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1.
Indian J Otolaryngol Head Neck Surg ; 76(1): 846-851, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38440510

RESUMO

To study the morphology and anthropometry of human ear ossicles from cadaveric temporal bone and to study the variations of the human ossicles from ossiculoplasty point of view. 38 sets of ear ossicles were collected, each containing malleus, incus and stapes, from temporal bone dissection done in Vasantrao Pawar medical college, Nashik. They were studied under microscope & anthropometrical, morphological evaluation done. Malleus showed variations in handle where 61% were straight and 39% curved. Weight of malleus ranged from 0.03-0.06 gm. The length ranged from 5.5 to 8.2 mm. Incus showed morphological variation in lenticular process which was present in 73% incii. Weight of incus ranged from 0.04 to 0.09 gm, average length of long process 3.5 mm, width of body 4 mm. In stapes variations was seen with head of stapes which was absent in 21% bones. With increasing awareness about postop hearing status, this study will add up in knowledge of morphological and anthropometric variations that exists in Indian population, help otologists to understand middle ear dynamics better which will improve results of ossiculoplasty.

2.
Laryngoscope ; 134(3): 1032-1041, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37584374

RESUMO

OBJECTIVE: To report the largest case series of isolated malleus fractures with systematic review to characterize the disease's presentation and natural history, and provide suggestions for management. DATA SOURCES: PubMed, Embase, Cochrane Library. REVIEW METHODS: Retrospective cohort study was performed on 12 patients with isolated malleus fractures. History, physical exam, pre- and post-treatment audiograms, and imaging were obtained. Systematic review of the literature was performed. RESULTS: Including the cases herein, 58 isolated malleus fractures were identified, the majority of which were published in the 21st century. Mean time to presentation after injury was 34.4 months. Most common etiology was external auditory canal (EAC) manipulation. Physical exam and imaging did not identify any abnormality at presentation in 16% and 21% of cases, respectively. The majority of fractures involved the manubrium. Air-bone gap (ABG) at initial presentation ranged from 16 to 26 dB, and was greater at higher frequencies. Thirty-six cases underwent surgery. ABG improvement was greater at all frequencies for those who underwent surgery. Final ABG was significantly less than initial ABG at nearly every frequency for those who underwent surgery (p < 0.05), while not at any frequency for those who were observed. CONCLUSIONS: Isolated malleus fractures may occur more often than historical data suggests, and are perhaps underdiagnosed. Abrupt removal of a finger from the EAC with pain and hearing loss is nearly pathognomonic. Conductive hearing loss with ABG greater at higher frequencies is most often observed. Observation is unlikely to produce spontaneous improvements in hearing, while surgery demonstrates reliable decreases in ABG. Laryngoscope, 134:1032-1041, 2024.


Assuntos
Fraturas Ósseas , Martelo , Humanos , Martelo/cirurgia , Perda Auditiva Condutiva/diagnóstico , Perda Auditiva Condutiva/etiologia , Perda Auditiva Condutiva/cirurgia , Estudos Retrospectivos , Audição , Testes Auditivos , Fraturas Ósseas/complicações , Resultado do Tratamento
3.
Laryngoscope ; 134(5): 2411-2414, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-37792383

RESUMO

To report the case of the simultaneous treatment of otosclerosis and malleus fixation through an entirely endoscopic transcanal approach. A targeted transcanalar epitympanotomy with annular bony ridge conservation was planned preoperatively, with 3D CT localization of the fixed part of the malleus head. The upper part of the malleus head and the superior ossified ligament of the malleus were drilled. A 0.6 mm stapedotomy was performed and a piston inserted. The patient's recovery was uneventful, with closure of the air-bone gap on her postoperative audiogram, associated with an overclosure in 500Hz, 1kHz, 2 kHz and 4 kHz. Laryngoscope, 134:2411-2414, 2024.


