581 results on '"Tympanic Membrane injuries"'
Search Results
152. Prospective study of resident-performed stapedectomy.
- Author
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Backous DD, Coker NJ, and Jenkins HA
- Subjects
- Audiometry, Pure-Tone, Auditory Threshold, Bone Conduction, Education, Facial Nerve physiopathology, Female, Hearing Loss, Conductive diagnosis, Hearing Loss, Conductive etiology, Humans, Male, Postoperative Complications, Professional Competence, Prospective Studies, Tympanic Membrane injuries, Internship and Residency, Otolaryngology education, Otosclerosis surgery, Stapes Surgery
- Abstract
Because of the diminishing number of patients diagnosed with otosclerosis, the adequacy of residency training in stapedectomy techniques remains controversial. A prospective study, conducted from 1986 to 1991, assessed whether or not surgical outcome obtained by residents, under close supervision by otologic faculty, could be improved using a single stapedectomy technique. Comparison of pre- and postoperative hearing results (pure-tone averages of 500, 1000, and 2000 Hz) from 49 cases revealed closure of the air-bone gap to within 10 dB in 68 percent of procedures. Complications included failure to improve the conductive hearing loss, tympanic membrane perforations, transient facial nerve weakness, subluxation of the incus, and adhesions. The failure to improve the success rate in resident-performed procedures relates to the individual learning curve and the limited number of training cases.
- Published
- 1993
- Full Text
- View/download PDF
153. [Clinical study on perforation of the tympanic membrane and discussion based on experimentally induced tympanic rupture].
- Author
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Kuroda R
- Subjects
- Adolescent, Adult, Age Factors, Athletic Injuries, Child, Child, Preschool, Female, Humans, Infant, Male, Middle Aged, Stress, Mechanical, Tympanic Membrane injuries, Tympanic Membrane pathology, Tympanic Membrane Perforation physiopathology, Wound Healing, Tympanic Membrane Perforation pathology
- Abstract
Unlabelled: Traumatic perforation of the tympanic membrane (TM) was clinically studied by analyzing photographs of 231 ears treated in the Department of Otolaryngology of Tokyo Women's Medical College from May 1983 to December 1991. The dynamic features of TM and the mechanism of perforation are discussed., Results and Discussion: 1) Direct and indirect injuries of the TM through the external auditory canals were observed in 101 and 130 ears, respectively. One hundred and twenty-seven injured ears were seen in males and 104 in females. Subjects ages ranged from 1 to 64 years. One hundred and thirty ears were on the left side and 101 on the right. 2) Approximately 80% of the perforated regions were observed in the antero-inferior or postero-inferior quadrant. "Triangular-type" perforation was predominant among direct injuries and "slit type" among indirect injuries. 3) Approximately 80% of the cases had a TM defect area smaller than 20%. 4) One hundred and twenty of 127 ears which were treated within 7 days after injury were healed by conservative treatment. One hundred and four ears among these 120 ears healed spontaneously. The average healing period for these 104 ears was 25 days. 5) It was suggested that the age of patients and the defect area of TM were factors that delayed healing. 6) The minimum breakage stress of human normal TM (the right angle to the radial fibers of TM) was 13.7 gf/mm2. 7) It was presumed that the strain stress and shear stress of TM contributed to traumatic TM perforation in indirect injuries.
- Published
- 1993
- Full Text
- View/download PDF
154. Direct application of basic fibroblast growth factor improves tympanic membrane perforation healing.
- Author
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Fina M, Baird A, and Ryan A
- Subjects
- Animals, Female, Guinea Pigs, Tympanic Membrane injuries, Fibroblast Growth Factor 2 therapeutic use, Tympanic Membrane pathology, Wound Healing, Wounds, Penetrating drug therapy
- Abstract
Topical application of basic fibroblast growth factor (b-FGF) on tympanic membrane (TM) perforations was studied in guinea pigs. One-millimeter simple round TM perforations or 2-mm TM perforations with medially flapped borders were performed. Either b-FGF or placebo was instilled in each ear on the day of surgery and daily thereafter. Treatment was applied either directly to the perforation or to a Gelfoam pledget over the defect. When no scaffolding material was interposed, b-FGF induced a faster healing response characterized by a hyperplastic but linear subepidermal connective tissue reaction compared to the control. When Gelfoam was interposed as a scaffold, a voluminous scar protruding into the middle ear cavity and involving the ossicles was observed in both b-FGF and control animals. Gelfoam-induced scars did not decrease after long-term observation, therefore discouraging its use.
- Published
- 1993
- Full Text
- View/download PDF
155. Animal model for persistent tympanic membrane perforations.
- Author
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Spandow O and Hellström S
- Subjects
- Animals, Chronic Disease, Hyaluronic Acid therapeutic use, Hydrocortisone, Male, Rats, Rats, Sprague-Dawley, Time Factors, Tympanic Membrane drug effects, Wound Healing drug effects, Tympanic Membrane injuries
- Abstract
Topically applied hydrocortisone was used to develop an animal model for persistent tympanic membrane (TM) perforations. Hydrocortisone suspension was applied on the margins of TM perforations of standardized size in rats once daily for 10 days. The healing patterns of the TMs were mapped weekly and, when the perforations were about to close, daily. After 50 days, all hydrocortisone-treated perforations were open, whereas the controls closed within 9 to 12 days. At 3 months, when one third of the perforations still were open, the TMs were studied by otomicroscopy and light microscopy. All TMs were thickened and covered by keratin and wax. The thickened epidermal layer at the border of the TM perforations that remained open also draped the surface of the perforation facing the middle ear cavity. The thickened connective tissue layer contained abundant fibroblasts with their axes of length oriented at random. Both application of 1.4% hyaluronan and wounding of the perforation border enhanced the healing rate of the hydrocortisone-induced chronic TM perforation.
- Published
- 1993
- Full Text
- View/download PDF
156. Tympanic membrane ossification.
- Author
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Baer S, Hehar S, and Maw AR
- Subjects
- Audiometry, Pure-Tone, Child, Preschool, Female, Humans, Middle Ear Ventilation adverse effects, Ossification, Heterotopic pathology, Tympanic Membrane injuries, Myringoplasty adverse effects, Ossification, Heterotopic etiology, Otitis Media with Effusion surgery, Tympanic Membrane pathology
- Abstract
Ossification of the tympanic membrane after myringoplasty is recorded for the first time. Myringoplasty was performed for closure of a perforation which followed the surgical treatment of otitis media with effusion and had included the insertion of a long-term T-tube.
