Tympanoplasty
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Tympanoplasty
Tympanoplasty is the surgical operation performed to reconstruct hearing mechanism of middle ear Classification Tympanoplasty is classified into five different types, originally described by Horst Ludwig Wullstein (1906–1987) in 1956. # Type 1 involves repair of the tympanic membrane alone, when the middle ear is normal. A type 1 tympanoplasty is synonymous to myringoplasty. # Type 2 involves repair of the tympanic membrane and middle ear in spite of slight defects in the middle ear ossicles. # Type 3 involves removal of ossicles and epitympanum when there are large defects of the malleus and incus. The tympanic membrane is repaired and directly connected to the head of the stapes. # Type 4 describes a repair when the stapes foot plate is movable, but the crura are missing. The resulting middle ear will only consist of the Eustachian tube and hypotympanum. # Type 5 is a repair involving a fixed stapes footplate. Also called fenestration operation. Myringoplasty The term 'myring ...
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Myringoplasty
Myringoplasty is the closure of the perforation of pars tensa of the tympanic membrane. When myringoplasty is combined with removal of scar tissue, it is called tympanoplasty. The operation is performed with the patient supine and face turned to one side. The graft material most commonly used for the surgery is temporalis fascia. The tragal cartilage and tragal perichondrium are also used as the graft by some surgeons. Myringoplasty restores hearing loss in certain cases of tinnitus. The chances of re-infection and persistent discharge is less after surgery. Myringoplasty should not be performed if there is active discharge from the middle ear, or if the patient has uncontrolled nasal allergy, or when the other ear is dead and in children less than 3 years of age. Myringoplasty is often done under general anaesthesia, but it can be done under local anaesthesia also. Technique of surgery Underlay technique The temporalis fascia is grafted. An incision is made along the edge of th ...
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Stapes
The ''stapes'' or stirrup is a bone in the middle ear of humans and other animals which is involved in the conduction of sound vibrations to the inner ear. This bone is connected to the oval window by its annular ligament, which allows the footplate to transmit sound energy through the oval window into the inner ear. The ''stapes'' is the smallest and lightest bone in the human body, and is so-called because of its resemblance to a stirrup ( la, Stapes). Structure The ''stapes'' is the third bone of the three ossicles in the middle ear and the smallest in the human body. It measures roughly , greater along the head-base span. It rests on the oval window, to which it is connected by an annular ligament and articulates with the ''incus'', or anvil through the incudostapedial joint. They are connected by anterior and posterior limbs ( la, crura). Development The ''stapes'' develops from the second pharyngeal arch during the sixth to eighth week of embryological life. The ce ...
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Surgical Operation
Surgery ''cheirourgikē'' (composed of χείρ, "hand", and ἔργον, "work"), via la, chirurgiae, meaning "hand work". is a medical specialty that uses operative manual and instrumental techniques on a person to investigate or treat a pathological condition such as a disease or injury, to help improve bodily function, appearance, or to repair unwanted ruptured areas. The act of performing surgery may be called a surgical procedure, operation, or simply "surgery". In this context, the verb "operate" means to perform surgery. The adjective surgical means pertaining to surgery; e.g. surgical instruments or surgical nurse. The person or subject on which the surgery is performed can be a person or an animal. A surgeon is a person who practices surgery and a surgeon's assistant is a person who practices surgical assistance. A surgical team is made up of the surgeon, the surgeon's assistant, an anaesthetist, a circulating nurse and a surgical technologist. Surgery usually sp ...
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Local Anesthesia
Local anesthesia is any technique to induce the absence of sensation in a specific part of the body, generally for the aim of inducing local analgesia, that is, local insensitivity to pain, although other local senses may be affected as well. It allows patients to undergo surgical and dental procedures with reduced pain and distress. In many situations, such as cesarean section, it is safer and therefore superior to general anesthesia. The following terms are often used interchangeably: * ''Local anesthesia'', in a strict sense, is anesthesia of a small part of the body such as a tooth or an area of skin. * ''Regional anesthesia'' is aimed at anesthetizing a larger part of the body such as a leg or arm. * ''Conduction anesthesia'' encompasses a great variety of local and regional anesthetic techniques. Medical A local anesthetic is a drug that causes reversible local anesthesia and a loss of nociception. When it is used on specific nerve pathways (nerve block), effects such as ...
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Myringotomy
A myringotomy is a surgical procedure in which an incision is created in the eardrum (tympanic membrane) to relieve pressure caused by excessive buildup of fluid, or to drain pus from the middle ear. A tympanostomy tube may be inserted through the eardrum to keep the middle ear aerated for a prolonged time and to prevent reaccumulation of fluid. Without the insertion of a tube, the incision usually heals spontaneously within two to three weeks. Depending on the type, the tube is either naturally extruded in 6 to 12 months or removed during a minor procedure. Those requiring myringotomy usually have an obstructed or dysfunctional eustachian tube that is unable to perform drainage or ventilation in its usual fashion. Before the invention of antibiotics, myringotomy without tube placement was also used as a major treatment of severe acute otitis media (middle ear infection). Nomenclature The words ''myringotomy'', ''tympanotomy'', ''tympanostomy'', and '' tympanocentesis'' overlap i ...