Assuntos
Otosclerose , Cirurgia do Estribo , Humanos , Feminino , Otosclerose/cirurgia , Otosclerose/complicações , Martelo/cirurgia , Condução Óssea , Cirurgia do Estribo/métodos , Endoscopia , Resultado do Tratamento , Estudos Retrospectivos
4.
Anat Histol Embryol ; 53(1): e12998, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37985461

RESUMO

It is important to know the morphometry of the auditory ossicles for middle ear surgical applications. The present study aims to investigate the morphometric measurements of sheep auditory ossicles and the relationship between these ossicles. In this study, 100 malleus, incus and stapes of 50 Akkaraman sheep were examined using at trinocular stereo microscope and a total of 19 morphometric measurements were taken. The mean values of the morphometric measurements were obtained, and correlation analysis was performed between each part of each auditory ossicle. Similarities were found between the measurements of the lengths of the malleus, manubrium mallei and incus, and the width of the base of the stapes with morphometric measurements in human auditory ossicles. A significant positive correlation was found between the length of the malleus with the length of the manubrium mallei, between the length of the incus with the lengths of the long crus and corpus incudis, between the length of the stapes with the lengths of the rostral crus, caudal crus, caput stapedis, and the length and width of the intercrural foramen. Due to the anatomic similarities between sheep and human auditory ossicles, it was concluded that the auditory ossicles of sheep are suitable for use in the training of human ear surgery applications.


Assuntos
Ossículos da Orelha , Orelha Média , Humanos , Animais , Ovinos , Bigorna , Estribo , Martelo
5.
J Anat ; 244(3): 514-526, 2024 03.
Artigo em Inglês | MEDLINE | ID: mdl-37988318

RESUMO

BACKGROUND: The sphenomandibular ligament (SML) is considered to originate from Meckel's cartilage (MC). However, no study has examined how the os goniale contributes to SML development. METHODS: Semiserial histological sections of heads from 18 near-term fetuses at 27-40 weeks of gestation were examined. OBSERVATIONS: The os goniale and the anterior process of the malleus (AP) provided a long, bar-like membranous bone complex that passed through the petrotympanic and tympanosquamosal fissures. Notably, the AP-goniale complex is sometimes elongated inferiorly to join the SML (n = 4 specimens). Along the complex in the bone fissures, a degenerating MC was often present (n = 12). With (n = 6) or without (n = 3) the MC remnant, the tympanic bone (TYB) protruded inferomedially near the tympanosquamosal fissure, and it sometimes continued to a cartilaginous SML (n = 3). The temporal bone squamosa or petrosa provided a similar bony process approaching the SML. The middle meningeal artery often ran between the sphenoid and petrosa. CONCLUSIONS: Most of the specimens (n = 15) exhibited a sequential change from a cartilaginous SML as a continuation of the MC remnant to the ligament after the disappearance of the cartilage. The degenerating MC appeared to cause transformation from the AP-goniale complex and/or TYB to "another ligament" that replaced the usual SML at the upper part. Near the MC remnant, a similar transformation was also suggested on the squamosa or petrosa. The sphenoid spine appeared to originate often from the sphenoid ala major but sometimes from the TYB.


Assuntos
Ligamentos Articulares , Articulação Temporomandibular , Humanos , Cartilagem , Feto , Osso Temporal , Mandíbula
6.
Indian J Otolaryngol Head Neck Surg ; 75(3): 1900-1905, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-37636676

