Outcomes following tympanoplasty surgery using porcine-derived small intestinal submucosa.

OBJECTIVE: To determine the outcomes of tympanoplasty surgery using porcine-derived small intestinal submucosa. METHOD: A retrospective audit was conducted in a hospital setting. Thirty-five adult and paediatric patients who received a small intestinal submucosa graft as part of tympanoplasty surgery were retrospectively reviewed. Patients underwent either simple tympanoplasty (n = 26) or complex tympanoplasty as part of a concurrent otological procedure such as atticotomy and mastoidectomy. The main outcome measures were rate of tympanic membrane closure and change in four-frequency mean air-bone gap. RESULTS: Thirty-one patients had a follow-up period of longer than two months. Closure was obtained in 22 patients (71 per cent). The mean air-bone gap improved from 20.7 to 12.3 dB HL in the simple tympanoplasty group and from 22.3 to 12 dB HL in the complex tympanoplasty group. CONCLUSION: Tympanoplasty surgery with small intestinal submucosa is a viable option for patients where autologous graft is not available or in order to minimise donor site morbidity.

Cochlear nerve anomalies in paediatric single-sided deafness - prevalence and implications for cochlear implantation strategies.

OBJECTIVE: To determine the prevalence of cochlear nerve anomalies on magnetic resonance imaging in patients with unilateral or bilateral sensorineural hearing loss. METHODS: A retrospective case series was conducted at a tertiary referral centre. The inclusion criteria were paediatric patients with bilateral or unilateral sensorineural hearing loss, investigated with magnetic resonance imaging. The primary outcome measure was the rate of cochlear nerve hypoplasia or aplasia. RESULTS: Of the 72 patients with unilateral sensorineural hearing loss, 39 per cent (28 cases) had absent or hypoplastic cochlear nerves on the affected side. Fifteen per cent (11 cases) had other abnormal findings on magnetic resonance imaging. Eighty-four patients had bilateral sensorineural hearing loss, of which cochlear nerve hypoplasia or aplasia was identified only in 5 per cent (four cases). Other abnormal findings were identified in 14 per cent (12 cases). CONCLUSION: Paediatric patients with unilateral sensorineural hearing loss are more likely to have cochlear nerve anomalies than those patients with bilateral sensorineural hearing loss. This has important implications regarding cochlear implantation for patients with single-sided deafness.