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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. 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

3. 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

4. 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

5. 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

6. 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

7. 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

8. 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

9. 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

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

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

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

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

12. 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

13. 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

14. 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

15. 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

16. Randomized Clinical Trial Comparing Bucket Handle and Cartilage Tympanoplasty Techniques for the Reconstruction of Subtotal or Anterior Tympanic Membrane Perforation (PubMed)

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.

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2018 International journal of otolaryngology

17. The short- and long-term adverse effects of FGF-2 on tympanic membrane perforations (PubMed)

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.

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2018 Acta Otorhinolaryngologica Italica

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

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

19. 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

20. 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

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