RESUMO

Previous studies of the middle ear in Chronic Otitis Media have focussed on radiological assessment of temporal bone; endoscopic studies were focussed on perforation size and location. The malleus handle (manubrium) is a constant ossicular feature visible on otoendoscopy. It's relative position may indicate the previously documented differences in ossicular chain and middle ear cleft development relative to the tympanic ring and inner ear capsule between affected ear and contralateral ear. DESIGN: descriptive. SETTING: hospital based. SUBJECTS: 84 patients with unilateral mucosal chronic otitis media. METHODS: each patient underwent Otoendoscopy and the findings were recorded through a camera connected to a laptop. Using image j software these images were analysed. Participants were of mean age of 35 years with left preponderance, and no gender preponderance was found. In our study, majority of the perforations were small sized perforations. The malleus handle foreshortening was about 92.6% compared to unaffected ear which was statistically insignificant. There was a significant inter group difference in the distance between the tip of the manubrium and the inferior annulus-which was decreased in affected ears and in the distance from the lateral process to the anterior tympanic ring-which was increased in affected ears. There was no difference in the malleo scutal angles. These differences were not dependent on the site or size of the perforation. The differences we found between ears were unexpected. The significance of the differences in the shape of the tympanic membrane between affected and unaffected ears in unilateral mucosal COM need further study. We did not find a statistically significant difference in the malleo-scutal angles between ears.

7.
Anat Rec (Hoboken) ; 306(11): 2853-2871, 2023 11.
Artigo em Inglês | MEDLINE | ID: mdl-36897245

RESUMO

The placental order Dermoptera, which includes two extant species, the Philippine and Sunda flying lemurs, Cynocephalus volans and Galeopterus variegatus, respectively, is generally held to be the sister group of Primates. Yet, little has been reported on their cranial anatomy. Here, the anatomy of the ear region is described and illustrated for a juvenile and adult C. volans based on CT scans. The inclusion of a juvenile is essential as nearly all cranial sutures are fused in the adult. Soft tissues are reconstructed based on sectioned histological pre- and postnatal specimens previously reported by the author. Numerous unusual features are identified, including: a small parasphenoid beneath the basisphenoid, a tensor tympani fossa on the epitympanic wing of the squamosal, a cavum supracochleare for the geniculate ganglion of the facial nerve that is not enclosed in the petrosal bone, a secondary facial foramen between the petrosal and squamosal, a secondary posttemporal foramen leading to the primary one, a subarcuate fossa that is floored in part by a large contribution from the squamosal, a body of the incus larger than the head of the malleus, and a crus longum of the incus that lacks an osseous connection to the lenticular process. Documentation of the anatomy of the Philippine flying lemur ear region is an essential first step in morphological phylogenetic analyses where features of the basicranium are widely sampled.


Assuntos
Quirópteros , Lemur , Gravidez , Animais , Feminino , Filogenia , Lemur/anatomia & histologia , Filipinas , Placenta , Primatas/anatomia & histologia
8.
J Pak Med Assoc ; 73(2): 319-322, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36800718

RESUMO

OBJECTIVE: To determine gender-based morphological variations in malleus. METHODS: The cross-sectional descriptive study was conducted at the Ear-Nose-Throat and Radiology departments of a public-sector hospital in Karachi, from January 20 to July 23, 2021, and comprised subjects of either gender aged 10-51 years who had intact ear ossicles. They were divided into equal male and female groups. After history and a thorough examination of the ear, high-resolution computed tomography scan of petrous temporal bone was done. The images were studied for malleus, to measure the parameters of its head width, length and shape of manubrium, and total length of malleus for possible morphological variations along gender lines. Data was analysed using SPSS 23. RESULTS: Of the 50 subjects, 25(50%) were males with mean width of the head 3.04±0.34mm, mean length of manubrium 4.47±0.48mm, and mean total length of malleus 7.76±0.60mm. The corresponding values in 25(50%) females were 3.00±0.28mm, 4.31±0.45mm and 7.41±0.51mm. The total length of malleus between both genders was significantly different (p= 0.031). The shape of manubrium was straight in 10(40%) males and 8(32%) females, and curved in 15(60%) males and 17(68%) females. CONCLUSIONS: Width of head, length of manubrium and total length of malleus were different in gender terms, but the total length of malleus was significantly different.


