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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. Full Text available with Trip Pro

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

2019 PLoS ONE

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

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

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

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

4. Commercial Quinolone Ear Drops Cause Perforations in Intact Rat Tympanic Membranes. (Abstract)

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

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

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

6. Endoscopic observation of different repair patterns in human traumatic tympanic membrane perforations. Full Text available with Trip Pro

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 (...) : 13.3±2.2 days vs. 21.8±4.2 days, and large perforations: 21.2±4.7 days vs. 38.4±5.7 days; p<0.01).In the regeneration of traumatic tympanic membrane perforations, Gelfoam patching not only plays a scaffolding role for epithelial migration, it also promotes edema and hyperplasia of granulation tissue at the edges of the perforation and accelerates eardrum healing.Copyright © 2017 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights

2019 Brazilian journal of otorhinolaryngology Controlled trial quality: uncertain

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

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

8. Risk for Tympanic Membrane Perforation after Quinolone Ear Drops for Acute Otitis Externa. (Abstract)

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

2019 Clinical Infectious Diseases

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

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

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. Full Text available with Trip Pro

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

2017 PLoS ONE

11. Efficacy of EGF and Gelatin Sponge for Traumatic Tympanic Membrane Perforations: A Randomized Controlled Study. (Abstract)

Efficacy of EGF and Gelatin Sponge for Traumatic Tympanic Membrane Perforations: A Randomized Controlled Study. Objective To compare the outcomes of epidermal growth factor (EGF) and gelatin sponge patch treatments for traumatic tympanic membrane perforations. Study Design Prospective, randomized, controlled. Setting University-affiliated teaching hospital. Subjects and Methods In total, 141 perforations encompassing >50% of the eardrum were randomly divided into 3 groups: EGF (n = 47), gelatin (...) in the EGF, gelatin sponge patch, and spontaneous healing groups, respectively ( P < .001). In addition, the presence of infection was not significantly associated with rate of closure in any group. Conclusions As compared with spontaneous healing, daily application of EGF and gelatin sponge patching reduced the closure time of traumatic tympanic membrane perforations. EGF treatment had a higher closure rate and shorter closure time but resulted in otorrhea. By contrast, gelatin sponge patches did

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

12. Endoscopic vs Microscopic Overlay Tympanoplasty for Correcting Large Tympanic Membrane Perforations: A Randomized Clinical Trial. (Abstract)

Endoscopic vs Microscopic Overlay Tympanoplasty for Correcting Large Tympanic Membrane Perforations: A Randomized Clinical Trial. Although overlay grafting for complicated tympanic perforations offers a high success rate, potential complications may outweigh its advantages. This study aimed to assess endoscopic overlay tympanoplasty (EOT), compared with microscopic overlay tympanoplasty (MOT), to optimize outcomes while minimizing complications associated with large tympanic (...) perforations.Nonmasked, randomized.Tertiary care university hospital.Altogether, 70 patients with large tympanic perforations were randomized to undergo overlay tympanoplasty between June 2014 and July 2016. Primary outcome was the visual analog scale (VAS) of pain. Secondary outcomes were anatomic closure, hearing results, middle ear findings, and postoperative complications.Overall, 34 EOT patients and 30 MOT patients completed the follow-up. VAS scores at 4, 24, and 48 hours in EOT and MOT groups were

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

13. Outcome of Graft Uptake and Hearing Results between 'U' Flap Technique and Conventional Tympanomeatal Flap Technique for Anterior and Subtotal Tympanic Membrane Perforation. (Abstract)

Outcome of Graft Uptake and Hearing Results between 'U' Flap Technique and Conventional Tympanomeatal Flap Technique for Anterior and Subtotal Tympanic Membrane Perforation. Myringoplasty done for anterior and subtotal perforation needs expertise and practice than conventional underlay myringoplasty. The objective of this study was to compare the graft uptake and postoperative hearing results between 'U' flap and conventional tympanomeatal flap technique in anterior and subtotal tympanic (...) membrane perforation.Sixty three patients of age fifteen years and above with chronic otitis media mucosal type with any sized anterior and subtotal perforation of tympanic membrane were randomly allocated for myringoplasty by lottery method. There were thirty one cases in 'U' flap group and thirty two cases in conventional tympanomeatal flap group. Graft uptake and hearing results were assessed after six weeks and results were compared within and between the groups.Graft uptake rate was 90.3%(28/31

