Vein Graft Tympanoplasty: How a Transiently Used Graft Material Transformed Middle Ear Surgery.

The inception of medial grafting as a technique for tympanic membrane repair was a critical milestone in the history of otology. John Shea introduced the medial graft technique and the use of vein grafts for tympanoplasty in 1960 after realizing that the vein grafts that he used to repair the oval window after stapedectomy could also be utilized to repair tympanic membrane perforations. At the time, tympanoplasty often utilized skin grafts, which required placement of the graft lateral to the tympanic membrane annulus. Placement of the graft medial to the tympanic membrane annulus allowed for more efficient surgery and avoided the complications associated with lateral grafting, such as blunting and lateralization. The introduction of vein grafts in tympanoplasty prompted a fundamental shift in technique from lateral to medial grafting, paving the way for decades of innovation in tympanoplasty.

Allograft tympanoplasty: a historical perspective.

OBJECTIVE: To present the rise and decline of allograft tympanoplasty and investigate how the challenges it has faced may inform us of its future. DATA SOURCES: Articles and books published over the last 48 years that refer to allograft tympanoplasty or its historical roots. HISTORY: The first published account of allograft tympanoplasty is by Ned Chalat in 1964; however, whether he was the first to use the technique is controversial. In 1966, Jean Marquet published the first clinically successful use of allograft tympanic membranes. Since that time, a number of surgeons have trialed both en bloc tympano-ossicular techniques and tympanomeatal techniques with separate ossicle interposition or columellar reconstruction, often with considerable success. The advent of the human immunodeficiency virus and Creutzfeldt-Jakob's disease resulted in a reduction in its application; however, a number of centers are still successfully using the technique in their current practice. CONCLUSION: Whether allograft tympanoplasty will have a place in the future of otology remains to be seen, but an understanding of the history of this technique is essential in evaluating its merit.

Efectividad quirúrgica de la timpanoplastia con cartílago tragal autólogo en niños: técnica inlay 2007-2011 / Effectiveness tympanoplasty surgery with autologous cartilage in children tragal-inlay 2007-2011

Objetivo: medir la efectividad quirúrgica, en términos anatómicos y audiológicos, de la timpanoplastia en niños, mediante la técnica inlay con cartílago tragal autólogo, en un hospital de tercer nivel de complejidad de la ciudad de Medellín, entre los años 2007-2011. Diseño: estudio descriptivo retrospectivo. Materiales y métodos: el formulario de recolección de información se dividió en tres grupos de variables: generalidades poblacionales, eficiencia y efectividad. Resultados: 91 pacientes cumplieron los criterios de inclusión, entre quienes se encontró eficacia quirúrgica en el cierre anatómico de la perforación (95,6%) y efectividad en la mejoría en los niveles audiológicos (89,01%). Conclusión: la timpanoplastia con cartílago es el método ideal en la corrección de las perforaciones timpánicas en niños, con el cual se han obtenido excelentes resultados anatómicos y audiológicos; además, se observan menos recurrencias, mayor facilidad en la revisión postoperatoria, menor tiempo quirúrgico y visitas posquirúrgicas, de rápida y fácil adaptación a las actividades acuáticas y deportivas y bajo costo.

Objective: To measure the effectiveness of surgical and audiological anatomical terms of tympanoplasty in children, using the inlay technique tragal autologous cartilage in a tertiary level of complexity of the city of Medellín 2007-2011. Design: Retrospective descriptive study. Materials and methods: Data collection form was divided into groups of variables: general population, variables of efficiency and effectiveness. Results: 91 patients met the inclusion criteria were found effective surgical anatomic closure of the perforation (95.6%) and effectiveness in improving audiological levels (89.01%) and clinical importance. Conclusion: Tympanoplasty with cartilage is the ideal method correction of tympanic perforations in children with excellent anatomic and audiological, there is also less recurrences, easier postoperative review, less surgical time and postoperative visits, quick and easy adaptation to water and sports activities and low cost.

History of myringoplasty and tympanoplasty type I.

