摘要:

AbstractDepending upon the presence or absence of stapedial mobility, treatment of ossicular fixation will vary. Methods and indication to preserve the fixed malleolar head and neck are discussed and positive indications for removal of the incus are enumerated. A description of various surgical techniques of interposition of the incus between the mobile malleus and stapes to relieve stapes fixation and restore continuity are described in detail.

ISSN:0023-852X    

DOI:10.1288/00005537-197602000-00001

出版商:John Wiley&Sons, Inc.    

年代:1976

数据来源: WILEY

摘要:

AbstractA technique for closure of tympanic membrane perforation which preserves the normal anterior sulcus‐tympanic membrane relationships is described. This underlay fixation technique provides a high graft take, good conization of the drum, prevention of lateralization of the reconstructed drum and elimination of tenting or blunting of the anterior sulcus. The reconstructed tympanic membrane presents a near normal appearance with good physiological and acoustic propertie

ISSN:0023-852X    

DOI:10.1288/00005537-197602000-00002

出版商:John Wiley&Sons, Inc.    

年代:1976

数据来源: WILEY

ISSN:0023-852X    

DOI:10.1288/00005537-197602000-00003

出版商:John Wiley&Sons, Inc.    

年代:1976

数据来源: WILEY

摘要:

AbstractTympanoplasty reconstruction of the eardrum approached normal anatomy and function with the use of connective tissue to replace the substantia media. Perichondrium taken from the concha is preferred because it lies flat and is easy to manipulate. Grafts placed on the outer surface of the remnant tend to lateralize with loss of drum conization. Grafts placed on the undersurface of the remnant do not have this disadvantage.

ISSN:0023-852X    

DOI:10.1288/00005537-197602000-00004

出版商:John Wiley&Sons, Inc.    

年代:1976

数据来源: WILEY

摘要:

AbstractA technique of grafting tympanic membrane perforations which incorporates the sandwiching of a temporalis facial graft between the epithelial and connective tissue layers of the remaining drumhead is presented.

ISSN:0023-852X    

DOI:10.1288/00005537-197602000-00005

出版商:John Wiley&Sons, Inc.    

年代:1976

数据来源: WILEY

摘要:

AbstractTemporal fascia placed medially to the tympanic remnants with the malleus handle exteriorized has been used successfully in over 1,200 tympanoplasties with adequate conization of the drumhead produced in most cases.

ISSN:0023-852X    

DOI:10.1288/00005537-197602000-00006

出版商:John Wiley&Sons, Inc.    

年代:1976

数据来源: WILEY

摘要:

AbstractThis paper presents the authors' experiences with one method of reconstruction of the tympanic membrane when it is totally absent or when there is a fixed, retracted, defective, or absent malleus. Ten patients undergoing surgery for chronic suppurative otitis media between April, 1971, and January, 1973, had homograft tympanic membranes and/or ossicles used to reconstruct the defect in the tympanic membrane or ossicular mechanism. The patients had certain clinical and surgical characteristics in common:1. all had either an absent tympanic membrane or almost total perforation of it;2. all were operated upon in the absence of acute infection or active drainage; cholesteatoma, if present, was totally removed;3. all had patent eustachian tubes;4. all had intact middle ear mucosa at the time of utilization of the homograft;5. all patients were operated upon by the same surgeon;6. all of the homografts were obtained within 24 hours and were used within one month after the death of the donor;7. all of the homografts used had been preserved in 70 percent ethyl alcohol;8. all of the homograft materials came from donors who were under 40 years of age at the time of death and who died of accidental causes. (None of the donors was known to have any pre‐existing disease);9. all homografts, after being placed in proper position in the recipient, were covered with ear canal skin;10. all patients received homografts that were from the corresponding ear of the donor. (In other words, right ear homografts were used in the patient's right ear, etc.);11. whenever the tympanic ring was greater than the size of the homograft. the patient's temporalis fascia was used in conjunction with the homograft tympanic membrane to bridge the defect;12. all patients had the middle ear packed with gelfoam prior to inserting the homograft (compressed gelfoam was used also for the outer packing);13. none of the patients had tissue‐typing procedures carried out in an effort to match the donor and the recipient, nor was any attempt made to match the sex of the donor and the recipient; and14. all patients received antibiotics postoperatively; however, none received immunosuppressive therapy postoperatively. In 3 of 10 patients receiving homografts, the malleus was normal, and only the tympanic membrane was reconstructed. In seven others there was a fixed, retracted, defective or absent malleus in addition to the tympanic membrane defect.All of the homografts were successful and have been followed for two years postoperatively. The best hearing results were in:1. those patients (VN, HS, MS) whose ossicular chains were intact and only a homograft tympanic membrane was used to replace the absent eardrum; and2. those patients who had a homograft incus interposed between their intact mobile stapes and the homograft tympanic membrane with attached malleus or manubrium (AB, CA, JH, GK). The patients (RL, BO) in whom no stapes superstructure was present did not have comparable results.The successful use of homografts in these patients is attributed primarily to selection of patients who were free of infection at surgery and to utilization of canal skin to cover all of the homogra

ISSN:0023-852X    

DOI:10.1288/00005537-197602000-00007

出版商:John Wiley&Sons, Inc.    

年代:1976

数据来源: WILEY

摘要:

AbstractTwo surgical techniques are presented for the treatment of ossicular fixation of the incus and malleus to the tegmen. One involves an atticotomy approach, the second a mastoid approach to the attic.

ISSN:0023-852X    

DOI:10.1288/00005537-197602000-00008

出版商:John Wiley&Sons, Inc.    

年代:1976

数据来源: WILEY

摘要:

AbstractThis study represents a review of 121 patients who underwent ossicular chain reconstruction during a five‐year period. They depict a general cross section of the sequelae of chronic otitis media. There was no selection of “favorable” cases. Ninety have been followed for one year or more. Hearing results in the most favorable cases (malleus handle and stapes arch present), were improved by the employment of a sculptured, fitted incus prosthesis between the handle and capitulum. Postoperative hearing was improved to within 10 db of the postoperative bone level in about half of the cases. Hearing was 20 db or better in more than 80 pe

ISSN:0023-852X    

DOI:10.1288/00005537-197602000-00009

出版商:John Wiley&Sons, Inc.    

年代:1976

数据来源: WILEY

ISSN:0023-852X    

DOI:10.1288/00005537-197602000-00010

出版商:John Wiley&Sons, Inc.    

年代:1976

数据来源: WILEY