Timpanoplastias: resultados cirúrgicos e análise dos fatores que podem interferir no seu sucesso

Abstract

Chroni c otitis media has a high prevalence on the population and their treatment continuous to be a challenge for the otorhinolaryngologists. Aim: To demonstrate the factors that could interfere in the tympanoplasty success and the surgical results during 2002. Study Design: Clinical prospective. Material and Method: were included 37 patients with chronic otitis media non cholesteatoma (COMNC) undergo to tympanoplasty (in lay or underlay, with homologous graft). All the patients were submitted to a survey pre and postoperative include clinical, physical examinations, flexible nasal endoscope and audiometry. Results: The age, the dimension and localization of the tympanic membrane perforation; the condition of middle ear mucosa; number of otorrhea/year; smoking; parents history of otorrhea and hearing loss; personals history of otological surgery; monthly family income; the graft, technique and access used were not significantly to repair tympanic membrane perforations. The closure rate was 65% and the gain in air-bone gap was 100%. Conclusion: The timpanoplasty must be considerate in the treatment of the COMNC.

Evaluation of the organic and functional results of tympanoplasties through a retro-auricular approach at a medical residency unit

“…18,[29][30][31] Several other studies have found no significant statistical correlation. 4,5,32 in our study, graft integration in patients with dry ears occurred in 94.5% of cases (p=0.254); it was 100% in patients with wet ears (p=0.387). Thus, the status of the ear (dry or wet) was not statistically important for surgical success.…”

The impact of chronic suppurative otitis media on children's and teenagers’ hearing

“…The hearing thresholds may be influenced by factors such as the size and location of the tympanic perforation, the presence of ossicular chain erosion or disarticulation as well as the presence of cholesteatoma and its growth patterns [2,3].…”

“…The goals of this study were as follows: (1) to compare air conduction thresholds (AC), bone conduction thresholds (BC) and air-bone gaps in children and teenagers with chronic suppurative otitis media with cholesteatoma (CCOM) and those without cholesteatoma (NCCOM); (2) to compare air-bone gaps between different cholesteatoma growth patterns; (3) to verify the relation between the number of perforated quadrants and the value of the airbone gap; (4) to compare air-bone gaps between posterior quadrant tympanic perforations and anterior quadrant tympanic perforations.…”

Efeito da timpanoplastia no zumbido de pacientes com hipoacusia condutiva: seguimento de seis meses

“…The efferent pathways dysfunction is one of the possible mechanisms causing tinnitus 7 . Tympanoplasties usually improve tonal thresholds [8][9][10][11][12] and the favorable tinnitus results are very likely a consequence of this improvement, since the proper vibration of middle ear fluids re-establishes both afferent and efferent stimuli 13 . This is the classical example of the probable association between hearing improvement and tinnitus improvement that may also be seen in the clinical practice in the postoperative of patients with middle ear effusion, ossicular chain fixation or broken; or external acoustic meatus stenosis Tinnitus improvement after hearing restoration can also be explained by the theory of central auditory pathways hypersensitivity after reduction in afference.…”

“…Gerber et al (2000) did a retrospective study of patients submitted to tympanoplasty with tragal cartilage pericondrium or temporal muscle fascia, observing improvements in tonal thresholds and gap, regardless of the type of graft used9. Fukuchi et al (2006) show that graft take does not depend on age, perforation size, graft type, time of disease, among others, despite the low success rate of 65% of graft take, they associated it to the surgeon's skills, since all the procedures were carried out by resident physicians 12 .…”