Eustachian tube functions and Eustachian tube function tests should be a routine investigation in all the cases planned for surgical reconstruction of the middle ear.
文摘<strong>Background:</strong> Myringoplasty is a technique for the closure of the simple perforation of the tympanic membrane. For the better outcome, myringoplasty combined with cortical mastoidectomy has been tried in many studies. <strong>Objectives:</strong> To compare the outcome of repair of tympanic membrane perforations with myringoplasty alone versus myringoplasty with opening of blocked aditus if any by doing antrostomy. <strong>Methodology:</strong> This was a prospective study. Patients included in the study were randomly allocated into 2 groups, the group I and the group II. The group I included 17 patients undergoing myringoplasty with antrostomy and the group II included 17 patients undergoing only myringoplasty. The blocked aditus was made patent if it was found blocked during antrostomy procedure. Graft uptake rate and improvement in conductive hearing loss were measured as success rate. <strong>Results:</strong> Mean age of the patients in the group I was 23.12 ± 7.55 years. The mean age of patients in the group II was 25.53 ± 8.79 years. In the group I unilateral disease was present in 6 (35%) cases. In the group II unilateral disease was present in 12 (70.5%) cases. In the group I subtotal perforation was present in 9 (52.9%) cases and moderate to large perforation was present in 8 (47%) cases. In the group II subtotal perforation and moderate to large perforation were present in 9 (52.9%) and 8 (47%) cases respectively. Aditus was found to be blocked in eleven (64.7%) patients in the group I. Successful graft uptake was seen in twelve cases (70.58%) in the group I and eleven cases (64.7%) in the group II with all of them showing improvement in hearing. The success rate of the group I was 70.58% while success rate of the group II was 64.7%. The mean of pre-operative and post-operative air-bone gap was 31.94 ± 11.7 dB and 24.8 ± 10.55 dB respectively in the group I with the mean hearing gain of 7.06 ± 3.9 dB. Similarly, the mean of pre-operative and post-operative air-bone gap was 28.24 ± 10.5 dB and 17.9 ± 0.08 dB respectively in the second group with the mean hearing gain of 10.29 ± 4.83 dB. <strong>Conclusion:</strong> There was no difference between success rate of myringoplasty with antrostomy group and myringoplasty alone group in the treatment of mucosal tympanic membrane perforation;however in majority of cases where aditus patency was checked (group I) it was found to be blocked (64.7%).
文摘Objective:Assess the long-term outcome of pediatric myringoplasty.Methods:Tympanoplasty type I,myringoplasty,was performed on 85 children(91 consecutive operations,74 primary and 17 revisions)under 16 years of age.The perforations were sequela either to acute or chronic inflammatory middle ear disease.Medial grafting technique was employed with temporalis fascia.Adenoidectomy was performed earlier on all but five children.The preoperative observation period exceeded one year for all patients.The mean follow-up was 5.4(SD 3.6)years.Results:The long-term graft take rate was 84%for primary myringoplasty,and 53%for revision operations.The re-perforations were associated with postoperative discharge,subtotal or total perforation and revision surgery.In the cohort,sixty ears(66%)were completely healthy(intact tympanic membrane in normal position without adhesions and with good mobility)after follow-up.Spontaneous healing took place in 37%after re-perforation.The preoperative ventilation tube treatment did not affect the outcome and there were no differences between age groups.Preoperative sonotubometry or Valsalva test results did not correlate with outcome.Four ears needed a ventilation tube during the follow-up due to poor ventilation.The mean pure tone thresholds improved significantly after operation.Conclusions:Myringoplasty in children is a reliable procedure without age restrictions.One year of preoperative observation excludes most unstable ears,and high tendency of spontaneous healing after re-perforation suggests the need for a lengthy follow-up before revision surgery.
文摘Purpose:Myringoplasty aims to improve hearing and prevent otorrhea,making graft uptake rates and hearing crucial considerations.This study analyzed the factors associated with unsuccessful graft uptake and hearing improvement to guide the selection of optimal surgical approaches for myringoplasty.Methods:We retrospectively reviewed 56 ears with chronic otitis media.All patients were followed up for>6 months after tympanic membrane closure surgery.We compared the underlay method using the transcanal approach with the inlay method using the retroauricular approach for myringoplasty in patients with chronic otitis media.The underlay and inlay methods were used for 23 and 33 ears,respectively.The primary outcomes were graft uptake rate and hearing improvement.Additionally,factors such as the location of tympanic membrane perforation,patient age,and the degree of mastoid development were evaluated.Results:The perforation rate was high when the transcanal underlay method was employed to repair perforations in the anterior inferior quadrant.Both the underlay and inlay methods significantly improved hearing.However,the success rate of the inlay method was lower.Within the cases performed using the inlay method,outcomes tended to be poorer in older age groups.There were no significant differences in surgical success rates related to mastoid development.Conclusion:The inlay method using the retroauricular approach is a favorable option for repairing perforations involving the anterior inferior quadrant.However,older patients presented lower rates of hearing improvement when the inlay method was used.
