The effect of preserved stapedial superstructure on hearing improvement

Boroń, Aleksandra; Wiatr, Agnieszka; Składzień, Jacek; Wiatr, Maciej

doi:10.5604/01.3001.0013.5954

Cited by 6 publications

(3 citation statements)

References 18 publications

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“…The most common cause of reoperation is recurrence or persistent cholesteatoma. In literature, recurrence of cholesteatoma is estimated between 2% and 18% [10,13,14], while in our study, the recurrence of cholesteatoma was 15%. There are two ways to treat recurrence: as incomplete removal in the course of a single procedure or creating a new cholesteatoma from…”

Section: Discussioncontrasting

confidence: 47%

Long-term results of a hearing test in patients operated for chronic otitis media

Boroń

Składzień

2020

Otolaryngol Pol

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Introduction: Chronic otitis media is characterized by tympanic membrane perforation and conductive hearing loss. In the active form of this disease, there will also be periodic or permanent otorrhea. With a number of surgical techniques available depending on intraoperative findings, otosurgery is the treatment of choice in such cases, the extent of which depends on the type and extent of the pathological changes. Material and Method: We carried out an analysis of 79 patients with chronic otitis media undergoing surgery at the Department of Otolaryngology, Jagiellonian University Medical College in Kraków between 2005 and 2014. Total audiometry was used as a part of hearing assessment, before the surgery, 6 months after the surgery and in the distant 10-year observation period. In addition, each patient completed the questionnaire and was examined by an otolaryngologist. Results: The analysis included 79 patients operated on due to chronic otitis media. The mean bone conduction (for frequencies 500,1000 and 2000 Hz) before surgery was 31.8 dB, it did not differ significantly (p = 0.355) after 6 months after surgery (32.8 dB), while it significantly increased (p < 0.001) in a distant 10-year control of 43.4 dB. The mean air conduction (for frequencies 500, 1000 and 2000 Hz) before the procedure was 57.6 dB, it significantly improved in the early control by 50.5 dB, at p < 0.001. In long-term follow-up it increased again to 61.3 dB and was significantly different from the early postoperative period (p < 0.001). The mean air-bone gap for frequencies 500, 1000 and 2000 Hz before surgery was on average 26.4 dB, it was significantly (p < 0.001) reduced in the postoperative period by 17.6 dB. The level of air-bone gap remained at a similar level in distant control. Conclusions: (1) A completely preserved ossicular chain in the absence of active chronic otitis media is the best prognosis for stable hearing improvement over the years with normal inner ear function; (2) Reoperation worsens the long-term results of a hearing test compared to the first operation.

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Section: Discussioncontrasting

confidence: 47%

Long-term results of a hearing test in patients operated for chronic otitis media

Boroń

Składzień

2020

Otolaryngol Pol

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“…Increased angiogenesis is one of the features of the inflammatory process that coexists with the formation of inflammatory infiltrate. The observations made require further investigation on a larger number of preparations [15][16][17][18].…”

Section: Purposementioning

confidence: 99%

Auditory ossicles in ScanningElectron Microscopy

2020

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Introduction: Knowledge about the physiology of a healthy middle ear is essential for understanding the activity and mechanics of the ear as well as the basics of ossiculoplasty. Trauma of the epithelial lining of the tympanic cavity as well as the ossicular chain may be the result of chronic inflammation and surgery. Depending on the observed changes of the middle ear lining, there are several types of distinguished chronic inflammatory changes: simple, with cholesteatoma, with the formation of inflammatory granulation tissue, in course of specific diseases. Purpose: The aim of the article is presentation of the microstructure and vasculature of the ossicular chain in the Scanning Electron Microscope. Particular attention is drawn to the anatomical aspects of the structure and connections of auditory ossicles as vital elements for reconstruction of the conduction system of the middle ear. Material and method: The analysis covered auditory ossicles standardly removed in accordance with the methodology of the investigated surgical procedures. The preparations were evaluated in a scanning electron microscope. Results: The exposure of bone surface promotes deep erosion. The advanced process of destruction of bone surface in the case of chronic otitis media correlates with a significant degree of damage to both the lining covering the auditory ossicles and that surrounding articular surfaces. Conclusions: (1) The ossicles in the image of the Scanning Electron Microscope are covered with lining. It passes from the surface of the ossicles to the vascular bundles, forming vascular sheaths; (2) Damage to lining continuity on the surface of the auditory ossicles promotes the rapid destruction of bone tissue in the inflammatory process; (3) The dimensions of the individual ossicles are respectively: malleus – 8.36 +/- 0.01, incus – 8.14 +/- 0.0, stapes – 3.23 +/- 0.01 mm. Behavior of the anatomical length of ossicular chain during tympanoplasty appears to be essential to maintaining adequate vibration amplitude of the conductive system of the middle ear.

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“…Chronic otitis media is characterized by a defect of the tympanic membrane, periodic leakage from the ear and various degrees of conductive or mixed hearing impairment. Depending on the observed changes in the lining of the middle ear, several types of chronic otitis media are distinguished: chronic simple otitis media, chronic otitis media with inflammatory granulation, chronic cholesteatoma of the middle ear and chronic otitis media in the course of specific diseases [1,2].…”

Section: Introductionmentioning

confidence: 99%

Chronic suppurative otitis media with cholesteatoma and chronic otitis media with granulation by scanning electron microscopy based on analysis of 140 patients

et al. 2021

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Objectives Chronic purulent cholesteatoma of the middle ear, as well as to a lesser extent chronic granulomatous otitis media, lead to destruction of bone structures within the middle ear space. Above process is controlled by the OPG/RANKL/RANK system. Material and methods An analysis of 140 patients operated on due to chronic otitis media was performed. For the detailed analysis in the scanning electron microscope, 40 patients were selected who had been diagnosed with chronic cholesteatoma of the middle ear and chronic granulomatous otitis media. Finally the study in SEM included 20 patients. Results The regular structure of cholesteatoma depicted in the Scanning Electron Microscope concerned 5 patients with diagnosed. In the remaining 7 patients, the system was irregular and even chaotic. Lack of regularity can also be observed in the case of granulation tissue, which in the SEM image presented itself as an irregular tissue mass without detectable regularities. Conclusions 1. Regular pattern of the cholesteatoma matrix cells observed in some patients with chronic cholesteatoma of the middle ear reduces the molecular permeability of inflammatory cytokines, concurrently limiting the destructive activity on bone structures. 2. The presence of inflammatory granulation tissue in the middle ear is accompanied by an influx of leukocytes: neutrophils and lymphocytes, which are the source of pro-inflammatory cytokines, the growth of which activates the processes leading to the damage of bone tissue and the development of inflammation. 3. No specimen of acquired cholesteatoma revealed presence of commensalism like organism on the surface of exfoliated human epithelium of Demodex species.

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The effect of preserved stapedial superstructure on hearing improvement

Cited by 6 publications

References 18 publications

Long-term results of a hearing test in patients operated for chronic otitis media

Long-term results of a hearing test in patients operated for chronic otitis media

Auditory ossicles in ScanningElectron Microscopy

Chronic suppurative otitis media with cholesteatoma and chronic otitis media with granulation by scanning electron microscopy based on analysis of 140 patients

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