Assuntos
Hospitais Públicos , Martelo , Feminino , Humanos , Masculino , Estudos Transversais , Setor Público , Grupo Social
9.
Ear Nose Throat J ; 102(11): 742-745, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34191618

RESUMO

We report a rare case of isolated malleus dislocation into the external auditory canal with lateralized intact tympanic membrane following a head trauma. The patient was a 63-year-old woman who presented at the outpatient department of our institute with hearing loss of 10 years' duration after a bicycle accident. During physical examination of the patient, total dislocation of the malleus-like bony structure into the external auditory canal on the right side was observed. In the computed tomography scan, an isolated malleus dislocation with intact incus-stapes articulation was identified. The patient was successfully treated with endoscopic exploratory tympanotomy and partial ossicular replacement prosthesis. The isolated malleus dislocation can rarely occur after trauma. A careful diagnostic step through history, physical examination, and temporal bone computed tomography scan are needed to confirm this rare condition.


Assuntos
Martelo , Prótese Ossicular , Feminino , Humanos , Pessoa de Meia-Idade , Martelo/cirurgia , Meato Acústico Externo/diagnóstico por imagem , Meato Acústico Externo/cirurgia , Bigorna/diagnóstico por imagem , Bigorna/cirurgia , Estribo
10.
Biol Invasions ; 25(5): 1441-1459, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36570095

RESUMO

The construction of the Suez Canal connected the Red Sea and the Mediterranean Sea, which allowed rapid marine bio-invasion. Over the last century, several bivalve species have invaded the Levantine basin, yet their distribution and impact on the benthic community have not been thoroughly studied. Large-scale benthic surveys along the rocky substrate of the Israeli Mediterranean coastline indicate that invading bivalves, such as Spondylus spinosus, Brachidontes pharaonis, and Pinctada radiata, now dominate the rocky environment, with densities of tens to hundreds of individuals per m2. No native bivalve specimens were found in any of the transects surveyed. The small-scale ecological effects of the established invading populations on the benthic community were examined over a year using an in-situ exclusion experiment where all invading bivalves were either physically removed or poisoned and kept in place to maintain the physical effect of the shells. Surprisingly, the experimental exclusion showed a little measurable effect of bivalve presence on the invertebrate community in close vicinity (~ 1 m). Bivalve presence had a small, but statistically significant, effect only on the community composition of macroalgae, increasing the abundance of some filamentous macroalgae and reducing the cover of turf. The generally low impact of bivalves removal could be due to (1) wave activity and local currents dispersing the bivalve excreta, (2) high grazing pressure, possibly by invading herbivorous fish, reducing the bottom-up effect of increased nutrient input by the bivalves, or (3) the natural complexity of the rocky habitat masking the contribution of the increased complexity associated with the bivalve's shell. We found that established invading bivalves have replaced native bivalve species, yet their exclusion has a negligible small-scale effect on the local benthic community. Supplementary Information: The online version contains supplementary material available at 10.1007/s10530-022-02986-1.

11.
Tomography ; 8(5): 2460-2470, 2022 Sep 29.
Artigo em Inglês | MEDLINE | ID: mdl-36287803

RESUMO

The aim of this research was to assess possible relationships between petrotympanic fissure (PTF) characteristics, malleus position, and temporomandibular joint disorders (TMD). A retrospective study was performed, including patients with TMD. Magnetic resonance imaging (MRI) and cone-beam computed tomography (CBCT) examination were used to evaluate temporomandibular joint (TMJ) disc position and condylar bone changes. Fifty-eight TMJs from twenty-nine patients (23:6 females: males) were assessed. Erosive changes (DDR-disc displacement with a reduction of 6 (24%), DDwR-disc displacement without a reduction of 8 (61.5%) vs. normal disc position 3 (15%), p = 0.012) and condyle osteophytes production (DDR 6 (24%), DDwR 9 (69.2%) vs. normal condyle 7 (35%), p = 0.012) were more frequent in subjects with disc displacement compared to normal disc position; malleus was closer to PTF in cases with erosive changes (median 2.15 interquartile range: (1.85-2.75) vs. 2.75 (2.25-3.15), p = 0.029) as well as those with condylar osteophytosis (2.25 (1.91-2.75) vs. 2.75 (2.33-3.32), p = 0.015); the PTF length was higher in cases with condylar osteophytosis compared to those without (4.45 (3.50-4.77) vs. 3.67 (3.34-4.28), p = 0.039). The disc position and disc shape were not related to PTF or malleus position. Malleus position and PTF dimensions were not associated with the PTF type. In cases with erosive changes and condylar osteophytosis, malleus was closer to PTF.


