Air-bone gap in ears with a well-repaired tympanic membrane after Type III and Type IV tympanoplasty

Okada, Masahiro; Gyo, Kiyofumi; Takagi, Toshiharu; Fujiwara, Takashi; Takahashi, Hirotaka; Hakuba, Nobuhiro; Hato, Naohito

doi:10.1016/j.anl.2013.10.006

Cited by 9 publications

(16 citation statements)

References 23 publications

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“…It is also noteworthy that ossiculoplasty had the greatest impact on hearing gain at low and mid frequencies (from 250 to 2000 Hz), but only a limited impact on frequencies above 4000 Hz, as shown in Table 5 . This result is in agreement with previous reports [ 18 , 35 , 36 ]. In 1997, Merchant et al [ 36 ] analyzed the middle ear mechanism and demonstrated that the middle ear would reach its maximum gain of 25 dB at around 1000 Hz and then decrease by about 6 dB per octave at frequencies above 1000 Hz.…”

Section: Discussionsupporting

confidence: 94%

“…In addition, the position of prosthesis placement on the footplate can also influence the hearing outcome in type IV tympanoplasty. Placement on the center footplate site has the best result, followed by the anterior and posterior footplate sites [ 18 ]. This suggests that the structural mechanism for sound transmission in type IV tympanoplasty is less optimal compared with the natural structure of intact stapes.…”

Section: Discussionmentioning

confidence: 99%

“…Types of tympanoplasty performed in this study included types I, III, and IV, denoting different statuses of the middle ear and ossicular defects following the removal of the cholesteatoma. Repositioning of sculptured bone grafts or prostheses was utilized in both type III and type IV tympanoplasties to reconstruct the sound conduction mechanism in the tympanic cavity, in accordance with the classification proposed by the Japan Otological Society in 2010 [ 18 ]. These tympanoplasties involved different ossicular chain assemblies and are thus further subdivided in this study as tympanoplasty type III-i (graft placing between the manubrium and the stapes head as interposition), type IV-i (graft placing between the manubrium and the footplate as interposition), type III-c (graft placing on the stapes head as columella under surface of the tympanic membrane (TM)), and type IV-c (graft placing on the footplate as columella under surface of the TM).…”

Section: Methodsmentioning

confidence: 99%

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Surgical Results of Retrograde Mastoidectomy with Primary Reconstruction of the Ear Canal and Mastoid Cavity

Kuo

Huang

Chen

et al. 2015

BioMed Research International

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The aim of this study was to retrospectively review the long-term hearing results and the impact of mastoid exclusion/obliteration in patients with cholesteatoma (102 ears) who underwent retrograde tympanomastoidectomy and in whom bone chips/paté were applied as the sole materials during the procedure. In 79 ears, this was combined with ossiculoplasty in a single-stage procedure. In >71% of ears, the results of audiometric testing were monitored for more than 2 years. The results suggested there was a significant gain in hearing following surgery, with respect to the postoperative change in both air-conduction thresholds and air-bone gaps (P < 0.001). Linear regression analyses of pure-tone averages at different frequencies, before and after surgery, demonstrated that patients benefitted from a postoperative hearing gain at low and middle frequencies, but their hearing often deteriorated at frequencies of 8000 Hz. As for the impact of the type of tympanoplasty on hearing outcomes, type III-interposition markedly increased hearing gain. The overall rate of postoperative adverse events was 8.8%. We conclude that reconstruction of the ear canal and mastoid via mastoid exclusion/obliteration using bone chips/paté can be considered as an alternative procedure following retrograde mastoidectomy. It gives excellent surgical results and has fewer postoperative adverse events.

