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Tympanic Membrane Perforation

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1. Bacterial causes of otitis media with spontaneous perforation of the tympanic membrane in the era of 13 valent pneumococcal conjugate vaccine. (PubMed)

Bacterial causes of otitis media with spontaneous perforation of the tympanic membrane in the era of 13 valent pneumococcal conjugate vaccine. After pneumococcal conjugate vaccine (PCV) implementation, the number of acute otitis media (AOM) episodes has decreased, but AOM still remains among the most common diagnoses in childhood. From 2% to 17% of cases of AOM feature spontaneous perforation of the tympanic membrane (SPTM). The aim of this study was to describe the bacteriological causes

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2019 PLoS ONE

2. Longitudinal Analysis of "Window Shade" Tympanoplasty Outcomes for Anterior Marginal Tympanic Membrane Perforations. (PubMed)

Longitudinal Analysis of "Window Shade" Tympanoplasty Outcomes for Anterior Marginal Tympanic Membrane Perforations. Although many techniques have been proposed for the repair of tympanic membrane perforations, few address the unique challenges presented by anterior marginal perforations. In these circumstances, traditional underlay and overlay techniques are often complicated by issues including blunting of the anterior tympanomeatal angle, graft lateralization, delayed healing, and reduced (...) was 94.2%. Overall complication rate was 4.6%. 82.6% of patients achieved air-bone gap closure within 10 dB.The results of this study further reinforce the success of the window shade technique in repairing anterior marginal tympanic membrane perforations.

2019 Otology and Neurotology

3. Distortion product otoacoustic emissions: Sensitive measures of tympanic -membrane perforation and healing processes in a gerbil model. (PubMed)

Distortion product otoacoustic emissions: Sensitive measures of tympanic -membrane perforation and healing processes in a gerbil model. Distortion product otoacoustic emissions (DPOAEs) evoked by two pure tones carry information about the mechanisms that generate and shape them. Thus, DPOAEs hold promise for providing powerful noninvasive diagnostic details of cochlear operations, middle ear (ME) transmission, and impairments. DPOAEs are sensitive to ME function because they are influenced (...) by ME transmission twice, i.e., by the inward-going primary tones in the forward direction and the outward traveling DPOAEs in the reverse direction. However, the effects of ME injuries on DPOAEs have not been systematically characterized. The current study focused on exploring the utility of DPOAEs for examining ME function by methodically characterizing DPOAEs and ME transmission under pathological ME conditions, specifically under conditions of tympanic-membrane (TM) perforation and spontaneous

2019 Hearing Research

4. Risk for Tympanic Membrane Perforation after Quinolone Ear Drops for Acute Otitis Externa. (PubMed)

Risk for Tympanic Membrane Perforation after Quinolone Ear Drops for Acute Otitis Externa. This study examined whether the use of quinolone ear drops increased the risk of perforation with intact tympanic membranes and acute otitis externa (AOE).This was a retrospective cohort study using Medicaid clinical encounter and pharmacy billing records from 1999-2010. Children and adults had to have 24 months continuous enrollment in Medicaid prior to the first antibiotic ear drop dispensing (index (...) date), and they had to maintain their enrollment for at least 18 months thereafter. Included ear drops were ofloxacin, ciprofloxacin plus hydrocortisone, ciprofloxacin plus dexamethasone, and neomycin plus hydrocortisone. Tympanic membrane perforation (TMP) was identified as two in- or out-patient encounters associated with TMP diagnosis at least 30 days apart. A Cox regression model, adjusting for patient demographics, calendar year, and the number of ear drop prescriptions was used to compare TMP

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2019 Clinical Infectious Diseases