The history of myringoplasty and tympanoplasty type I is a delightful chapter in the development of otologic surgery. The aim of this commentary is to sketch the great lines of the history of myringoplasty and tympanoplasty type I. From its first controversial description in 1878 to its actual foundation in 1952, different otologists, mostly German, participated in its development.

[History of endaural surgery]. / Historia chirurgii wewnatrzusznej.

History of the endaural mastoid surgery and the development of this approach to the temporal bone begins with the first paracentesis, which is the oldest endaural operation of the middle ear. Prior to the invention of the ear mirror paracentesis was a difficult operation. In 1885 Kessel reported endaural radical ear surgery. A great inconvenience is the narrow operative field within the external auditory meatus. It influenced the surgeon to extend the incision posteriorly into the auricle. In 1930 Heermann H. described antero-superior extracartilaginous endaural incision.

[Introduction of middle ear surgery "aimed at hearing improvement" by Jan Miodonski--tympanoplasty at the centenary of his birthday]. / O wprowadzeniu przez Jana Miodonskiego "operacji zmierzajacych do poprawy sluchu"--tympanoplastyk w setna rocznice Jego urodzin.

The author recalls the introduction of the functional surgery of the Middle Ear--tympanoplasty by Miodonski and reminds of Miodonski's types of surgical reconstruction of the sound conducting mechanism: 1. "Ecranisatio" of the Round Window--the formation of the Small Middle Ear--Myringoplatinopexy (1949); 2. "Columellisatio" of the "Small Middle Ear--the formation of the Middle Ear with one ossicle--the Columella Effect--Myringostepedopexy" (1949); 3. "Columellisatio I-III"--the connection of the malleus with the stapes--Ossiculoplasty--Malleostapedopexy (1955). A comparison of Miodonski's solution in the range of functional surgery of the Middle Ear with present reconstructive Middle Ear techniques leads us to the conclusion that most of the tympanoplasty are only various modifications of Miodonski's principles.

[Tympanoplasty and Sourdille]. / La tympanoplastie et Maurice Sourdille.

In his article published earlier in 1929, Maurice Sourdille proposed two innovations in middle ear surgery: the tympanomeatal flap and surgery of chronic otitis. Those events were not only the starting point of a new era of modern tympanoplasty but also led to the way to the development of middle ear exploration with purposeful resection of the tympanic framework for accessing to the windows and for sealing a perforated tympanic membrane.

[A century in the history of chronic ear surgery]. / Un siècle d'histoire de la chirurgie d'otite chronique.

Although some advocated surgery of the tympanic membrane and stapes as early as early as the end of the nineteenth century, it took a long time for widespread development. Mastoid surgery had just been born and was to be greatly improved over the next century. Preservation of the tympano-ossicular its later reconstruction gradually came into use with the creation of the tympanomeatal flap and the recent development of middle ear surgery, followed by posterior tympanotomy and myringoplasty, thus allowing closed tympanoplasty. Likewise, the ventilation tube, forgotten for more than half a century, has found an important place in the treatment of chronic otitis with a closed ear drum.

Overlay versus underlay tympanoplasty. Part I: historical review of the literature.

The history of otology is the history of the successful treatment of infections of the middle ear and the eardrum. Otologists have sought to restore hearing lost to infections of the eardrum since the 1600s. The development of instruments, techniques, and materials to treat infection is fascinating because of the serendipitous nature of the discoveries and the insight of the discoverers. This historical review describes the history of the treatment of infections of the ear and the development of modern techniques of ear surgery. Two contemporary methods of tympanic membrane repair are then described.

Tympano-ossicular allografts following J. Marquet: the evaluation of a school.

The experience with 1.645 transplantation procedures by ENT surgeons, trained in tympano-ossicular allograft technique following J. Marquet, is reported. The grafts originated from different tissue banks. The anatomical and functional results one year postoperatively were analysed. There appeared to be no statistical differences between tissue banks, nor between surgeons. Contrary to the anatomical results, functional differences existed between allograft tympanoplasties and some types of allograft tympano-ossiculoplasties. It was concluded that the routine use of allograft tympano-ossiculoplasty offers a major tool in otological surgery and that it is the method of choice by the ENT surgeons trained by the School of J. Marquet.