Assuntos
Transtornos da Articulação Temporomandibular , Doenças da Língua , Masculino , Feminino , Humanos , Martelo/diagnóstico por imagem , Martelo/patologia , Articulação Temporomandibular/patologia , Estudos Retrospectivos , Transtornos da Articulação Temporomandibular/diagnóstico por imagem , Transtornos da Articulação Temporomandibular/patologia , Disco da Articulação Temporomandibular/patologia , Doenças da Língua/patologia
12.
Vet Sci ; 9(9)2022 Sep 08.
Artigo em Inglês | MEDLINE | ID: mdl-36136699

RESUMO

Given the scarce morphological data regarding the middle ear anatomy of this species, the paper attempts to describe the morphological and morphometrical data of the auditory ossicles in the badger. The study was performed using the standard morphological investigations and provides a complete morphological description of the ossicular assembly (malleus, incus and stapes) with some comparative features and attempts to provide a complete set of standardized metrical data for each ossicle. A more-detailed attempt to compare some functional aspects in the light of combined metrical ratios is also implied.

13.
Rev. otorrinolaringol. cir. cabeza cuello ; 82(2): 184-189, jun. 2022. ilus
Artigo em Espanhol | LILACS | ID: biblio-1389854

RESUMO

Resumen La fractura aislada del mango del martillo es una entidad clínica poco habitual, pero frecuentemente subdiagnosticada. Lo fundamental es la sospecha clínica. El diagnóstico se confirma con la otoscopia neumática o la otomicroscopia con maniobra de Valsalva, en la cual se observa una movilidad anormal del mango del martillo. El rasgo de fractura se puede demostrar con tomografía computada de alta resolución o cone beam. Existen diferentes opciones de tratamiento como interposición de cartílago o uso de prótesis de reemplazo osicular así como cemento óseo. El cemento ionomérico vidrioso autocurado, muy utilizado en odontología, se ha usado en distintas cirugías otológicas con buenos resultados y biocompatibilidad. A nuestro saber no se ha usado en esta patología por lo que presentamos esta serie de tres casos en los cuales se ha usado esta novedosa técnica con buenos resultados clínicos.


Abstract Isolated fracture of the manubrium of the malleus is a rare clinical entity. Clinical suspicion is paramount. The usual clinical presentation is acute otalgia followed by tinnitus and fluctuating hearing loss after a brisk introduction and withdrawal of a finger into the external auditory canal. On physical examination, the eardrum looks normal on otoscopy. Only in pneumatic otoscopy or otomicroscopy with Valsalva an abnormal motility of the manubrium could bee seen. High-resolution computed tomography (CT) or cone beam CT is able to show the fracture line. Several treatment options have been proposed, such as interposition of bone or cartilage between the manubrium and the incus, total or partial ossicular replacement prosthesis; and the use of bone cement. Glass ionomer luting cement, with wide use in dentistry, has been used in several otological procedures with good biocompatibility and results, however, to our best knowledge, it has not been used to repair this type of fractures, so we present this novel material in three cases.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Cemento Dentário , Fraturas Ósseas/diagnóstico por imagem , Martelo/cirurgia , Martelo/lesões , Cimentos Ósseos , Manobra de Valsalva , Otoscopia , Meato Acústico Externo , Dor de Orelha , Tomografia Computadorizada de Feixe Cônico , Perda Auditiva/etiologia
14.
Dev Dyn ; 251(10): 1711-1727, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-35618654