- Published
- 1993
- Full Text
- View/download PDF
157. Clinical characteristics and hearing recovery in perilymphatic fistulas of different etiologies.
- Author
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Kubo T, Kohno M, Naramura H, and Itoh M
- Subjects
- Adult, Causality, Female, Fistula epidemiology, Fistula therapy, Hearing Tests, Humans, Labyrinth Diseases epidemiology, Labyrinth Diseases therapy, Male, Tinnitus diagnosis, Tympanic Membrane injuries, Fistula diagnosis, Labyrinth Diseases diagnosis, Perilymph
- Abstract
Clinical features and hearing recovery were compared between three types of perilymphatic fistula groups; surgically confirmed (PLF-conf, n = 16), suspected (PLF-susp, n = 24) and traumatic (trauma-PLF, n = 11). Initial average hearing level was best in the PLF-susp group (50.9 dBHL), followed by the trauma-PLF (55.7 dBHL) and PLF-conf (59.7 dBHL) groups, though the difference was not significant (ANOVA, p > 0.05). Of 51 patients, 27 cases were operated on and fistula was confirmed in 19 ears (70.4%). Conservative treatment, including bed rest and medication, was given to all patients. After the treatment, meaningful hearing recovery was obtained only at 1 kHz in the PLF-conf group (paired t-test, p < 0.05). However, significant recovery was seen at all frequency ranges (0.125-8 kHz) in the PLF-susp group (average, 16.8 dB; p < 0.01), while hearing improvement was intermediate for the trauma-PLF group. The initial hearing level and the period until the start of treatment strongly correlated with the final hearing level. Although 27 patients (47%) complained of dizziness, the prognosis for vertigo is excellent as noted by other authors. It was concluded that if conservative treatment is started early for PLF patients with mild hearing loss, hearing recovery can be ensured.
- Published
- 1993
- Full Text
- View/download PDF
158. Facial nerve paralysis from slag injury to the ear.
- Author
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Panosian MS, Wayman JW, and Dutcher PO Jr
- Subjects
- Adolescent, Adult, Alloys, Follow-Up Studies, Foreign Bodies complications, Humans, Male, Metallurgy, Ear, Middle injuries, Facial Paralysis etiology, Tympanic Membrane injuries, Wounds, Penetrating complications
- Abstract
Transtympanic facial nerve paralysis resulting from a penetrating injury through the external auditory canal is a rare occurrence. The common mechanism of paralysis is direct fracture or penetration of the fallopian canal. Slag injuries of the ear caused by hot sparks or molten metal are well known to otolaryngologists because they often result in chronic tympanic membrane perforations and chronic otorrhea. We have encountered two unusual cases of transtympanic slag injury to the ear that resulted in facial nerve injury. In one patient, a significant inner ear injury also occurred. A pathophysiologic mechanism of thermal injury is proposed, and the use of ear protection in welders is discussed.
- Published
- 1993
- Full Text
- View/download PDF
159. Histological study of the healing of traumatic tympanic membrane perforation after basic fibroblast growth factor application.
- Author
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Mondain M and Ryan A
- Subjects
- Animals, Basement Membrane drug effects, Basement Membrane pathology, Cell Division, Connective Tissue drug effects, Connective Tissue pathology, Epithelium drug effects, Epithelium pathology, Exudates and Transudates, Fibrin, Fibroblasts drug effects, Fibroblasts pathology, Hyperplasia, Hypertrophy, Keratins, Male, Microscopy, Electron, Neutrophils drug effects, Neutrophils pathology, Rats, Rats, Sprague-Dawley, Tympanic Membrane drug effects, Tympanic Membrane physiopathology, Wound Healing drug effects, Fibroblast Growth Factor 2 therapeutic use, Tympanic Membrane injuries, Tympanic Membrane pathology
- Abstract
Basic fibroblast growth factor (bFGF) can stimulate the proliferation and differentiation of keratinocytes, fibroblasts, and endothelial cells. These cells are involved during the healing of tympanic membrane (TM) perforations. Light and electron microscopy examinations were used to study the histology of TM healing after application of 400 ng of bFGF on the perforation. The progress of healing is accelerated, but the basic healing process is unchanged, i.e., epithelial proliferation first closes the perforation and is then followed by connective tissue growth. There is more connective tissue in the TM receiving bFGF, and extracellular fibers are better oriented. No significant increase of neoangiogenesis was detected in the treated TM. In the nonperforated area of treated TM, an extensive hyperplasia of the submucosal connective tissue is observed. These results demonstrate that bFGF can produce a TM scar containing more connective tissue, which may be of benefit in the prevention of atrophic healed TM.
- Published
- 1993
- Full Text
- View/download PDF
160. Barotrauma in Boeing 737 cabin crew.
- Author
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Kortschot HW and Oosterveld WJ
- Subjects
- Adult, Aerospace Medicine, Ear Diseases etiology, Female, Humans, Aircraft, Barotrauma etiology, Eustachian Tube physiopathology, Occupational Diseases etiology, Tympanic Membrane injuries
- Abstract
Several aircrew members of a Boeing 737 aircraft were referred to our department because they suffered from a barotrauma. The fast rate of pressure change during the descent of a Boeing 737 aircraft, as compared to the Boeing 747, DC-10 and Airbus 310 aircrafts, is most likely the cause of the development of the barotraumata.
- Published
- 1993
- Full Text
- View/download PDF
161. Asymptomatic osteomas of the middle ear.
- Author
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Silver FM, Orobello PW Jr, Mangal A, and Pensak ML
- Subjects
- Adult, Ear Neoplasms diagnosis, Ear Neoplasms surgery, Ear, Middle physiopathology, Ear, Middle surgery, Female, Humans, Osteoma pathology, Osteoma surgery, Otitis Media etiology, Otitis Media physiopathology, Respiratory Tract Infections complications, Respiratory Tract Infections physiopathology, Tympanic Membrane injuries, Tympanic Membrane surgery, Tympanoplasty adverse effects, Ear Neoplasms pathology, Ear, Middle pathology, Osteoma diagnosis, Tympanic Membrane pathology
- Abstract
Osteomas of the middle ear are extremely rare lesions. Of the nine cases reported, eight presented with conductive hearing loss. We recently treated two patients whose osteomas, of the promontory and of the posteroinferior tympanic wall, were asymptomatic. We suggest that middle ear osteomas need not be removed when they do not impinge on the sound conduction system.
- Published
- 1993
162. Middle ear barotrauma associated with hyperbaric oxygenation treatment.
- Author
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Igarashi Y, Watanabe Y, and Mizukoshi K
- Subjects
- Adult, Aged, Aged, 80 and over, Barotrauma diagnosis, Humans, Locomotion physiology, Middle Aged, Postural Balance physiology, Risk Factors, Tympanic Membrane injuries, Barotrauma etiology, Ear, Middle injuries, Hyperbaric Oxygenation adverse effects
- Abstract
We investigated the signs and symptoms of middle ear barotrauma in 67 patients with hyperbaric oxygenation treatment as well as the influence of predisposing factors. Ear damage was classified into 5 grades on the basis of objective findings at otoscopic examination. The incidence of middle ear barotrauma assessed by objective criteria was 68.7%, and showed little variation with age or primary disease. On the other hand, the incidence assessed by subjective symptoms was lower than the objectively-based incidence in aged patients, those with severe neurological diseases, and those who had difficulties speaking. Patients with a trauma grade of 2 or more complained of severe symptoms and were appropriate candidates for treatment. It is considered that otoscopic examination should be performed in patients who undergo hyperbaric oxygenation treatment and that prior management of nasal and paranasal diseases is beneficial in the prevention and treatment of middle ear barotrauma.