文摘Middle ear surgery is usually performed using a surgical microscope. Initially, in otorhinolaryngology practice, endoscopes were used for paranasal sinus surgeries. It was only later that they were applied in the area of otology. In otologic surgeries, endoscopes were first used to visualize the middle ear, before being used to assist with visualization of instruments during cholesteatoma surgeries, although they are still not used alone in various otologic surgeries. As in other surgical fields, there is also a trend towards minimally invasive intervention in the field of otorhinolaryngology. Smaller incisions performed under the guidance of endoscopes are preferred over conventional large incisions. Using this approach, improved outcomes can be achieved and postoperative morbidities can be reduced. In addition, the outcomes of grafts performed using the endoscopic approach are similar to that achieved by the microscopic approach. Therefore, endoscopic ear surgery implementations are becoming increasingly popular.
文摘Objective: To study the clinical and therapeutic epidemiological profile of chronic purulent otorrhea in the ENT and CCF departments of the Gabriel Touré university hospital. Materials and Method: This was a retrospective study from May 2019 to April 2021. We made an exhaustive sampling of all patients who consulted for chronic purulent otorrhea with a complete medical file. All ages were included (except from 0 to - 5 years), and all sexes combined. The data medium was the patient records and the department’s operating report register. The non-inclusion criteria were patients with incomplete files and patients who were less than 5 years old. Results: In total, we collected 135 cases. The average age of our patients was 29.27 years. The most represented age group was 16 to 25 years old. We noted a male predominance in 60.7%. The associated signs found were hearing loss, earache, tinnitus, ear pruritus, vertigo, headache and facial paralysis. The main pathology involved is chronic otitis media (CMO) in 55.5%, the most serious of which is dangerous chronic otitis (8.1%). All of our patients have received medical treatment. The treatment was surgical in 64% of patients after medical treatment. With the mean follow-up of 6 months, tinnitus and reperforation were the most common complications found in 6.2% and 3.1% respectively. Conclusion: Chronic purulent otorrhea is the most common ear discharge in ENT consultation. The main pathology involved is CMO, the most formidable of which is cholesteatoma. Medico-surgical treatment.
基金funded by the 4NanoEARDRM project,under the frame of EuroNanoMed III,an ERA-NET Cofund scheme of the Horizon 2020 Research and Innovation Framework Programme of the European Commission,the Netherlands Organization for Scientific Research(NWO,grant number OND1365231)German Federal Ministry of Education and Research(BMBF,grant number 13XP5061A)the Italian Ministry of Education,University and Research(MIUR,grant number B56H18000140001).
文摘Approximately 740 million symptomatic patients are affected by otitis media every year.Being an inflammatory disease affecting the middle ear,it is one of the primary causes of tympanic membrane(TM)perforations,often resulting in impaired hearing abilities.Antibiotic therapy using broad-spectrum fluoroquinolones,such as ciprofloxacin(CIP),is frequently employed and considered the optimal route to treat otitis media.However,patients often get exposed to high dosages to compensate for the low drug concentration reaching the affected site.Therefore,this study aims to integrate tissue engineering with drug delivery strategies to create biomimetic scaffolds promoting TM regeneration while facilitating a localized release of CIP.Distinct electrospinning(ES)modalities were designed in this regard either by blending CIP into the polymer ES solution or by incorporating nanoparticles-based co-ES/electrospraying.The combination of these modalities was investigated as well.A broad range of release kinetic profiles was achieved from the fabricated scaffolds,thereby offering a wide spectrum of antibiotic concentrations that could serve patients with diverse therapeutic needs.Furthermore,the incorporation of CIP into the TM patches demonstrated a favorable influence on their resultant mechanical properties.Biological studies performed with human mesenchymal stromal cells confirmed the absence of any cytotoxic or anti-proliferative effects from the released antibiotic.Finally,antibacterial assays validated the efficacy of CIP-loaded scaffolds in suppressing bacterial infections,highlighting their promising relevance for TM applications.