RESUMO

BACKGROUND: Asymmetries in craniofacial anomalies are commonly observed. In the facial skeleton, the left side is more commonly and/or severely affected than the right. Such asymmetries complicate treatment options. Mechanisms underlying variation in disease severity between individuals as well as within individuals (asymmetries) are still relatively unknown. RESULTS: Developmental reductions in fibroblast growth factor 8 (Fgf8) have a dosage dependent effect on jaw size, shape, and symmetry. Further, Fgf8 mutants have directionally asymmetric jaws with the left side being more affected than the right. Defects in lower jaw development begin with disruption to Meckel's cartilage, which is discontinuous. All skeletal elements associated with the proximal condensation are dysmorphic, exemplified by a malformed and misoriented malleus. At later stages, Fgf8 mutants exhibit syngnathia, which falls into two broad categories: bony fusion of the maxillary and mandibular alveolar ridges and zygomatico-mandibular fusion. All of these morphological defects exhibit both inter- and intra-specimen variation. CONCLUSIONS: We hypothesize that these asymmetries are linked to heart development resulting in higher levels of Fgf8 on the right side of the face, which may buffer the right side to developmental perturbations. This mouse model may facilitate future investigations of mechanisms underlying human syngnathia and facial asymmetry.


Assuntos
Região Branquial , Coração , Animais , Fator 8 de Crescimento de Fibroblasto/genética , Humanos , Anormalidades Maxilomandibulares , Maxila , Camundongos , Anormalidades da Boca
15.
Int J Pediatr Otorhinolaryngol ; 156: 111113, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35314375

RESUMO

OBJECTIVES: Establish normal reference values for the human malleus during the second and third trimesters of pregnancy, and describe its growth dynamics and ossification process. METHODS: Thirty spontaneously aborted human fetuses, 12-36 weeks of age, were examined. Temporal bones were obtained en bloc and processed using the skeletal clearing and staining technique. Each malleus was obtained by microdissection. Measurements of anatomical points of the malleus were performed. Ossification was recorded. Statistics were applied. RESULTS: Sixty mallei were obtained. At the end of development, the following measurements were obtained in millimeters: head length, 2.87 (2.30-3.44); neck length, 1.15 (0.92-1.38); manubrium length, 4.45 (3.75-5.16); total length, 8.51 (8.02-8.99); neck width, 1.33 (0.70-1.97); manubrium width, 0.84 (0.82-0.86); and Meckel cartilage width, 0.43 (0.06-0.95). The angle of the longitudinal axis of the malleus was 160° (156-164°). The ossification process of the malleus followed a stereotyped pattern that began at week 16, at the level of the neck, with a single center that expanded to the head and then to the manubrium. Toward the end of development, only the umbo remained cartilaginous. There were no sex-based differences in human malleus size during prenatal development. From the beginning of the second trimester of pregnancy, the longitudinal axis of the malleus acquires dimensions comparable to adults. CONCLUSION: The study of the malleus development provides clues that would explain some anomalies in its development, and can influence decision-making during the placement and design of prostheses in the malleus.


Assuntos
Martelo , Osso Temporal , Adulto , Humanos
16.
J Laryngol Otol ; 136(3): 268-270, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34666860