- Published
- 1993
- Full Text
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163. T-tubes: a retrospective review of 1274 insertions over a 4-year period.
- Author
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Mangat KS, Morrison GA, and Ganniwalla TM
- Subjects
- Cerumen, Child, Child, Preschool, Ear, Middle pathology, Humans, Otitis Media with Effusion epidemiology, Retrospective Studies, Sclerosis, Time Factors, Tympanic Membrane injuries, Middle Ear Ventilation adverse effects, Middle Ear Ventilation statistics & numerical data, Otitis Media with Effusion surgery
- Abstract
1274 T-tubes were inserted for persistent otitis media with effusion in 661 patients over a 4-year period. The peak ages for insertion were between 4 and 7 years, and by 11 years the condition is uncommon. If a tube has not extruded spontaneously after 30 months it becomes increasingly less likely to do so. Complications were persistent perforations (32.6%), tympanosclerosis (23.6%), repeated otorrhoea or tympanic membrane granulations (21%), and impacted wax (10.9%). Forty-eight percent of patients experienced one or more complication in the study period, and the complication rate increased dramatically in patients whose tubes had remained in situ for longer than 36 months. After this time surgical removal is recommended.
- Published
- 1993
- Full Text
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164. Experimental pressure induced rupture of the tympanic membrane in man.
- Author
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Jensen JH and Bonding P
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Cadaver, Child, Child, Preschool, Humans, Infant, Middle Aged, Pressure, Rupture, Tympanic Membrane pathology, Tympanic Membrane injuries
- Abstract
The size of the overpressure in the ear canal which causes rupture of the tympanic membrane (TM) in man (rupture pressure, RP) was determined in 90 subjects 7-112 h post mortem in connection with the autopsy. The equipment allowed an overpressure in the ear canal to be applied either gradually or suddenly. In 144 normal TMs it was demonstrated that the tensile strength of the TM increases post mortem. Corrected to the time 0 post mortem, RP of normal TMs ranged 0.5-2.1 kp/cm2, median 1.2 kp/cm2. It was found to be correlated to the age of the patient, i.e. RP decreased with increasing age. No correlation was found between RP and the application speed of the overpressure. Ninety-nine percent of the ruptures were localized to the pars tensa (63% to the anterior part of this structure) and typically had the shape of a minor tear. The RP of 23 TMs with atrophic scars was significantly lower, 0.3-0.8 kp/cm2, and the rupture typically had the shape of a larger defect. The results of this study indicate large intersubject variability of the tensile strength of the human TM. Some individuals are at increased risk of TM rupture at minor overpressures in the ear canal (e.g. during certain watersports, such as diving) which may carry medicolegal implications.
- Published
- 1993
- Full Text
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165. Spontaneous healing of traumatic tympanic membrane perforations in man: a century of experience.
- Author
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Kristensen S
- Subjects
- Humans, Remission, Spontaneous, Rupture, Tympanic Membrane injuries, Wound Healing
- Abstract
Widespread controversy exists concerning the treatment of traumatic tympanic membrane perforations. To elucidate the issue, a reference value for the rate of spontaneous tympanic membrane closure in man, to which the healing rates following different techniques of early surgical repair should be compared, was established on the basis of a review of more than 500 texts covering a century's literature on the traumatically perforated tympanic membrane. The spontaneous healing rate appeared to be close to 80 (78.7 per cent) in 760 evaluable cases of traumatic tympanic membrane perforations of all sorts diagnosed within 14 days post injury. A relative, causal-related variation of spontaneous healing could be demonstrated, and a pathogenetic classification of direct traumatic tympanic membrane perforations into ruptures induced by air-pressure changes, heat or corrosives, solids, and water pressures, is of proved clinical value and may have medico-legal validity. There is an obvious need for clinically controlled studies on the spontaneous healing of all kinds of traumatic perforations of the tympanic membrane in humans, and important elements in the design of future studies are advocated.
- Published
- 1992
- Full Text
- View/download PDF
166. Long-term results of Goode's tympanostomy tubes in children.
- Author
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Prichard AJ, Marshall J, Skinner DW, and Narula AA
- Subjects
- Child, Child, Preschool, Female, Humans, Male, Middle Ear Ventilation instrumentation, Otitis Media with Effusion etiology, Retrospective Studies, Tympanic Membrane injuries, Middle Ear Ventilation adverse effects
- Abstract
The results of a retrospective study of the complications of middle ear ventilation by Goode's T-tubes in children are presented. 248 T-tubes were inserted into 119 patients. 16.9% progressed to spontaneous extrusion with a mean period of ventilation approaching 20 months. 54.9% of patients experienced otorrhoea which was found to be significantly more common in those ears with a mucoid effusion at the time of T-tube insertion. 21.1% of ears developed a persistent perforation where spontaneous extrusion had occurred or the T-tubes had been removed. Perforation also occurred more frequently in those with otorrhoea.
- Published
- 1992
- Full Text
- View/download PDF
167. Repair of chronic tympanic membrane perforations using epidermal growth factor.
- Author
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Amoils CP, Jackler RK, and Lustig LR
- Subjects
- Animals, Chinchilla, Recombinant Proteins therapeutic use, Tympanic Membrane anatomy & histology, Tympanic Membrane injuries, Epidermal Growth Factor therapeutic use, Myringoplasty, Tympanic Membrane physiology, Wound Healing physiology
- Abstract
Perforation of the tympanic membrane (TM) is a frequent cause of conductive hearing loss. Persistent TM perforations often require surgical repair with an autologous tissue graft to restore hearing and prevent recurrent infection. While highly efficacious, this method of closure requires a relatively complex and expensive microsurgical procedure. We have recently developed a chronic TM perforation model in the chinchilla for use in the exploration of novel methods of TM repair.
- Published
- 1992
- Full Text
- View/download PDF
168. Unsuspected factors in 'self-limiting' ailments.
- Author
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Bennett JD and McFarlane HW
- Subjects
- Administration, Topical, Adult, Cerumen, Ear Diseases diagnosis, Ear Diseases drug therapy, Female, Humans, Nonprescription Drugs, Rupture, Spontaneous, Tympanic Membrane injuries
- Abstract
An unsuspected subtotally perforated eardrum treated with wax softening drops shows how clinical findings do not always correlate with symptoms or history. Attention is drawn to the dilemma posed by delegating matters such as diagnosis and prescribing which have been considered to be purely in the medical sphere.