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Section: Discussionsupporting

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Surgical Results of Retrograde Mastoidectomy with Primary Reconstruction of the Ear Canal and Mastoid Cavity

Kuo

Huang

Chen

et al. 2015

BioMed Research International

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show abstract

“…Although modeling in human temporal bones does suggest subtle gains from an intact ossicular chain (Nakajima, Ravicz, Merchant, Peake, & Rosowski, 2005). A near complete air-bone gap closure can also be achieved in cases of type three tympanoplasty where the malleus and incus are removed and the TM is laid onto the stapes head (Okada et al, 2014). One can therefore be almost as good as three.…”

Section: Tms Across Land Vertebratesmentioning

confidence: 99%

Developmental aspects of the tympanic membrane: Shedding light on function and disease

Mozaffari

Jiang

Tucker

2019

Genesis

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Summary The ear drum, or tympanic membrane (TM), is a key component in the intricate relay that transmits air‐borne sound to our fluid‐filled inner ear. Despite early belief that the mammalian ear drum evolved as a transformation of a reptilian drum, newer fossil data suggests a parallel and independent evolution of this structure in mammals. The term “drum” belies what is in fact a complex three‐dimensional structure formed from multiple embryonic cell lineages. Intriguingly, disease affects the ear drum differently in its different parts, with the superior and posterior parts being much more frequently affected. This suggests a key role for the developmental details of TM formation in its final form and function, both in homeostasis and regeneration. Here we review recent studies in rodent models and humans that are beginning to address large knowledge gaps in TM cell dynamics from a developmental biologist's point of view. We outline the biological and clinical uncertainties that remain, with a view to guiding the indispensable contribution that developmental biology will be able to make to better understanding the TM.

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“…Type III tympanoplasty has shown satisfactory outcomes in chronic otitis media [COM], both in experimental [2] and clinical studies [3]. It also has shown a lesser ABG apart from hearing outcome [4]. Data on clinical outcome of type III tympanoplasty in Indian patients are limited.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Cartilage Type Iiia and Iiib Tympanoplasty in Indian Patients With Chronic Suppurative Otitis Media

Reddy¹,

Vuppala

Bhat

2018

Asian J Pharm Clin Res

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Objective: This prospective comparative study determined the efficacy of type III tympanoplasty using homologous septal spur cartilage in patients with chronic otitis media (COM). Methods:We selected patients by random sampling. Complete otolaryngological examination including otological examination, tuning fork tests, pure tone audiometry (PTA), and relevant investigations was done. Post-tympanoplasty residual air-bone gap (ABG) was graded. Type III tympanoplasty was done for all and followed up until month 6.Results: Of 50 patients, 70.0% were men. Mean age was 27.72±10.81 years, 24 and 26 patients underwent type III-A and III-B tympanoplasty, respectively. Pre-operative mean PTA and ABG was 50.08 dB and 38.27 dB, respectively. Pre-operative ABG of 31-60 dB was seen in 41 patients while nine had an ABG of 0-30 dB. Overall, pre and post-operative PTA was 50.24 dB and 28.54 dB, respectively. Overall, pre-and post-operative ABG was 38.32 dB and 16.40 dB (III-A 36.92 dB and 14.79 dB; III-B 39.62 dB and 17.88 dB). Mean overall hearing gain postoperatively in PTA was 21.70 dB (type III A 22.33 dB, III B −21.115 dB). Overall, ABG closure was 23.53 dB (type III-A 22.333 dB, III-B −21.115 dB). None had failure (>30 dB). Good ABG of 10-20 dB was seen in 72% and 78% of patients at month 3 and 6, respectively.Conclusion: Significant post-operative hearing improvement was seen in both types of tympanoplasty using homologous cartilage graft for ossicular reconstruction. Type III-A is better than type III-B as the stapes superstructure is vital for hearing.

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Air-bone gap in ears with a well-repaired tympanic membrane after Type III and Type IV tympanoplasty

Cited by 9 publications

References 23 publications

Surgical Results of Retrograde Mastoidectomy with Primary Reconstruction of the Ear Canal and Mastoid Cavity

Surgical Results of Retrograde Mastoidectomy with Primary Reconstruction of the Ear Canal and Mastoid Cavity

Developmental aspects of the tympanic membrane: Shedding light on function and disease

Comparison of Cartilage Type Iiia and Iiib Tympanoplasty in Indian Patients With Chronic Suppurative Otitis Media

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