Jurnalul de Chirurgie
 Jurnalul de chirurgie
Aparitie trimestriala in a doua luna a trimestrului
Published quarterly in the second month of the quarter
ISSN: 1584 - 9341 Vol.10 Nr.3 - Iulie-Septembrie 2014 | sâmbătă, 23 martie 2019
ISSN: 1584 - 9341 Vol.10 No.3 - July-September 2014
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THE IMPORTANCE OF AUTOGRAFTS IN THE RECONSTRUCTIONS OF OSSICULAR CHAIN IN CHRONIC SUPPURATIVE OTITIS MEDIA
A. Vlase, V. Costinescu, T.Ghindaru
ENT Department, Faculty of Medicine,
University of Medicine and Pharmacy Iasi
Jurnalul de chirurgie 2011; 7 (1): 64-70
Full text:
Format PDF (Română/Romanian)

Abstract:

Improvement of hearing in ossiculoplasty depends on the efficiency of the methods to reestablish the ossicular continuity and the connection with the tympanic membrane.  While various prosthesis have been used to bridge the ossicular defect, we have used autogenous bone (incus remnant and cortical bone) and autogenous cartilage ( tragal and concal) for the reconstruction of ossicular continuity. The study was performed on a lot of 86 patients suffering of chronic suppurative otitis media, with good cochlear reserve and good eustachian tube function, admitted in the C.F. Hospital in Iasi during a period of four years. Patiens with atico-antral disease and cholesteatoma were excluded from the study and all these procedures were intact canal wall procedures. The operations were done in local or general anesthesia by post-aural or endaural route. After raising the tympanomeatal flap, it was insured that there was no other disease in the middle ear. The status of the ossicular chain was assessed. Mastoid antrum was opened in most cases to look for any disease there. The patency of the aditus was also checked. Ossicular reconstructive procedure was planned according to the status of the ossicular chain. Temporalis fascia or tragal perichondrum was used to close the perforation. In this stady, we  have included only the cases where autogenous cartilage (tragal or choncal) or autogenous bone (incus remnant or cortical bone) was used between1) malleus & head of stapes (malleus-stapes assembly), 2) beetwin malleus & footplate (malleus footplate assembly), 3) stapes head & newly constructed tympanic membrane(short collumela), 4) footplate & newly constructed tympanic membrane (long collumela). Hearing results at 18 months follow up have been fairly good, for example 84% patients had closures of air bone gap within 20 dB and 16% had closure of air bone gap within 10 dB. The study has revealed fairy good hearing results in patients implanted with autogenous cartilage and bone autografts. The functional results were better when using bone grafts in favour of cartilage, these are easily available and cost effective, moreover, they are stable, easily accepted by the body and never extruded out.

KEY WORDS: OSSICULOPLASTY, AUTOGRAFTS, TYMPANOPLASTY, MIDDLE EAR

Correspondence to: Dr. Alex Vlase, ENT Department, C.F. Hospital Iasi, str. G.Ibraileanu, nr.1, Iaşi, e-mail: .536-540



: Creative Commons License
Jurnalul de chirurgie [Journal of Surgery] by Editorial Board, Department of Surgery University of Medicine and Pharmacy Iasi, E. Tarcoveanu, R. Moldovanu is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License.
Based on a work at www.jurnaluldechirurgie.ro.