- Published
- 1992
169. Functional/metabolic modulation of the brain stem lesions caused by 1,3-dinitrobenzene in the rat.
- Author
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Ray DE, Brown AW, Cavanagh JB, Nolan CC, Richards HK, and Wylie SP
- Subjects
- Acoustic Stimulation, Animals, Blood Glucose metabolism, Brain Stem metabolism, Brain Stem pathology, Fixatives, Male, Noise, Rats, Rats, Inbred F344, Rupture, Specimen Handling methods, Auditory Threshold physiology, Brain Stem drug effects, Dinitrobenzenes poisoning, Tympanic Membrane injuries
- Abstract
To determine whether neuronal activity plays a role in the localisation of brain stem lesions in 1,3-dinitrobenzene intoxication we produced asymmetrical changes in auditory input by rupturing the left tympanic membrane in Fischer rats. This raised the auditory threshold on that side from 57-63 dB to 104-122 dB. It also decreased glucose utilisation in the ipsilateral cochlear nucleus and significantly increased utilisation in the contralateral nucleus, resulting in a relative deficit of 72 +/- 6%. Similarly, tympanic membrane rupture led to decreased glucose utilisation in the contralateral and increased utilisation in the ipsilateral inferior colliculus. Additional exposure to "white noise" prevented the decrease in glucose utilisation in the contralateral inferior colliculus. Dosing with dinitrobenzene (10 mg/kg in 4 doses over 48 hr) to otherwise normal rats produces symmetrical vasculonecrotic lesions in these regions, but in animals with left tympanic membrane rupture the severity of morphological changes in the ipsilateral cochlear nucleus and the contralateral inferior colliculus were substantially reduced. Additional exposure to "white noise" increased the degree of damage in the ipsilateral cochlear nucleus and contralateral inferior colliculus. These findings indicate that altered auditory function in rats, with its associated metabolic consequences exercises a significant role in the development of brain stem damage in auditory pathways following dinitrobenzene intoxication.
- Published
- 1992
170. [A method of myringoplasty used in patients with extensive defects of the tympanic membrane].
- Author
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Sitnikov VP, Kin TI, and Aleksandrovskiĭ IuK
- Subjects
- Adolescent, Adult, Child, Child, Preschool, Female, Humans, Male, Microtomy methods, Middle Aged, Transplantation, Autologous, Transplantation, Homologous, Tympanic Membrane surgery, Cartilage transplantation, Fascia transplantation, Myringoplasty methods, Ribs, Temporal Muscle transplantation, Tympanic Membrane injuries, Wounds, Penetrating surgery
- Abstract
Multilayer transplants made up of an ultrathin allocartilaginous plate (an internal layer), autofascia of musculus temporalis (an intermediate layer) and stored amnion (an external layer) were used to eliminate extensive perforations of the tympanic membrane. The transplantation resulted in high proportion of the graft takes with a considerable improvement of hearing.
- Published
- 1992
171. Burn of the auricle.
- Author
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Crumley RL and Abemayor E
- Subjects
- Adult, Burns etiology, Burns surgery, Ear, External surgery, Humans, Male, Tympanic Membrane injuries, Burns drug therapy, Ear, External injuries, Mafenide therapeutic use, Silver Sulfadiazine therapeutic use, Steam adverse effects
- Abstract
Silvadene cream and Sulfamylon make up the treatment regimen for one contributor (Dr. Crumley). No systemic antibiotics would be given. Any areas of obvious third-degree burns would be debrided and grafted. The tympanic membrane perforation would be treated with antibiotic/steroid drops. The second author concurs with use of Silvadene cream and would avoid any pressure on the area (Dr. Abemayor). While he agrees that systemic antibiotics should be avoided, he also would not prescribe ear drops. He recommends evaluation for a pulmonary or ophthalmologic injury. There is a disagreement regarding imaging studies. One expert would order a CT scan to rule out facial fractures (Dr. Crumley). His counterpart would not order a CT but would check a baseline chest x-ray if there were any sign of pulmonary compromise (Dr. Abemayor). Both experts would obtain an audiogram after the acute problems are treated. In the case of foul drainage, burn reconstruction would be delayed. In addition to treating the otorrhea with ear drops, one physician would add oral antibiotics (Dr. Abemayor). The other author believes tympanoplasty should be performed prior to reconstruction (Dr. Crumley). There were several procedures suggested for the reconstruction. Both authors discuss a method of creating a postauricular pocket, burying the ear pedicle, and using costal cartilage for an inlay helical graft. Another approach involves minimal debridement of the cartilage and letting the wound mature for 6 to 8 months. At that time the area would be debrided and the postauricular skin used for external coverage (Dr. Crumley). If the facial scar is a cosmetic problem 1 year after the injury, triamcinolone injections and local massage should be considered.(ABSTRACT TRUNCATED AT 250 WORDS)
- Published
- 1992
- Full Text
- View/download PDF
172. [Ear surgeon's tactics in temporal bone fractures with injury of the facial nerve and sound-conducting system].
- Author
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Shuster MA and Chkannikov AN
- Subjects
- Facial Nerve surgery, Facial Paralysis etiology, Humans, Nerve Compression Syndromes etiology, Skull Fractures surgery, Tympanic Membrane surgery, Tympanoplasty methods, Facial Nerve Injuries, Facial Paralysis surgery, Nerve Compression Syndromes surgery, Skull Fractures complications, Temporal Bone injuries, Tympanic Membrane injuries
- Abstract
Out of 486 patients with basilar skull fracture, 74 developed peripheral paralysis of the facial nerve (28 cases of early and 39 of late posttraumatic paralysis). 19 (67.8%) patients with early paralysis recovered function of the facial nerve, whereas only 9 (32.2%) with late paralysis were cured. Indications to surgical management of relevant paralyses are specified. Cases of one-stage tympanoplasty are described.
- Published
- 1992
173. [Physician malpractice in unmonitored delegation of ear canal irrigation to a physician assistant].
- Author
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Wienke A
- Subjects
- Humans, Cerumen, Malpractice legislation & jurisprudence, Physician Assistants legislation & jurisprudence, Therapeutic Irrigation adverse effects, Tympanic Membrane injuries
- Published
- 1992
174. [Sandwich-graft myringoplasty: the authors' personal technic and results].