5. Correlation between hearing loss and middle ear volume in patients with a tympanic membrane perforation. (PubMed)

Correlation between hearing loss and middle ear volume in patients with a tympanic membrane perforation. To investigate a possible correlation between the degree of conductive hearing loss (CHL) caused by an isolated tympanic membrane (TM) perforation and mastoid-middle ear volume.Retrospective chart, audiometry, and computed tomography (CT) imaging review.Adult patients with a diagnosis of isolated TM perforation between 2010 and 2018 were identified and their audiometric data collected (...) to that determined by tympanometry (absolute average percent difference = 33.8%; range -49.5% to +155.2%; P = .03). Greater MMEV determined by segmentation analysis correlated with smaller air bone gap; this trend approached but did not reach statistical significance (P = .09).Calculated MMEV by segmentation analysis on CT imaging may be a more accurate estimate of MMEV than tympanometry. MMEV may be correlated to the degree of conductive hearing loss in the setting of isolated TM perforation where greater

2019 Laryngoscope

6. The Feasibility to Isolate and Expand Tympanic Membrane Squamous Epithelium Stem Cells From Scarred Perforation Margins. (PubMed)

The Feasibility to Isolate and Expand Tympanic Membrane Squamous Epithelium Stem Cells From Scarred Perforation Margins. The scarred rim of chronic tympanic membrane (TM) perforation contains keratinocytes with potential for regeneration while maintaining their morphological and genetic characteristics.The squamous epithelium of the TM has a good regeneration capacity. Successful isolation and expansion of human TM keratinocytes (hTMKR) was reported from a full, en-bloc, healthy TM.Trimmed (...) margins of the TM perforation (harvested during tympanoplasty) underwent enzymatic digestion (collagenase or trypsin) and were seeded either with serum-containing medium (SCM) or keratinocyte serum-free medium (KSFM) and progenitor cell growth medium (PR) (KSFM:PR, 1:1). Gene expression analysis by real-time qRT-PCR was used to compare between human TM cells derived from scarred perforation margins (hTMKR), normal human skin keratinocytes (NhSKR), and human fibroblasts.Twelve patients were included

2019 Otology and Neurotology

7. Commercial Quinolone Ear Drops Cause Perforations in Intact Rat Tympanic Membranes. (PubMed)

Commercial Quinolone Ear Drops Cause Perforations in Intact Rat Tympanic Membranes. Commercial quinolone ear drops may promote the development of perforations (TMPs) in intact tympanic membrane (TMs).Quinolone ear drops have been associated with TMPs after myringotomy +/- tube placement in a drug-specific manner and potentiation by steroids.Rats were randomized to six groups (10/group), with one ear receiving otic instillation of dexamethasone, ofloxacin, ciprofloxacin, ofloxacin

2019 Otology and Neurotology

8. Platelet-Rich Plasma Fat Graft versus Cartilage Perichondrium for Repair of Medium-Size Tympanic Membrane Perforations. (PubMed)

Platelet-Rich Plasma Fat Graft versus Cartilage Perichondrium for Repair of Medium-Size Tympanic Membrane Perforations. To compare clinical and audiologic outcomes among patients who underwent myringoplasty with fat graft enriched with platelet-rich plasma and cartilage perichondrium graft.Prospective randomized controlled study.Department of Otolaryngology-Head and Neck Surgery, Tanta University, Egypt.The study comprised 50 patients who had tympanic membrane perforation of medium size (25%-50 (...) , 16.9-19.25) for group 1 and 18.24 dB (95% CI, 16.94-19.53) for group 2.Fat graft enriched with platelet-rich plasma can be recommended as an alternative choice for first-line treatment of medium-size central perforations of the tympanic membrane, with healing and hearing results comparable to those of conventional cartilage perichondrium myringoplasty.

