The effect of using a PORP to reconstruct the ossicular chain under otoendoscopy with and without a malleus handle

Comparison of healing of acute total tympanic membrane perforation between rats with and without excision of the mallear handle

Objective

We compared the histological changes and hearing restoration during the healing of acute total tympanic membrane (TM) perforations between Sprague-Dawley (SD) rats with and without excision of the mallear handle.

Materials and methods

Bilateral, acute, and total TM perforations were created in 36 male SD rats. The mallear handle was preserved in the left ear (handle-preserved ear [HPE]) and excised from the right ear (handle-excised ear [HEE]). Endoscopical examination, auditory brainstem response (ABR) thresholds, histopathological, and scanning electron microscope (SEM) analysis were performed.

Results

Endoscopic photographs showed that all perforations in the 18 SD rats were closed. The mean closure times were 6.83 ± 0.85 and 8.50 ± 0.71 days in the HPE and HEE groups, respectively (p < .001). SEM images showed radial arrangement of fiber bundles in a single direction in HPEs, although normal arrangement was not achieved. In contrast, HEEs showed disorganized arrangement. At 1 month after perforation closure, the ABR thresholds at high frequencies were significantly higher in the HEE group than in the HPE group (p = .029 and p = .017 for 16 and 32 kHz, respectively). Additionally, the changes in ABR threshold were significantly different at high frequencies (p = .011 and p = .017 for 16 and 32 kHz, respectively) before and 1 month after perforation closure between the HPE and HEE groups, although the differences were not statistically significant at the remaining frequencies.

Conclusion

Although the malleus handle may not affect the closure of total perforation in SD rats, it contributes to accelerate the perforation closure by possible guide the migration of proliferative epithelial cell on the upper halves of the annulus. Additionally, resection of the malleus handle impairs high frequency hearing recovery following spontaneous closure of the TM.

Efficacy of Otomicroscopy Combined with Otoendoscopy Double-Lens Technology-Assisted Tympanic Membrane Repair on Elderly Patients with Chronic Suppurative Otitis Media

Objective

To investigate the effect of otomicroscopy combined with otoendoscopy double-lens technology-assisted tympanic membrane repair on elderly patients chronic suppurative otitis media (CSOM).

Methods

120 elderly CSOM patients from January 2017 to July 2019 were selected and divided into the otomicroscopy group (n = 40), the otoendoscopy group (n = 40), and the double-lens group (n = 40) by the random number method. All patients were treated with tympanic membrane repair. The otomicroscopy group was assisted by otomicroscopy, the otoendoscopy group was assisted by otoendoscopy. and the double-lens group was assisted by otomicroscopy combined with otoendoscopy. The three groups of operations status, clinical efficacy, the incidence of adverse reactions, hearing improvement rate, and satisfaction rate with incision after 6 months were compared.

Results

The operation time, intraoperative blood loss, hospitalization time, and VAS score of the otoendoscopy group and the double-lens group were all lower than those of the otoendoscopy group, and the operation time of the double-lens group was lower than that of the otoendoscopy group (P < 0.05). The clinical efficacy of the double-lens group was better than that of the otomicroscopy group and otoendoscopy group (P < 0.05). The adverse reaction rate of the otoendoscopy group and the double-lens group was lower than that of the otomicroscopy group, and the average postoperative air-bone conductance of the double-lens group was lower than that of the otomicroscopy group and the otoendoscopy group, and the hearing improvement rate was higher than that of the otomicroscopy and otoendoscopy groups (P < 0.05). The satisfaction rate with postoperative incision in the otoendoscopy group and double-lens group was higher than that in the otomicroscopy group (P < 0.05).

Conclusion

The double-lens technology-assisted tympanic membrane repair has an obvious effect on elderly patients with CSOM. Compared with the single-use otomicroscopy, the operation time, intraoperative blood loss, hospitalization time, patient's dry ear condition, degree of surgical pain, clinical efficacy, adverse reaction rate, hearing improvement rate, and patient's incision satisfaction of the double-lens technology are better. Compared with the single-use otoendoscopy, the operation time, clinical efficacy, and hearing improvement rate of the double-lens technology are better.