- Author
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Pagnini P, Scarpini L, Fanfani F, and Norberti A
- Subjects
- Adolescent, Adult, Child, Follow-Up Studies, Humans, Middle Aged, Myringoplasty statistics & numerical data, Otitis Media epidemiology, Otitis Media physiopathology, Otitis Media surgery, Surgical Flaps methods, Surgical Flaps statistics & numerical data, Tympanic Membrane injuries, Tympanic Membrane physiopathology, Myringoplasty methods
- Abstract
The authors describe the anatomic and functional results obtained with a sandwich myringoplasty technique (MPL) employing an endaural approach. The suggested technique is a modified sandwich MPL by endaural approach with a reduced Shambaugh incision, a systematic profiling of the canal wall bulge and separation of the meatal and tympano-meatal flaps that are maintained pedunculated. The temporal fascia is inserted between the fibrous layer of the tympanic remnant and a single pedunculated tympano-meatal cutaneous flap replaced in the original location. The authors present 72 cases operated between January 1987 and December 1989 for perforations involving up to three quadrants. In 93.1% of the cases a complete and lasting resolution of the perforation was obtained. Of the 5 failures, 4 presented a perforation smaller than the original one. An average (250, 500, 1000 Hz) functional recovery of 14.1 dB was observed compared to an average pre-operatory gap of 21.6 dB. In 25% of the cases, average recovery was greater than 25 dB and in 5 patients a slight worsening with an average difference of -3.3 dB was observed. On the whole, in 41 patients a residual post-operatory gap of only 10 dB was achieved. The anatomical results obtained with the MPL presented are similar to those found in the literature describing the classical overlay technique. However, the cases reported do not present those inconveniences associated to the latter technique (lateralization of the graft and blunting). The anatomic and functional results obtained with the technique discussed are on the whole superior to those described with the underlay and the classical overlay techniques. The Authors believe that this is mainly due to the absence of the gelfoam in the middle ear and to the double contention and vascularization of the temporal fascia graft. By means of the profiling of the canal wall the endaural approach permits a good view of the operating field. Furthermore, it is less traumatic and more acceptable to the patient than the postauricular one that has to be limited to the MPL where there are clinical indications for the exploration of antrum. The personal technique here presented implies, however, a certain presence of epithelial pearls. Their localization is nevertheless facilitated by the absence of blunting, thickening and lateralization of the graft. This allows for an early and easy removal on an out-patient basis. Other inconveniences of the technique are the length of the procedure and a more difficult control of the ossicular chain.(ABSTRACT TRUNCATED AT 400 WORDS)
- Published
- 1992
175. Gelfilm myringoplasty: a technique for residual perforations.
- Author
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Baldwin RL and Loftin L
- Subjects
- Child, Humans, Middle Ear Ventilation adverse effects, Tympanic Membrane injuries, Gelatin, Myringoplasty methods
- Published
- 1992
- Full Text
- View/download PDF
176. Persistent tympanic membrane perforation from ventilation tubes.
- Author
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Robinson GD
- Subjects
- Child, Humans, Middle Ear Ventilation adverse effects, Tympanic Membrane injuries
- Published
- 1992
- Full Text
- View/download PDF
177. [Silicone foreign body in the middle ear caused by auditory canal impression in hearing aid fitting].
- Author
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Schimanski G
- Subjects
- Aged, Aged, 80 and over, Foreign Bodies surgery, Humans, Male, Tympanic Membrane injuries, Tympanic Membrane surgery, Ear, Middle surgery, Foreign Bodies etiology, Hearing Aids, Hearing Loss, Sensorineural therapy, Silicone Elastomers
- Abstract
We report an 81-year-old man who suffered a rupture of the tympanic membrane during the taking of an impression for the fitting of a hearing aid. A large amount of impression material thus penetrated the middle ear. The symptoms and surgical treatment are reported. Criteria for the qualification of persons entrusted with the prescription and adaptation of hearing aids are presented to help to prevent similar incidents.
- Published
- 1992
178. Functional study of the eustachian tube with sequential scintigraphy.
- Author
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Paludetti G, Di Nardo W, Galli J, De Rossi G, and Almadori G
- Subjects
- Chronic Disease, Eustachian Tube diagnostic imaging, Humans, Nasopharynx diagnostic imaging, Nasopharynx physiopathology, Otitis Media diagnostic imaging, Postural Balance physiology, Pressure, Radioactivity, Radionuclide Imaging, Technetium Tc 99m Aggregated Albumin, Time Factors, Tympanic Membrane diagnostic imaging, Wounds, Penetrating diagnostic imaging, Eustachian Tube physiopathology, Otitis Media physiopathology, Tympanic Membrane injuries, Wounds, Penetrating physiopathology
- Abstract
The authors investigated the tubal function by means of sequential scintigraphy in 16 patients affected by chronic otitis media and in 3 patients with posttraumatic perforation of the tympanic membrane. Evaluated parameters were: appearance time (AT), radioactivity peak time, rise time in the tympanic cavity, eustachian tube and rhinopharynx, and radioactivity percent values passed in the rhinopharynx. The tubal pressure-equilibrating function was determined by means of the manometer pump section of the impedance meter. A significant relationship between the pressure-equilibrating function and the tubal scintigraphy parameters has been detected. The variability of the AT in the tube and the almost constant time needed by the radioactive tracer to go through the tube and reach the rhinopharynx could indicate that a major role in the tympanic cavity drainage is played by the tympanic ostium and the surrounding mucosa.
- Published
- 1992
- Full Text
- View/download PDF
179. [Occlusive dressing--s potential treatment for tympanic membrane rupture?].
- Author
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Spandow O and Hellström S
- Subjects
- Animals, Bandages, Hydrocolloid, Paper, Rats, Rupture, Tympanic Membrane physiology, Wound Healing, Colloids therapeutic use, Occlusive Dressings, Tympanic Membrane injuries
- Abstract
In a rat study, an occlusive double-layer transparent hydrocolloid dressing, Duo-DERM, was compared with a rice paper dressing in the treatment of tympanic membrane perforation. The Duo-DERM dressing manifested better healing properties, and the healed membrane was histologically similar to spontaneously healed membrane, being generally thin with moderate connective tissue thickening. If this dressing is found to have good healing properties in clinical trials, it would mean a great saving in health care resources. The method is simple, inexpensive, and gives immediate improvement in hearing.
- Published
- 1992
180. Diagnosis of middle ear disease with eardrum perforation by a newly developed sweep frequency measuring apparatus.
- Author
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Wada H, Kobayashi T, and Tachizaki H
- Subjects
- Ear Ossicles physiopathology, Equipment Design, Female, Humans, Male, Models, Biological, Otitis Media complications, Otitis Media physiopathology, Rupture complications, Rupture diagnosis, Rupture physiopathology, Wounds, Penetrating complications, Wounds, Penetrating diagnosis, Wounds, Penetrating physiopathology, Acoustic Impedance Tests instrumentation, Otitis Media diagnosis, Tympanic Membrane injuries
- Abstract
Dynamic characteristics of an artificial middle ear model with and without eardrum perforations were measured with our newly developed sweep frequency measuring apparatus. Then, the dynamic characteristics of patients with chronic otitis media having eardrum perforations and with traumatic perforations were measured with this apparatus, and the results were compared with those of the artificial middle ear model with an eardrum perforation. The comparison leads to the conclusion that the middle ear condition of patients with eardrum perforations can be distinguished on the basis of their measurement results. Furthermore, the ossicular chain conditions of patients with eardrum perforations can be diagnosed after putting a paper patch on the eardrum perforation. Therefore, this apparatus seems to be highly useful in the diagnosis of both ossicular chain disorders and eardrum perforations.
