Central Tympanic Perforation Research Articles

Intraoperative Finding of Cholesteatoma in Central Tympanic Perforation

Intraoperative Finding of Cholesteatoma in Central Tympanic Perforation

Endoscopic tympanoplasty with inlay cartilage graft in an university hospital

IntroductionTympanoplasty is the surgical procedure aimed at the reconstruction of the tympanic membrane and restoration of the sound conducting mechanism. It can be performed with several types of access and grafts and is considered successful when it achieves complete closure of the tympanic perforation and sound conduction improvement. ObjectiveTo describe the prevalence of successful closure of tympanic perforations and auditory results of endoscopic tympanoplasty with an inlay tragus cartilage graft. MethodsRetrospective study developed at a tertiary referral hospital. Patients with central tympanic perforations and intact ossicular chains operated with endoscopic tympanoplasty with inlay tragus cartilage graft were included. The neo-tympanum integrity index was evaluated, and the preoperative and postoperative auditory parameters were compared using the paired Student's t-test. ResultsWe identified 83 endoscopic tympanoplasties with inlay cartilage, of which 63 (76 %) had an intact neo-tympanum and 20 (24 %) had residual perforations. The preoperative air-bone gap was, on average, 18 ± 8.9 dBHL, and the postoperative 11 ± 10 dBHL (p = 0.0005), showing reduction in 71 % and complete recovery in 27 %. The mean preoperative speech recognition threshold was 35 ± 13.5 and the postoperative SRT was 27 ± 14.4 (p = 0.0002). The preoperative tritonal mean was 34 ± 14.3 and the postoperative was 24 ± 15 (p = 0.0002). ConclusionIn this series, endoscopic tympanoplasties with inlay tragus cartilage graft showed a 76 % prevalence of complete closure of the tympanic perforation, with significant improvement in the auditory parameters.

Tympanic membrane changes in central tympanic membrane perforations

Purpose The objective of this study was to evaluate the histopathological changes in central tympanic membrane perforations caused by chronic otitis media without cholesteatoma. Materials and methods Twenty-nine temporal bones from 25 patients (13 male patients and 12 female patients) with central tympanic membrane perforations—18 chronic otitis media with perforation and 11 chronic otitis media with perforation caused by ventilation tubes—and 30 aged-matched normal temporal bones were included in this study. A scale was used to evaluate the extension of the migration of stratified squamous epithelium in the inner surface of the tympanic membrane. The thickness of tympanic membranes was measured halfway between the annular ligament and the perforation and compared with that of the normal bones. The presence of tympanosclerosis and papillary projections of squamous epithelium was also noted. Results The extension of the migration of stratified squamous epithelium in the inner surface of the tympanic membrane was observed in 11 of the 29 perforations (38%). The thickness of tympanic membranes was significantly different between the perforation groups and the control group. Of the 29 tympanic membranes, 13 (44%) had tympanosclerosis and 8 (28%) revealed papillary projections of squamous epithelium. Conclusions Our study shows that a central tympanic perforation should not merely be considered as a simple defect. Most of the tympanic membranes showed one or more signs of sequelae or persistent abnormalities such as tympanosclerosis, papillary projections, thickening, and ingrowth without significant differences between the 2 central perforation groups.