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Prolonged Middle Ear Ventilation by Cartilage-grommet Tympanoplasty

International Journal of Otolaryngology and Head & Neck Surgery 2015年第1期4卷 13-17页

作者： Kartik Parelkar Smita Nagle Mohan Jagade Vandana Thorawade Poonam Khairnar Anoop Attakil Madhavi Pandare Rajanala Nataraj Reshma Hanwate Rajesh Kar Department of ENT Grant Government Medical College & Sir J J Group of Hospitals Mumbai India

In 1994, the American Otological Society reported favourable experience with composite cartilage shield tympanoplasty. The tragal cartilage with a grommet inserted in it was used for tympanoplasty in our patient with unilateral CSOM, supposedly because of severe chronic eustachian tube dysfunction. The marriage of cartilage tympanoplasty with grommet insertion was aimed to add the advantages and abolish the disadvantages of both the procedures. In 1990 Lary Hall first introduced the “long term ventilation of the middle ear” with a T-tube placed in the tragal cartilage perichondrium composite island graft. T-tube insertion in the cartilage has been described. But insertion of the Indian Sheperds grommet (ventilation tube) in the cartilage graft as described in this case and its technique are possibly the first of its kinds in literature. The report is aimed to ignite innovation of newer and better techniques of cartilage tympanoplasty.

关键词： Tragal Cartilage grommet Tympanoplasty

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Prospective Study on the Results of the Tuboplasty in Rural Region in Germany

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International Journal of Otolaryngology and Head & Neck Surgery 2025年第1期14卷 1-11页

作者： Peter R. Issing Hendrik Tebben Emad Alsabbagh Christian Issing Department of Otorhinolaryngology Head- Neck- and Facial Plastic Surgery Klinikum Bad Hersfeld GmbH Bad Hersfeld Germany Department of Ophthalmology Klinikum Bad Hersfeld GmbH Bad Hersfeld Germany Department of Otorhinolaryngology Johann-Wolfgang von Goethe University Frankfurt Germany

1) Introduction: Ventilation disorders of the middle ear play a major role in everyday clinical ENT-practice and sometimes represent a major therapeutic challenge. In addition to the conventional therapy of tympanostomy tube insertion, tuboplasty (TP) offers a less invasive option for treating this problem. The study should examine whether TP can be performed in a rural setting. 2) Material and methods: This is a prospective, monocentric study of patients scheduled for TP because of tubal ventilation disorder (TVD) in a rural region of Germany. The diagnosis was established after a thorough clinical examination and by assessing the possibility of performing the Valsalva maneuver, the tympanogram type, recording the middle ear pressure and air-bone gap. The subjective impairment caused by the TVD was evaluated using the EDTQ-7 questionnaire pre- and approximately 3 months postoperatively. 3) Results: Sixty-two patients with 92 TP were included with a mean age of 44.1 years. The EDTQ-7 score decreased highly significantly from 3.6 to 1.7 (p < 0.0001) without correlating with parameters such as age, sex, BMI, allergies or smoking. Middle ear pressure fell in average by −87 daPa, resulting in an improvement of the tympanogram type. The preoperative air-bone gap of 10.2 dB also was reduced significantly in most patients to 8.0 dB after the procedure. No notable complications occurred beside a sore throat due to the use of a laryngeal mask for ventilation during anesthesia in two cases. 4) Conclusion: In our experience, TP represents a less invasive and, in many cases, successful alternative to the established tympanostomy tube insertion with the advantage of an intact eardrum. It can also be offered and successfully performed in a rural setting.

关键词： Eustachian Tube Dysfunction Tuboplasty Eustachian Tube Valsalva Maneuver grommet

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Otitis media with effusion in children: Pathophysiology, diagnosis, and treatment.A review

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Journal of Otology 2019年第2期14卷 33-39页

作者： Pauline Vanneste Cyril Page Department of Otorhinolaryngology and Head & Neck Surgery Amiens University Hospital

Otitis media with effusion(OME)is a frequent paediatric *** condition is often asymptomatic,and so can easily be ***,OME can lead to hearing loss that impairs the child's language and behavioural *** diagnosis is essentially clinical,and is based on otoscopy and(in some cases)*** endoscopy is only indicated in cases of unilateral OME or when obstructive adenoid hypertrophy is *** media with effusion is defined as the observation of middle-ear effusion at consultations three months *** must be evaluated(using an age-appropriate audiometry technique)before and after treatment,so as not to miss another underlying cause of deafness(*** deafness).Craniofacial dysmorphism,respiratory allergy and gastro-oesophageal reflux all favour the development of *** a certain number of medications(antibiotics,corticoids,antihistamines,mucokinetic agents,and nasal decongestants)can be used to treat OME,they are not reliably effective and rarely provide long-term *** benchmark treatment for OME is placement of tympanostomy tubes(TTs)and(in some cases)adjunct *** TTs rapidly normalize hearing and effectively prevent the development of cholesteatoma in the middle *** contrast,TTs do not prevent progression towards tympanic atrophy or a retraction *** enhances the effectiveness of *** children with adenoid hypertrophy,adenoidectomy is indicated before the age of 4 but can be performed later when OME is identified by nasal *** must be followed up until OME has disappeared completely,so that any complications are not missed.

关键词： Otitis media with effusion Tympanostomy tube Ventilation tube grommet Child

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