- Published
- 1992
- Full Text
- View/download PDF
181. Myringoplasty for the anterior perforation: experience with the Kerr flap.
- Author
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Sharp JF, Terzis TF, and Robinson J
- Subjects
- Adolescent, Adult, Aged, Child, Humans, Middle Aged, Myringoplasty methods, Surgical Flaps methods, Tympanic Membrane injuries
- Abstract
Surgical closure of the anteriorly located tympanic membrane perforation can present a problem. The lack of anterior support for the graft frequently leads to graft failure if an underlay method is used whereas anterior blunting is a complication of onlay techniques in this situation. The experience with the Kerr flap, an underlay graft fashioned to include a tab of fascia which is placed laterally under the annulus and the anterior meatal skin, is presented. This method gave a 97.5 percent closure rate with no cases of anterior marginal blunting and a mean auditory threshold gain of 8.5 dB (95 percent confidence limits 5 to 11.9 dB, P less than 0.01) was achieved at the frequencies tested. The use of the Kerr flap is recommended when repairing the anteriorly placed tympanic membrane perforation.
- Published
- 1992
- Full Text
- View/download PDF
182. An animal model of chronic tympanic membrane perforation.
- Author
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Amoils CP, Jackler RK, Milczuk H, Kelly KE, and Cao K
- Subjects
- Animals, Chronic Disease, Otitis Media etiology, Rupture, Tympanic Membrane pathology, Wound Healing, Wounds and Injuries complications, Chinchilla, Disease Models, Animal, Tympanic Membrane injuries
- Abstract
Previous investigations into the healing and reconstruction of tympanic membrane (TM) perforations have involved animal models with acute TM perforations. A problem with the acute TM perforation model is that most acute TM perforations will heal spontaneously, both in animals and human beings. A second inadequacy of acute perforation models is that they are not analogous to the salient problem in human beings: long-standing TM perforation. The ideal animal model must have a TM perforation that is permanent, well-epithelialized, and free from infection. The perforation must also be subtotal to preserve a rim of membrane for experimental manipulations. In the chinchilla, we have identified a hardy animal with a short, wide ear canal and relatively large tympanic membranes. Thermal myringectomy, followed by medial infolding of TM microflaps, has resulted in permanent, subtotal chronic TM perforations in the chinchilla animal model. Of the 19 chinchillas (38 TMs) perforated, chronic subtotal perforations were created in 32 ears, 6 to 8 weeks after the initial procedure (84% success). Persistent infection or TM regeneration despite reperforation was recorded in 6 ears (16%) failure). This model is currently being used to assess various biomembrane scaffolds impregnated with growth-promoting substances in the regeneration of a physiologically sound TM, initially in our animal model and then in human beings. We envision the development of a biomembrane disc impregnated with biorecombinant growth factors that may provide a simple office technique for the repair of chronic, non-infected TM perforations.
- Published
- 1992
- Full Text
- View/download PDF
183. [Healing of tympanic membrane perforation-a complex process influenced by a variety of factors].
- Author
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Spandow O and Hellström S
- Subjects
- Heparin pharmacology, Humans, Hyaluronic Acid pharmacology, Tympanic Membrane injuries, Tympanic Membrane physiopathology, Wound Healing drug effects
- Abstract
It is known that the healing of a perforated tympanic membrane can be influenced by mechanical procedures as well as drugs. Animal experiments have recently shown that local treatment with steroids delays the healing of a tympanic membrane perforation, whereas hyaluronan (hyaluronic acid) improves the healing rate as well as the quality of the scar. Hyaluronan, a non-sulphated glycosaminoglycan, belongs to the extracellular matrix substances. In the present study another glycosaminoglycan--heparin--was applied on experimental tympanic membrane perforations. This report confirmed that also this extracellular matrix substance improves the healing rate of a tympanic membrane perforation and the scar quality.
- Published
- 1992
184. [Primary lesions caused by explosions].
- Author
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Pérez-Castanedo J, Metje MT, Vilaplana J, Vizuete G, March X, and García-Jiménez MR
- Subjects
- Adult, Amputation, Traumatic therapy, Burns etiology, Burns therapy, Combined Modality Therapy, Explosions, Humans, Leg Injuries etiology, Lung Injury, Male, Multiple Trauma etiology, Multiple Trauma therapy, Pneumothorax etiology, Pneumothorax therapy, Positive-Pressure Respiration adverse effects, Shock etiology, Shock therapy, Testis injuries, Tympanic Membrane injuries, Violence, Blast Injuries classification, Blast Injuries physiopathology, Blast Injuries surgery, Blast Injuries therapy, Emergency Medical Services
- Abstract
The lesions produced by the expansive wave are characteristic of severe injury produced by explosion. This type of injury is being classified as primary lesion. We report a 28 years old male patient who suffered amputation of both lower extremities associated with hypovolemic shock. The patient presented primary tympanic perforation and pneumothorax after initiation of mechanical ventilation at positive pressure. In the discussion section we analyze the physical mechanisms leading to this primary lesion and we indicate the organs most commonly affected. We rise general considerations dealing with the management of these patients and we remark the advantages of a coordinated medical attendance policy.
- Published
- 1992
185. Interlay method for myringoplasty.
- Author
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Komune S, Wakizono S, Hisashi K, and Uemura T
- Subjects
- Adolescent, Adult, Aged, Child, Child, Preschool, Chronic Disease, Epithelium growth & development, Female, Humans, Male, Middle Aged, Otitis Media surgery, Postoperative Complications epidemiology, Rupture, Tympanic Membrane injuries, Tympanic Membrane physiopathology, Tympanic Membrane surgery, Wound Healing, Myringoplasty methods
- Abstract
Sixty-nine ears with perforation of the tympanic membrane were reviewed. All had undergone myringoplasty by the interlay method. The average period for complete epithelization was 16.1 days after surgery. Neither blunting of the anterior tympanomeatal angle nor lateralization of the tympanic membrane was observed. The success rate was 94.2% for the initial surgery, when "success" is defined as closure of the perforation and complete epithelization (dry ear). The surgical technique and various advantages of the interlay method of myringoplasty are described.
- Published
- 1992
- Full Text
- View/download PDF
186. Real ear unaided responses in ears with tympanic membrane perforations.
- Author
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Moryl CL, Danhauer JL, and DiBartolomeo JR
- Subjects
- Acoustics, Adolescent, Adult, Aged, Aged, 80 and over, Chronic Disease, Ear Canal, Female, Humans, Male, Middle Aged, Myringoplasty, Rupture, Tympanic Membrane injuries, Tympanic Membrane surgery, Audiometry methods, Auditory Threshold, Hearing Aids, Tympanic Membrane physiopathology
- Abstract
This study evaluated 13 adult patients with tympanic membrane (TM) perforations in one or both ears. Probe microphone real ear unaided responses (REURs) for mean peak frequency and peak dB gain showed no substantial differences among patients, across ears with intact TMs, ears with TM perforations (regardless of size), or between measures taken before and after closure of the perforations. Inspection of individual differences in the patients' REURs, however, produced an interesting finding. The REURs of ears having small TM perforations did not differ from those with intact TMs, but the REURs for ears having larger perforations consistently revealed bimodal responses (two prominent peaks separated by a valley of at least 10 dB lower gain). Thus, size of the perforation affected the REURs.
