ABSTRACT
This study was carried out to evaluate the anatomical and hearing results of the reparation of attic defects in closed tympanoplasty. Reparation was carried out in 194 patients by using a costal cartilage allograft, and in 159 patients with a bone pate autograft. The follow-up was from 1 to 5 years. The study was not truly randomized owing to an occasional lack of allogenic costal cartilage. In the group 'costal cartilage' a partial resorption was observed in 5.7% and a complete resorption in 4.7% of the cases. In the group 'bone pate', partial resorption was observed in 5.5% and total resorption in 2.7% of the patients. Satisfactory hearing results were obtained in 86% of the patients of the group 'costal cartilage' and in 82% of the patients of the group 'bone paté'. Both graft materials may be recommended for repairing erosions caused by the cholesteatoma in the wall of the external auditory canal.
Subject(s)
Bone Transplantation , Cartilage/transplantation , Cholesteatoma, Middle Ear/surgery , Otitis Media/surgery , Tympanoplasty/methods , Adult , Child , Chronic Disease , Female , Follow-Up Studies , Hearing Loss, Conductive/surgery , Humans , Male , Postoperative Complications/surgery , Recurrence , Reoperation , Treatment OutcomeABSTRACT
Cholesterol granuloma of the petrous apex is a relatively rare tumor, and usually is not associated with middle ear pathology. Precise assessment of the diagnosis and extension allows the surgeon to plan the most appropriate and functional strategy. The advent of magnetic resonance imaging has helped, showing a high signal in T1 and T2 without enhancement after the administration of intravenous paramagnetic contrast. The occipito-temporal approach provides direct access to the anterior and posterior petrous apex without opening the dura, which preserves the facial and the cochlear-vestibular functions.
Subject(s)
Granuloma/diagnostic imaging , Granuloma/pathology , Petrous Bone/diagnostic imaging , Petrous Bone/pathology , Adult , Bone Diseases/diagnostic imaging , Bone Diseases/pathology , Bone Diseases/surgery , Diagnosis, Differential , Female , Granuloma/surgery , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Petrous Bone/surgery , Tomography, X-Ray ComputedABSTRACT
Autogenous temporal fascia is the material most frequently used for the reconstruction of the tympanic membrane, in spite of certain drawbacks: 1) it is obtained by enlarging the incision or by a supplemental incision; 2) it may be insufficient or absent for reinterventions; 3) it tends to adhere to the middle ear, and 4) it retracts easily when the Eustachian tube is not functioning. This is the synthesis of 20 years of experience with Parmatymp (jugular bovine vein xenograft), a material that is easily available, resistant and suitable for all types of ear surgery.
Subject(s)
Bioprosthesis , Prosthesis Implantation , Tympanic Membrane/surgery , Adolescent , Adult , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Retrospective StudiesABSTRACT
Middle-ear reconstruction using a closed surgical technique has the same surgical stages as in combined-approach tympanoplasty. The only special feature is the reconstruction of the posterior canal wall and scutum, an essential step. This reconstruction process is carried out with allogenic costal cartilage affixed to two deep bony slots with fibrin glue. In 90% of cases surgery is done in two stages.
