Evaluation of High-Resolution CT After Tympanoplasty

Stabilization technique for columella using trimmed autologous temporal fascia in type III and IV tympanoplasty – muffler method

“…Three of 13 patients who did not have improved postoperative hearing realized that sudden hearing loss happened immediately after strongly blowing their noses, sneezing and/or nasal sniffing while they were in the hospital. The cause of these sudden hearing losses was discovered to be the dislocation of columella by high-resolution CT imaging of the middle ear [4]. Two of these three patients underwent reoperation with the same technique and could achieve good hearing.…”

“…At the present time, however, satisfactory results of the latter have not been obtained in type III and IV tympanoplasty [1,2]. There are many causes of these failures; factors related to ossicular chains, immobility of the ossicles themselves and/or dislocation of columella are thought to be the main causes [3,4].…”

“…However, hearing results are not always satisfactory, especially in type III and/or IV tympanoplasty [1,2]. One of the major causes of this failure is the dislocation of substitute for ossicles [3,4]. We contrived a new stabilization technique for columella using trimmed autologous temporal fascia in type III and IV tympanoplasty and achieved better hearing results.…”

Imaging of the postoperative middle ear

“…In approximately 20% of cases (S. Riehm et al, unpublished observations), the tympanomastoid cavities are filled by a non-specific soft tissue mass. In such cases CT is not able to determine the nature of this soft tissue mass, which may either correspond to inflammatory hyperplasic mucosa, granulation tissue, cholesterol granuloma, postoperative scar, or cholesteatoma which present no significant difference in density [22]. It had been stated that MR imaging was not a reliable technique to detect cholesteatoma [23,24,25].…”

Usefulness of Cone-Beam Computed Tomography in Determining the Position of Ossicular Prostheses

“…High-resolution CT in the follow-up of these patients can be helpful in assessing complications that may be contributing to postoperative conductive hearing loss. Numerous causes may be readily visible on highresolution CT including mechanical complications such as prosthesis dislocation, subluxation, and extrusion, as well as recurrent cholesteatoma, otitis media, granulation tissue formation, and adhesions (6,7). High-resolution CT is effective in evaluating prostheses of varying composition (plastipore, hydroxyapatite, titanium).…”