- Published
- 1992
187. Blast injuries of the ear as a result of the Peterborough lorry explosion: 22 March 1989.
- Author
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Bruins WR and Cawood RH
- Subjects
- Audiometry, Hearing Loss, Sensorineural surgery, Humans, Tympanic Membrane surgery, Blast Injuries complications, Cochlea injuries, Hearing Loss, Sensorineural etiology, Tinnitus etiology, Tympanic Membrane injuries
- Abstract
The incidence of blast trauma to the ears in significant numbers is relatively rare in peace time. This paper outlines the results and management of twenty patients injured as a result of the outside explosion of 800 kg of high explosives in Peterborough on 22 March 1989.
- Published
- 1991
- Full Text
- View/download PDF
188. Exostosis of the external auditory canal: an interesting histopathological finding.
- Author
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Pace-Balzan A and Hawke M
- Subjects
- Ear Canal surgery, Ear Diseases surgery, Exostoses surgery, Humans, Intraoperative Complications, Ear Canal pathology, Ear Diseases pathology, Exostoses pathology, Tympanic Membrane injuries
- Abstract
Perforation of the tympanic membrane is a frequent complication of surgery for exostoses of the external auditory canal. We report an unusual histopathological finding in a temporal bone containing external canal exostoses which suggests that some of these perforations may be unavoidable.
- Published
- 1991
- Full Text
- View/download PDF
189. Traumatic perforation of the tympanic membrane.
- Author
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Weiss LS and Amedee RG
- Subjects
- Humans, Rupture, Wounds and Injuries diagnosis, Wounds and Injuries therapy, Tympanic Membrane injuries
- Abstract
Traumatic perforations of the tympanic membrane are not uncommon injuries. The various etiologies of this injury along with the appropriate evaluation will be discussed. The goal of this review is to enhance the nonotolaryngologist's knowledge of this condition and its treatment.
- Published
- 1991
190. [Welding spark injuries of the ear. Observations of personal case material].
- Author
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Mertens J, Bubmann M, and Reker U
- Subjects
- Cicatrix physiopathology, Follow-Up Studies, Hearing Disorders etiology, Humans, Recurrence, Rupture, Tympanic Membrane surgery, Tympanoplasty methods, Burns surgery, Occupational Diseases surgery, Tympanic Membrane injuries, Welding
- Abstract
25 cases of tympanic welding spark injuries of the years 1959-1989 are reported. Early results and late sequelae after conservative therapy, immediate and interval operation are described and discussed. Regarding the tendency of tympanic defects to enlarge after thermal injuries despite conservative and early operative therapy, secondary seal by tympanoplasty is recommended. Even then, however, the rate of residual and recurring perforations must be reckoned as being higher than after tympanoplasty in comparable defects of other origin, due to the inferior nutritive supply owing to the extended scar caused by burning. On the other hand, the rate of inner ear traumatisation with 12% directly after welding injury and with 4% remaining impairment of hearing, is low.
- Published
- 1991
- Full Text
- View/download PDF
191. Complications following ventilation of the middle ear using Goode T tubes.
- Author
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Bulkley WJ, Bowes AK, and Marlowe JF
- Subjects
- Adolescent, Adult, Bacterial Infections etiology, Child, Child, Preschool, Ear Diseases etiology, Follow-Up Studies, Humans, Infant, Otitis Media therapy, Recurrence, Retrospective Studies, Suppuration etiology, Tympanic Membrane injuries, Middle Ear Ventilation adverse effects, Middle Ear Ventilation instrumentation
- Abstract
This is a 3.5-year retrospective review on the insertion of 210 Goode T tubes into 182 ears of 93 patients. Otorrhea was noted postoperatively in 35.2% of the ears treated, with chronic drainage lasting longer than 4 months developing in more than 7% of the cases. Perforations were found in 34 ears (18.7%) following removal or extrusion of the T tubes; in 13 (7.1%) of these patients, chronic perforations requiring tympanoplasties developed. The literature was screened for additional studies addressing the complications associated with tympanostomy tubes. The documented incidence of perforations between conventional tubes and Goode T tubes was emphasized, and comparisons were made. Our findings indicate that, even with the immediate placement of paper patches following removal of all Goode T tubes, the percentage of tympanic membrane perforations resulting from the use of Goode T tubes is significantly greater than previously reported.
- Published
- 1991
- Full Text
- View/download PDF
192. Lightning and its effects on the auditory system.
- Author
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Jones DT, Ogren FP, Roh LH, and Moore GF
- Subjects
- Adult, Burns, Electric etiology, Ear Canal injuries, Hearing Loss, High-Frequency etiology, Humans, Male, Oval Window, Ear injuries, Rupture, Tinnitus etiology, Tympanic Membrane injuries, Deafness etiology, Hearing Loss, Sensorineural etiology, Lightning Injuries complications
- Abstract
Patients struck by lightning can present with a wide variety of unusual otologic problems including burns to the external auditory canal, tympanic membrane rupture, middle ear injury, and sensorineural hearing loss. Four patients who incurred various otologic problems, including one patient with previously unreported bilateral oval window fistulas following lightning injury, are presented. Audiologic, otologic, and surgical findings are reviewed as well as patient follow-up and outcome.
- Published
- 1991
- Full Text
- View/download PDF
193. Tympanic membrane injury in welders: is prevention neglected?
- Author
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Fisher EW and Gardiner Q
- Subjects
- Adult, Female, Humans, Male, Middle Aged, Myringoplasty, Occupational Diseases surgery, Occupational Diseases therapy, Tympanic Membrane surgery, Head Protective Devices, Occupational Diseases prevention & control, Tympanic Membrane injuries, Welding
- Abstract
Injury to the ear in welders is a recognized but poorly documented entity. Five cases are described to demonstrate a spectrum of severity of injury, ranging from minor burns to tympanic membrane perforation requiring myringoplasty. Welders are most at risk when working overhead, in cramped conditions or adjacent to other welders. Conventional safety helmets offer inadequate protection to the ears and it is recommended that insert ear plugs should be offered to all workers at risk, in addition to safer working practices. An increased awareness of these risks among occupational physicians, welders and employers is required before these recommendations can realistically be implemented.
- Published
- 1991
- Full Text
- View/download PDF
194. Sequelae of experimental tympanic and inferior canal wall perforations: the double meaning of epithelial migration.
- Author
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Smelt G, Stoney P, Weinberger J, and Hawke M
- Subjects
- Animals, Cell Movement, Coloring Agents, Cytoplasm ultrastructure, Cytoplasmic Granules ultrastructure, Ear Canal pathology, Epithelium pathology, Exudates and Transudates, Fibrosis, Guinea Pigs, Hyperplasia, Male, Mucous Membrane pathology, Sebaceous Glands pathology, Staining and Labeling, Temporal Bone pathology, Tympanic Membrane pathology, Wound Healing, Carbon, Ear Canal injuries, Tympanic Membrane injuries
- Abstract
The term "epithelial migration" has been used to describe both the normal surface movement of the tympanic epithelium and the movement of epithelial basal cells in repair processes. In an attempt to distinguish between these two processes and to determine their role in the repair of a wounded tympanic membrane, 20 guinea pig tympanic membranes were perforated inferiorly and tattooed with ink through an external incision. Sequential histology of whole temporal bones at intervals from the time of injury up to three weeks showed evidence of movement of the superficial layers of epidermis which was effective in the clearance of cellular debris but not in the closure of the perforation. Drum closure was effected more by the accumulation of exudate and epithelial hyperplasia. The migration of the epithelial basal cells was slow when compared to surface movement. It is suggested that tympanic epithelial surface movement is best described by a passive term such as "epithelial displacement" and that the term migration should be restricted to the activities of the living layers of epidermis.