RESUMO

OBJECTIVES: To report an extremely rare case of malleoincudal osteoma that led to conductive hearing loss despite an unusually normal otomicroscopic appearance, and to highlight the usefulness of costal cartilage for ossicular chain reconstruction after tumour removal. CASE REPORT: A 37-year-old woman presented with a 2-year history of progressive, right-sided hearing loss. Physical examination revealed a normal tympanic membrane. Pure tone audiometry showed a right-sided conductive hearing loss. High-resolution computed tomography revealed a right-sided epitympanic mass arising from the malleus head and contiguous with the incus. The patient underwent a closed mastoido-epitympanectomy. The malleus head and the incus with associated malleoincudal osteoma were removed. Ossicular chain reconstruction using costal cartilage was performed at the time of tumour removal. CONCLUSION: The possibility of a middle-ear osteoma must be considered in cases of unilateral and progressive conductive hearing loss with a normal otomicroscopic appearance in patients with no history of ear infection, trauma or prior surgery, and with no family history of hearing loss. Surgical treatment is indicated in cases of significant conductive hearing loss. To our knowledge, this is the first case report of malleoincudal osteoma in which the ossicular chain was reconstructed using costal cartilage.


Assuntos
Neoplasias Ósseas/cirurgia , Cartilagem Costal/transplante , Bigorna , Martelo , Substituição Ossicular/métodos , Osteoma/cirurgia , Adulto , Feminino , Humanos
17.
Eur Ann Otorhinolaryngol Head Neck Dis ; 139(1): 17-20, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34052161

RESUMO

OBJECTIVES: The main goal of the present study was to assess hearing outcome for malleus removal in cholesteatoma surgery compared to a group with malleus conservation. The secondary aim was to compare the auditory involvement of the stapes between the two groups. MATERIAL AND METHODS: A single-center observational study included adult patients operated on by ossiculoplasty for acquired cholesteatoma between 2015 and 2019. Endpoints comprised improvement in pure-tone average air-bone gap (PTA-ABG) and air-bone gap (ABG) at conversational frequencies and, independently, per frequency. 136 patients were included: 95 with conserved malleus (M+) and 41 with malleus removal (M(). Mean time to audiometric follow-up was 9 months in both groups. RESULTS: The PTA-ABG improvement was 4.4±12.6dB for the M+ group and 3.8±13.4dB for the M- group, with no significant significance (P=0.8). Better results (not exceeding 7.5dB) were found for the M+ group at 2 and 8kHz (P=0.3 and P=0.052 respectively). Presence or absence of the stapes did not affect the results in either group. CONCLUSION: Those results suggest a negligible role of the malleus in early hearing outcome of tympanoplasty for cholesteatoma. A slight improvement was observed in the M+ group at 2 and 8kHz, but its interpretation remains uncertain.


Assuntos
Colesteatoma da Orelha Média , Prótese Ossicular , Substituição Ossicular , Adulto , Audiometria de Tons Puros , Colesteatoma da Orelha Média/cirurgia , Estudos de Coortes , Audição , Humanos , Martelo/cirurgia , Estudos Retrospectivos , Resultado do Tratamento , Timpanoplastia
18.
Artigo em Chinês | MEDLINE | ID: mdl-34886600

RESUMO

Objective:To study the effect of retaining the manubrium of malleus and tensor tympani muscle tendon (TT) on postoperative hearing reconstruction in tympanoplasty. Methods:Ninety-seven patients underwent tympanoplasty and ossiculoplasty in Peking University Third Hospital from January 2012 to December 2017, their postoperative results of audiometry were analyzed and compared with the preoperative results. The patients were divided into two groups according to retaining the manubrium of malleus and TT or not during the operation. Retention group include the cases with the manubrium of malleus and TT retained, resection group include the cases with TT resected with the manubrium retained or resected. T test was used to analyze and compare the differences of air conduction threshold air-bone gap (ABG) and the postoperative improvement between the two groups. Results:One year after operation, the air conduction thresholds and ABG were lower in retention group (n= 44) than those in resection group (n= 53) at each frequency, and there were differences with statistically significant at 0.25, 0.5 and 1.0 kHz (P<0.05); the postoperative improvement of hearing thresholds and ABG at above frequencies in retention group was better than that in resection group. In cases with canal-wall-up operations or partial ossicular prostheses implanted, the above differences still existed between the two groups with statistical significance (P<0.05); while in cases with canal-wall-down operations or total ossicular prostheses implanted, there were no significant differences between the two groups (P>0.05). Conclusion:The preservation of the manubrium of malleus and TT is significant for postoperative hearing improvement in tympanoplasty, especially in the canal-wall-up operation with partial ossicular prostheses.