2019 Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery Controlled trial quality: uncertain

9. Endoscopic observation of different repair patterns in human traumatic tympanic membrane perforations. (PubMed)

Endoscopic observation of different repair patterns in human traumatic tympanic membrane perforations. In the last decade, there has been an increasing use of biomaterial patches in the regeneration of traumatic tympanic membrane perforations. The major advantages of biomaterial patches are to provisionally restore the physiological function of the middle ear, thereby immediately improving ear symptoms, and act as a scaffold for epithelium migration. However, whether there are additional (...) biological effects on eardrum regeneration is unclear for biological material patching in the clinic.This study evaluated the healing response for different repair patterns in human traumatic tympanic membrane perforations by endoscopic observation.In total, 114 patients with traumatic tympanic membrane perforations were allocated sequentially to two groups: the spontaneous healing group (n=57) and Gelfoam patch-treated group (n=57). The closure rate, closure time, and rate of otorrhea were compared

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2019 Brazilian journal of otorhinolaryngology Controlled trial quality: uncertain

10. Epidemiology of Otitis Media with Spontaneous Perforation of the Tympanic Membrane in Young Children and Association with Bacterial Nasopharyngeal Carriage, Recurrences and Pneumococcal Vaccination in Catalonia, Spain - The Prospective HERMES Study. (PubMed)

Epidemiology of Otitis Media with Spontaneous Perforation of the Tympanic Membrane in Young Children and Association with Bacterial Nasopharyngeal Carriage, Recurrences and Pneumococcal Vaccination in Catalonia, Spain - The Prospective HERMES Study. The Epidemiology of otitis media with spontaneous perforation of the tympanic membrane and associated nasopharyngeal carriage of bacterial otopathogens was analysed in a county in Catalonia (Spain) with pneumococcal conjugate vaccines (PCVs (...) ) not included in the immunization programme at study time. A prospective, multicentre study was performed in 10 primary care centres and 2 hospitals (June 2011-June 2014), including all otherwise healthy children ≥2 months ≤8 years with otitis media presenting spontaneous tympanic perforation within 48h. Up to 521 otitis episodes in 487 children were included, showing by culture/PCR in middle ear fluid (MEF): Haemophilus influenzae [24.2%], both Streptococcus pneumoniae and H. influenzae [24.0%], S

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2017 PLoS ONE

11. Analysis of Effect of Eggshell Membrane Patching for Moderate-to-Large Traumatic Tympanic Membrane Perforation (PubMed)

Analysis of Effect of Eggshell Membrane Patching for Moderate-to-Large Traumatic Tympanic Membrane Perforation To evaluate the effect of eggshell membrane (ESM) patching for tympanic membrane (TM) perforation, and to investigate correlations between healing time and age, gender, patching time, perforation size, and perforation location.One hundred and seventy-five patients diagnosed with traumatic TM perforation at the Department of Otorhinolaryngology-Head and Neck Surgery, Korea University (...) or large traumatic TM perforations (≥grade II). However, patient age, gender, perforation location, and especially timing of procedure, did not significantly affect healing time.ESM patching can be a good treatment choice to promote tympanic membrane healing in large traumatic TM perforations.

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2017 Journal of Audiology & Otology

12. Use of a platelet-rich fibrin membrane to repair traumatic tympanic membrane perforations: a comparative study. (PubMed)

Use of a platelet-rich fibrin membrane to repair traumatic tympanic membrane perforations: a comparative study. (1) To evaluate the effects of a platelet-rich fibrin (PRF) membrane in the repair of traumatic tympanic membrane (TM) perforations; and (2) to compare the use of a PRF membrane with the paper patch technique with regard to recovery rates, healing time, and correction of the mean air-bone gap.A randomized, prospective analysis was performed for 60 patients who were treated (...) for traumatic TM perforations using one of the two methods. Closure rate, speed of healing, and hearing gain were compared between the PRF (Group 1) and paper patch (Group 2) groups.Closure was obtained in 28 (93%) perforations in Group 1 and 25 (83%) perforations in Group 2 (p > 0.05). On day 10, full closure of the TM was observed in 24 (80%) patients in Group 1 and 16 (53%) patients in Group 2 (p < 0.05). The improvement in the mean air-bone gap was 14.1 dB in Group 1 and 12.4 dB in Group 2 on post