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Tympanostomy Tube
Tympanostomy tube, also known as a grommet or myringotomy tube, is a small tube inserted into the eardrum in order to keep the middle ear aerated for a prolonged period of time, and to prevent the accumulation of fluid in the middle ear. The operation to insert the tube involves a myringotomy and is performed under local or general anesthesia. The tube itself is made in a variety of designs. The most commonly used type is shaped like a grommet. When it is necessary to keep the middle ear ventilated for a very long period, a "T"-shaped tube may be used, as these "T-tubes" can stay in place for 2–4 years. Materials used to construct the tube are most often plastics such as silicone or Teflon. Stainless steel tubes exist, but are no longer in frequent use. Medical uses Inserting grommets is a common surgical procedure for treating children around the world. Grommets are most commonly used to help improve hearing for children who have a condition commonly called "glue ear" (pe ...
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Eardrum
In the anatomy of humans and various other tetrapods, the eardrum, also called the tympanic membrane or myringa, is a thin, cone-shaped membrane that separates the external ear The outer ear, external ear, or auris externa is the external part of the ear, which consists of the auricle (also pinna) and the ear canal. It gathers sound energy and focuses it on the eardrum (tympanic membrane). Structure Auricle The ... from the middle ear. Its function is to transmit sound from the air to the ossicles inside the middle ear, and then to the oval window in the fluid-filled cochlea. Hence, it ultimately converts and amplifies vibration in the air to vibration in cochlear fluid. The malleus bone bridges the gap between the eardrum and the other ossicles. Rupture or perforation of the eardrum can lead to conductive hearing loss. Collapse or tympanic membrane retraction, retraction of the eardrum can cause conductive hearing loss or cholesteatoma. Structure Orientation and r ...
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Joseph Toynbee
Joseph Toynbee FRS (30 December 1815 Another son, Harry Valpy Toynbee (1861–1941), was the father of universal historian Arnold J. Toynbee, and archaeologist and art historian Jocelyn Toynbee. He died on 7 July 1866, at 18, Saville Row, Mayfair, while conducting experiments with prussic acid and chloroform as a remedy for tinnitus. Either one of these substances or their combination is to blame for his death. He was buried at St Mary's Church, Wimbledon, on 11 July 1866. Joseph's residence on the burial register was listed as Wimbledon. He lived at Beech Holme, Wimbledon. Career He performed studies on the functionality of the Eustachian tube and of the tympanic membrane and tried to restore attempts, the tympanoplasty. When St. Mary's Hospital was founded in Paddington, he a became an aural surgeon and a lecturer on ear diseases – his course of clinical lectures being published in 1855 and 1866. During this time period he composed two major works: "A Descriptive Catal ...
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James Yearsley
James Yearsley (1805–1869), aural surgeon, was born in 1805 to a north-country family settled in Cheltenham. Medical career Adopting a medical career, he became a pupil of Ralph Fletcher of Gloucester, (a surgeon of considerable eminence in his profession, and of some note as a collector of pictures), and later married his daughter. Yearsley moved to London, where he entered himself a student at St. Bartholomew's Hospital. He was admitted a member of the Royal College of Surgeons of England and a licentiate of the Society of Apothecaries in 1827; later in life he added to these qualifications the licentiateship of the Royal College of Physicians, Edinburgh (1860), and he graduated M.D. at St. Andrews University in 1862. After practising for a short time in Cheltenham, he established himself about 1829 as a general practitioner at Ross in Herefordshire. He removed to London about 1837, and started to practise as an aural surgeon. He opened an institution for the relief of dise ...
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Pig's Bladder
Pig bladder (also pig's bladder) is the urinary bladder of a domestic pig, similar to the human urinary bladder. Today, this hollow organ has various applications in medicine, and in traditional cuisines and customs. Historically, the pig bladder had several additional uses, all based on its properties as a lightweight, stretchable container that could be filled and tied off. Traditional uses The pig bladder has several traditional ceremonial uses in Europe. It is traditional during the festival Fasching in Bad Aussee to brandish inflated pig bladders on sticks. Similarly, in Xinzo de Limia, Spain, inflated pig bladders are carried during Carnival. See also Clown society and Jester and Gigantes y cabezudos and Vejigante. In traditional Germanic communities a public Schlachtfest (of a pig) is announced by hanging the pig's inflated bladder in front of the host establishment. The bladder is used as a casing for several traditional food items, including the sausages known as v ...
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Ivory
Ivory is a hard, white material from the tusks (traditionally from elephants) and teeth of animals, that consists mainly of dentine, one of the physical structures of teeth and tusks. The chemical structure of the teeth and tusks of mammals is the same, regardless of the species of origin, but ivory contains structures of mineralised collagen. The trade in certain teeth and tusks other than elephant is well established and widespread; therefore, "ivory" can correctly be used to describe any mammalian teeth or tusks of commercial interest which are large enough to be carved or scrimshawed. Besides natural ivory, ivory can also be produced synthetically, hence (unlike natural ivory) not requiring the retrieval of the material from animals. Tagua nuts can also be carved like ivory. The trade of finished goods of ivory products has its origins in the Indus Valley. Ivory is a main product that is seen in abundance and was used for trading in Harappan civilization. Finished ivory pr ...
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General Anesthesia
General anaesthesia (UK) or general anesthesia (US) is a medically induced loss of consciousness that renders the patient unarousable even with painful stimuli. This effect is achieved by administering either intravenous or inhalational general anaesthetic medications, which often act in combination with an analgesic and neuromuscular blocking agent. Spontaneous ventilation is often inadequate during the procedure and intervention is often necessary to protect the airway. General anaesthesia is generally performed in an operating theater to allow surgical procedures that would otherwise be intolerably painful for a patient, or in an intensive care unit or emergency department to facilitate endotracheal intubation and mechanical ventilation in critically ill patients. A variety of drugs may be administered, with the overall goal of achieving unconsciousness, amnesia, analgesia, loss of reflexes of the autonomic nervous system, and in some cases paralysis of skeletal muscles. The ...
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