Assuntos
Prótese Ossicular , Substituição Ossicular , Audição , Humanos , Martelo/cirurgia , Manúbrio , Músculos , Estudos Retrospectivos , Tendões/cirurgia , Tensor de Tímpano , Resultado do Tratamento , Timpanoplastia
19.
Vestn Otorinolaringol ; 86(6): 87-91, 2021.
Artigo em Russo | MEDLINE | ID: mdl-34964336

RESUMO

The isolated malleus handle and neck fractures are rare pathology which demands detailed diagnosis and individual treatment plan in every case. Sometimes it could heal without surgery, but in most part of cases surgical treatment is indicated. The short literature review and 2 clinical cases of this pathology are presented in this article. We describe our own variants of surgery repair with autologous cartilage with good results.


Assuntos
Fraturas Ósseas , Martelo , Perda Auditiva Condutiva , Humanos , Martelo/cirurgia
20.
Arq. bras. med. vet. zootec. (Online) ; 73(6): 1287-1293, Nov.-Dec. 2021. tab, ilus
Artigo em Inglês | LILACS, VETINDEX | ID: biblio-1355687

RESUMO

The social and economic roles of goat farming in Northeastern Brazil, allied to the fact that the use of goat middle ear ossicles for research and human ear surgery training has not yet been proposed, justify the study of their applicability as an experimental model. The middle ears of 19 goats (Capra aegagrus hircus) from the bone collection of the Laboratory and Didactic Anatomy Museum of Domestic and Wild Animals of the Federal University of Vale do São Francisco (UNIVASF) were dissected. The malleus, incus, and stapes were evaluated regarding their macroscopic morphology and biometry (length, width, and height). Ossicle morphology was similar to sheep, human, and bovine morphology. The malleus was 1.3 times heavier and 2.2 times longer than the incus, and 9.0 times heavier and 3.7 times longer than the stapes. The size relationship was positive between the stapes and the malleus and negative between the stapes and the incus. It is concluded that the middle ear size and the anatomical similarities with human ossicles make goats a useful model for experimental scientific studies, reconstructive surgery practice of the ossicular chain, and human ear surgery training.(AU)


Tanto o papel social quanto o econômico da caprinocultura na região Nordeste do Brasil, somados ao fato de que o uso de ossículos da orelha média de caprinos para estudos e treinamento cirúrgico otológico humano ainda não foi proposto, justificam o estudo de sua aplicabilidade como modelo experimental. Foram dissecadas as orelhas médias de 19 caprinos (Capra aegagrus hircus), provenientes do ossuário do Laboratório e Museu Didático de Anatomia dos Animais Domésticos e Silvestres - Universidade Federal do Vale do São Francisco. Martelos, bigornas e estribos tiveram a morfologia macroscópica e a biometria (comprimento, largura e altura) avaliadas. A morfologia dos ossículos assemelhou-se a de ovinos, humanos e bovinos. O martelo foi 1,3 vez mais pesado e 2,2 vezes mais comprido que a bigorna e 9,0 vezes mais pesado e 3,7 vezes mais comprido que o estribo. A relação de tamanho entre o estribo e o martelo foi positiva, e entre o estribo e a bigorna negativa. Conclui-se que o tamanho da orelha média e as semelhanças anatômicas com os ossículos humanos tornam os caprinos um modelo útil para estudos científicos experimentais, prática cirúrgica reconstrutiva da cadeia ossicular e treinamento cirúrgico otológico humano.(AU)


Assuntos
Animais , Estribo/anatomia & histologia , Cabras/anatomia & histologia , Ossículos da Orelha/anatomia & histologia , Bigorna/anatomia & histologia , Martelo/anatomia & histologia , Biometria , Modelos Animais
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