2017 Acta oto-laryngologica Controlled trial quality: uncertain

13. A novel gel patch for minimally invasive repair of tympanic membrane perforations. (PubMed)

A novel gel patch for minimally invasive repair of tympanic membrane perforations. Evaluate the efficacy of a photocrosslinkable gel patch for repairing tympanic membrane (TM) perforations using a minimally invasive procedure.38 adult male chinchillas underwent bilateral TM perforation via CO2 laser (n = 76 TMs). Eight weeks post-perforation induction, either a gel patch (n = 26) or EpiDisc (n = 12) was applied to the perforation through the ear canal. Perforation margins were not abraded prior (...) to gel patch application in order to make the procedure minimally invasive. During the study, the application process was refined, and 9 of 26 gel-treated TMs received a second gel-patch augmentation. Perforations were observed for 14 weeks post-treatment to determine healing rates, after which animals were euthanized and their TMs and cochlea removed for histological analysis.38 perforations (50%) persisted for 8 weeks without manipulation. Healing rates stabilized within three weeks post-treatment

2018 International Journal of Pediatric Otorhinolaryngology

14. Application of Regenerative Treatment for Tympanic Membrane Perforation With Cholesteatoma, Tumor, or Severe Calcification. (PubMed)

Application of Regenerative Treatment for Tympanic Membrane Perforation With Cholesteatoma, Tumor, or Severe Calcification. To apply regenerative treatment for tympanic membrane (TM) perforation to patients with severe calcification of the TM, cholesteatomas, or tumors localized to the tympanic cavity.Controlled clinical pilot study.General hospitals.Forty-five patients (age: 8-85; M = 19, F = 26) were selected from patients with or without TM perforation for the regenerative treatment. Twenty (...) -five patients had cholesteatomas, 3 had tumors, and 17 had severe TM calcification. Patients were classified into three groups based on TM perforation size: less than 1/3 of the TM as Grade I (n = 5), 1/3 to 2/3 as Grade II (n = 19), and over 2/3 as Grade III (n = 21). Twenty patients who underwent standard tympanoplasty type I were selected as historical controls.Materials for the TM repair included gelatin sponge with basic fibroblast growth factor and fibrin glue. After lesions were removed

2018 Otology and Neurotology

15. Tympanic Membrane Perforation Repair Using Porcine Small Intestinal Submucosal Grafting. (PubMed)

Tympanic Membrane Perforation Repair Using Porcine Small Intestinal Submucosal Grafting. To evaluate the use of porcine small intestinal submucosal grafts for tympanic membrane repair.Adult and pediatric patients with tympanic membrane perforations with and without chronic otitits media, and perforations after removal of cholesteatoma.Endoscopic or microscopic tympanic membrane repair using porcine small intestinal submucosal grafts (Biodesign).Perforation closure, bone and air pure-tone (...) of the tympanic membrane. These grafts are an excellent choice in total endoscopic cases as it avoids incisions necessary for allograft harvest.

2018 Otology and Neurotology

16. Achieving a Successful Closure of an Anterior Tympanic Membrane Perforation: Evidence-Based Systematic Review.

Achieving a Successful Closure of an Anterior Tympanic Membrane Perforation: Evidence-Based Systematic Review. Objectives Surgical repair of a tympanic membrane perforation is a common otologic procedure. However, achieving a successful closure can be challenging, especially if the anterior margin of the tympanic membrane is involved. The aim of this study was to systematically review the literature on evidence published in closure of anterior tympanic membrane perforations. Data Sources (...) tympanic membrane perforations, (2) primary cases only, (3) articles published in the English language, (4) minimum 6-month follow-up, and (5) recorded pre- and postoperative audiometry. The exclusion criteria were non-English language articles, revision surgery, and no audiometric outcomes. Results On initial search, a total of 181 articles were identified (PubMed, n = 136; Cochrane, n = 28; Embase, n = 17). Based on the criteria, 136 articles were excluded. Full text of 45 articles was reviewed

