Myringostapediopexy after tympanomastoidectomy

August 31, 2007     Matthew Taljebini, MD; Eric P. Wilkinson, MD; Jose N. Fayad, MD

A 53-year-old man presented with chronic otitis media in the right ear and a cholesteatoma in the right ear. Audiometric testing revealed a high-frequency sensorineural hearing loss in both ears and a mixed hearing loss in the right ear.


July 31, 2007     James Lin, MD; Jose N. Fayad, MD

Glomus tympanicum tumor

March 31, 2007     Troy Hutchins, MD; Enrique Palacios, MD

Jugular bulb diverticulum

March 1, 2007     J. Walter Kutz, Jr., MD; Antonio De la Cruz, MD

Traumatic hemotympanum with facial palsy

February 1, 2007     Sampan Singh Bist, MS; Manisha Bisht, MBBS; Saurabh Varshney, MS

Facial nerve schwannoma presenting as a tympanic mass

May 31, 2006     Sejal P. Sarolia, BS; Christopher J. Danner, MD; Eren Erdem, MD

Tympanic membrane atelectasis

April 30, 2006     J. Walter Kutz Jr., MD; Jose N. Fayad, MD

The mechanical reduction of early acquired cholesteatomas in children: Indications and limitations

April 1, 2006     Eric R. Grimes, MD; Glenn Isaacson, MD, FAAP, FACS
The standard treatment for acquired cholesteatoma involves surgical removal of the lesion and reconstruction of the tympanic membrane. In some children, these lesions can be treated more conservatively. We conducted a retrospective study of 29 ears in 24 children who had been treated for early acquired cholesteatoma with mechanical reduction and a tympanostomy tube. Outcomes measures included hearing status, the postoperative appearance of the tympanic membrane, and the need for additional surgery. We found that anterior and inferior pars tensa lesions, with or without squamous debris, can be successfully reduced, but that posterosuperior retractions respond less well when the ossicular chain has been eroded. None of the children who responded to mechanical reduction required major reconstructive surgery later. We conclude that mechanical reduction of retraction pocket cholesteatomas with tympanostomy tube placement is sufficient to restore normal hearing and a normal tympanic membrane appearance in selected children with early lesions. We also identified several important prognostic features, including the patient's age, the specific location of the retraction pocket on the tympanic membrane, the extent of the pocket, ossicular chain involvement, and the patient's adenoid status.

Underlay tympanoplasty with laser tissue welding

April 1, 2006     David Foyt, MD; William H. Slattery III, MD; Matthew J. Carfrae, MD
We investigated the feasibility of using laser tissue welding techniques to perform transcanal underlay tympanoplasty. We used 10 temporal bones obtained from human cadavers. After creating a subtotal tympanic membrane perforation, we introduced harvested periosteum through the perforation and used laser tissue welding to secure the periosteum graft in place in an underlay fashion. The procedure was performed via a transcanal approach and did not require middle ear packing. Immediately after the graft had been placed, we qualitatively tested its integrity with a blunt probe. The graft was as strong as the native cadaver tympanic membrane in all 10 cases. We conclude that laser transcanal underlay tympanoplasty is a feasible and effective method of repairing a tympanic membrane. The ultimate goal is to develop a technique that will allow physicians to routinely perform underlay tympanoplasty on moderately sized perforations in an office setting.

Partial medial canal fibrosis

February 1, 2006     Adrien A. Eshraghi, MD; S. Arif Ulubil, MD
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