2018 Journal of Nepal Health Research Council Controlled trial quality: uncertain

14. Bacterial cellulose graft versus fat graft in closure of tympanic membrane perforation. (Abstract)

Bacterial cellulose graft versus fat graft in closure of tympanic membrane perforation. To compare between results of bacterial cellulose graft myringoplasty and fat graft myingoplasty in patients had mild or moderate size safe perforation.120 patients undergoing myringoplasty due to mild or moderate size perforation were divided into 3 groups: group I: 40 patients undergoing myringoplasty with use of bacterial cellulose graft, group II: 40 patients undergoing myringoplasty with use of fat (...) graft, group III: 40 patients undergoing usual myringoplasty with use of temporalis fascia graft (control group).Healing in 20 patients with small perforation and 17 patients with moderate perforation in Group I, Healing in 15 patients with small perforation and 10 patients with moderate perforation in Group II, Healing in 18 patients with small perforation and 12 patients with moderate perforation in Group III.Bacterial cellulose graft myringoplasty would be a good, simple, rapid and safe surgery

2018 American Journal of Otolaryngology

15. Comparative study of epidermal growth factor and observation only on human subacute tympanic membrane perforation. (Abstract)

Comparative study of epidermal growth factor and observation only on human subacute tympanic membrane perforation. To compare the effects of epidermal growth factor (EGF) and observation only on human subacute tympanic membrane perforation (TMP).A total of 44 patients with traumatic TMPs >2 months after trauma were divided into an observation group (n = 18) and EGF group (n = 26). Patients in the EGF group underwent direct application of EGF without stripping of the perforation edge. All (...) patients were followed up for at least 6 months. The TMP closure rate, closure time, and hearing gain were evaluated.At 6 months, 25 of 26 (96.2%) perforations achieved complete closure with a mean closure time of 9.1 ± 3.9 days (range, 3-14 days) in the EGF group. However, only 11 of 18 (61.1%) perforations achieved complete closure in the observation group, with a mean closure time of 20.6 ± 10.7 days (range = 9-71 days). The patients in the EGF-treated group had significantly improved closure rates

2018 American Journal of Otolaryngology

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

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

17. Traumatic tympanic membrane perforations: characteristics and factors affecting outcome Full Text available with Trip Pro

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

2018 Ghana Medical Journal

18. Randomized Clinical Trial Comparing Bucket Handle and Cartilage Tympanoplasty Techniques for the Reconstruction of Subtotal or Anterior Tympanic Membrane Perforation Full Text available with Trip Pro

Randomized Clinical Trial Comparing Bucket Handle and Cartilage Tympanoplasty Techniques for the Reconstruction of Subtotal or Anterior Tympanic Membrane Perforation The purpose of the study is to compare the clinical outcome of the two techniques of Bucket Handle Tympanoplasty and Cartilage Tympanoplasty in achieving success in graft survival as well as acceptable auditory results. 60 patients who suffered chronic otitis media with anterior perforation of the tympanic membrane were chosen (...) , in terms of PTA outcome (P Value = 0.547) and SRT outcome (P Value = 0.352), between Bucket Handle Tympanoplasty group and the Cartilage Tympanoplasty group. In total, postoperative tympanic membrane perforation was found in 10.0% of patients in Cartilage Tympanoplasty group and 13.3% in Bucket Handle Tympanoplasty group with no difference (P = 0.500).Hearing improvements in both methods were similar.The trial is registered with IRCT2016022626773N1.

2018 International journal of otolaryngology Controlled trial quality: uncertain

19. The short- and long-term adverse effects of FGF-2 on tympanic membrane perforations Full Text available with Trip Pro

The short- and long-term adverse effects of FGF-2 on tympanic membrane perforations The objective of this study was to investigate the short- and long-term adverse effects of fibroblast growth factor-2 treatment of tympanic membrane perforations. A total of 134 patients with traumatic tympanic membrane perforations were randomly divided into two groups: an observational group and a fibroblast growth factor-2 treatment group. The closure rate, closure time and principal side-effects were (...) that the topical application of fibroblast growth factor-2 to human traumatic tympanic membranes is safe. Otorrhoea was the most common short-term side-effect; other less common side-effects included otitis media with effusion and reperforation. No serious long-term side-effects were found.Copyright © 2018 Società Italiana di Otorinolaringologia e Chirurgia Cervico-Facciale, Rome, Italy.

2018 Acta Otorhinolaryngologica Italica Controlled trial quality: uncertain

20. Tympanic Membrane Perforation Repair Using Porcine Small Intestinal Submucosal Grafting. (Abstract)

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

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