2018 Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery

17. Hemorrhage within the tympanic membrane without perforation (PubMed)

Hemorrhage within the tympanic membrane without perforation Hemotympanum refers to both the presence of blood in the middle ear cavity and to ecchymosis of the tympanic membrane (TM), and a systematic study of intra-TM (iTM) hemorrhage without bleeding in the middle ear cavity has not been conducted. The goals of our study were to analyze the causes of iTM hemorrhage without TM perforation or bleeding in the middle ear cavity, and to demonstrate the clinical characteristics of the disease.This (...) Case series study included five patients with iTM hemorrhage between August 2014 and August 2017. An iTM hemorrhage was diagnosed when otoendoscopic examination demonstrated minor bleeding behind the intact TM, a hemorrhage was observed between the TM annulus and the epidermal layer, and temporal bone computed tomography revealed thickening of the TM without soft tissue density within the tympanic cavity or temporal bone fracture. Initial symptoms, and serial findings of otoendoscopy and pure tone

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2018 Journal of Otolaryngology - Head & Neck Surgery

18. Determinants of hearing loss severity in tympanic membrane perforations in a sub-Saharan African setting. (PubMed)

Determinants of hearing loss severity in tympanic membrane perforations in a sub-Saharan African setting. Factors specific to sub-Saharan Africa could have an impact on tympanic membrane perforation characteristics. Obtaining precise information on these characteristics and determinants of hearing loss severity would enable better management.To determine the relationship between characteristics of tympanic membrane perforation and subsequent hearing impairment.A cross-sectional study (...) of consenting patients presenting with tympanic membrane perforation was conducted. They were examined using otoendoscopy with a digital camera to obtain precise measurements, followed by pure tone audiometry.Eighty-six cases of tympanic membrane perforation were included. Mean tympanic membrane perforation proportion was 34.1 ± 18.4 per cent. Medium-sized tympanic membrane perforations were predominant (47.7 per cent). Median tympanic membrane perforation duration was 20 years. Tympanic membrane

2018 Journal of Laryngology & Otology

19. Traumatic tympanic membrane perforations: characteristics and factors affecting outcome (PubMed)

Traumatic tympanic membrane perforations: characteristics and factors affecting outcome To characterize traumatic tympanic membrane perforation (TTMP) in terms of distribution, mechanisms, and outcome of treatment. To assess the factors influencing such outcome.Prospective analytical study, assessing outcomes post-injuries.Clinical department of a tertiary referral hospital.Patients with TTMP based on history of trauma to the ear, and otoscopic examination confirming tympanic membrane (TM (...) ) perforation.Conservative, inactive treatment.Distribution and healing of perforations.There were 53 patients, Male: Female ratio =1.5:1, age 8-71years (Mean ±SD= 33.8 ±12.9). Median duration of injury before presentation was 3 days. 11 patients had both ears traumatized. 46.9% of perforations were in the antero-inferior part of the TM. Median size of perforations was 33.0%; Patients main complaints were blockage of the ears/ hearing loss and tinnitus. Common causes of perforations were domestic assault (28.3%), self

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2018 Ghana Medical Journal

20. What Effect Does Smoking Have on the Surgical Closure of Tympanic Membrane Perforations? A Review. (PubMed)

What Effect Does Smoking Have on the Surgical Closure of Tympanic Membrane Perforations? A Review. The link between cigarette smoking and outcome following surgical repair of tympanic membrane perforation is unclear. The objective of this study was to conduct a systematic review on the link between smoking and success rate following surgical repair of tympanic membrane perforations.Systematic review performed using the following data sources: 1) Cochrane central register of controlled trials (...) (1997 to April 30, 2018), 2) Medline (February 1948 to April 30, 2018), and 3) Embase (1975 to April 30, 2018). Inclusion criteria for this study was: 1) studies reporting surgical closure of tympanic membrane perforations in smokers, 2)primary and revision cases, 3) English language literature, 4) minimum follow-up period of 6 months, and 5) pre and postoperative audiogram. The exclusion criteria were: 1) no identifiable data on smokers in reported outcomes, 2) less than 6 months follow-up, 3

2018 Otology and Neurotology

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