- Published
- 1991
195. The ear: "dos" and "don'ts".
- Author
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Bear VD
- Subjects
- Acute Disease, Adult, Child, Hearing Disorders etiology, Hearing Disorders therapy, Hearing Loss, Noise-Induced etiology, Hematoma surgery, Humans, Otitis Externa therapy, Otitis Media with Effusion drug therapy, Rupture, Tympanic Membrane injuries, Ear, Ear Diseases therapy, Foreign Bodies therapy
- Published
- 1991
- Full Text
- View/download PDF
196. Impedance measurement in divers during a scuba-diving training programme.
- Author
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Paaske PB, Staunstrup HN, Malling B, and Knudsen L
- Subjects
- Adolescent, Adult, Barotrauma physiopathology, Ear, Middle injuries, Ear, Middle physiology, Elasticity, Humans, Male, Tympanic Membrane physiology, Acoustic Impedance Tests, Diving injuries, Tympanic Membrane injuries
- Abstract
An assessment of the strain on the tympanic membrane caused by diving was performed using impedance measurement of the middle ear in 21 untrained young men going through a scuba-diving training programme (scuba, self-contained under-water breathing apparatus). Tympanometry was carried out just before and after diving. The divers made 104 dives between them (median 5 each, range 2-7) at depths from 2 to 12 m (median 6 m). The results showed a significant increase in middle ear compliance on diving. The increase in compliance was significant at different depths, was transient, and fell to the initial level between the dives. We conclude that the strain exerted on the tympanic membrane and middle ear from barotrauma due to diving results in a reversible impairment of the recoiling capacity of the elastic fibrils of the tympanic membrane. This transient increase in compliance, we think, is the first measurable change in elasticity of the tympanic membrane. If barotrauma continue the changes could be irreversible.
- Published
- 1991
- Full Text
- View/download PDF
197. Basic principles and clinical applications of tympanometry.
- Author
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Shanks J and Shelton C
- Subjects
- Acoustic Impedance Tests instrumentation, Humans, Otitis Media diagnosis, Otosclerosis diagnosis, Tympanic Membrane injuries, Acoustic Impedance Tests methods
- Abstract
This article presents an overview of tympanometric measures using a 226-Hz probe tone, with an additional focus on complex admittance measures at 678 Hz and an introduction to multiple frequency tympanometry. Basic principles underlying all admittance measures are presented. The clinical implementation and interpretation of tympanometry is discussed.
- Published
- 1991
198. Incidence of perforation with Goode T-tube.
- Author
-
Matt BH, Miller RP, Meyers RM, Campbell JM, and Cotton RT
- Subjects
- Chicago epidemiology, Cholesteatoma etiology, Ear Diseases etiology, Ear, Middle, Equipment Design, Equipment Failure, Follow-Up Studies, Humans, Incidence, Middle Ear Ventilation adverse effects, Ohio epidemiology, Otitis Media with Effusion surgery, Retrospective Studies, Tympanic Membrane surgery, Wound Healing, Middle Ear Ventilation instrumentation, Tympanic Membrane injuries
- Abstract
Two groups of patients from the same era were retrospectively studied in Cincinnati and Chicago. In Cincinnati two subgroups were studied. The first group received myringotomy with insertion of a 'T'-shaped ventilating tube (75 patients, 140 ears, 147 insertions). Fifty-eight ears still had the tube in place, 31 had healed after spontaneous extrusion, 17 had healed after removal of the tube, 20 had persistent perforation after the tube was gone, 2 had a cholesteatoma, and 4 patients (7 ears) were lost to follow-up. The second set received myringotomy and insertion of a small grommet (Donaldson tube, 71 patients, 140 ears, 164 insertions) tympanostomy tube. None could be documented to still have the tube in place, 156 ears healed after spontaneous extrusion, none required removal, 3 ears had a persistent perforation after the tube was gone, none had cholesteatoma, and 5 patients (5 ears) were lost to follow-up. The perforation rate for the T-tube is 13.6% and for the grommet is 1.8% (P = 0.0005). In Chicago, 93 patients who received the Goode T style tube (175 ears, 175 insertions) prior to March, 1986 were evaluated. The degree of retraction of the tympanic membrane preoperatively was recorded. No ears still had the tube in place, 145 had healed after spontaneous extrusion or removal of the tube, 30 had persistent perforation 12 months after the tube was gone, 4 had a cholesteatoma, and 8 patients (15 ears) were lost to follow-up. The rate of perforation is 18.8% which is not statistically different from the Cincinnati rate.(ABSTRACT TRUNCATED AT 250 WORDS)
- Published
- 1991
- Full Text
- View/download PDF
199. Ear wax removal.
- Author
-
Drysdale AJ
- Subjects
- Humans, Syringes, Cerumen, Tympanic Membrane injuries
- Published
- 1991
- Full Text
- View/download PDF
200. Repair of chronic tympanic membrane perforations using applications of hyaluronan or rice paper prostheses.
- Author
-
Laurent C, Söderberg O, Anniko M, and Hartwig S
- Subjects
- Adolescent, Adult, Aged, Child, Chronic Disease, Female, Humans, Male, Middle Aged, Oryza, Otitis Media complications, Paper, Rupture, Wounds and Injuries complications, Hyaluronic Acid, Myringoplasty adverse effects, Prostheses and Implants, Tympanic Membrane injuries
- Abstract
A controlled randomized study was performed in 60 patients with 64 chronic, dry tympanic membrane (TM) perforations. The perforations were randomly allocated to either resection of the perforation rim and instillation of 1% hyaluronan (Healon; HYA) in the perforation gap once daily for 7 days (33 ears) or resection of the perforation margin and application of a sterile rice paper prosthesis (31 ears). The treatment effect was documented by TM photography and morphometric measurements of the perforation area. The hearing was assessed with puretone and high-frequency audiometry. After 2 months, 5 of the HYA-treated perforations (15%) and 4 of the rice-paper-treated TMs (13%) were healed. After 1 year, 18 perforations (9 in each treatment group) were healed. In neither group were there any persistent adverse effects on hearing. It is noteworthy that 28% (18/64) of the chronic, long-standing TM perforations could be repaired by these technically simple and time-saving methods. Both procedures should be considered as easy first-choice alternatives to myringoplasty in selected cases.
- Published
- 1991
- Full Text
- View/download PDF
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