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Christopher A Schutt - One of the best experts on this subject based on the ideXlab platform.
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outcomes after Tympanic Membrane Perforation during primary stapes surgery for otosclerosis
Laryngoscope, 2021Co-Authors: Alexander L Luryi, Amy Schettino, Elias Michaelides, Seilesh Babu, Dennis I Bojrab, Christopher A SchuttAbstract:Objective/hypothesis Stapes surgery is occasionally complicated by an intraoperative Tympanic Membrane Perforation (ITMP), traditionally indicating abortion of the procedure due to concerns for postoperative infection and sensorineural hearing loss (SNHL). This work examines outcomes and complications in completed primary stapes surgeries with and without ITMP. Study design Retrospective review. Methods All patients diagnosed with otosclerosis between February 2008 and September 2017 at a tertiary otology referral center were reviewed retrospectively. Primary outcome measures were post-operative air-bone gap (ABG), air conduction and bone conduction pure tone averages, and post-operative complications. Results Review revealed 652 primary stapes operations meeting inclusion criteria, of which ITMP occurred in 10. There were no significant differences in pre-operative hearing metrics or demographic characteristics between ears with and without ITMP. There were also no significant differences in post-operative ABG (6.4 vs. 8.0 dB HL, P = .43) or change in ABG after surgery (-21.6 vs. -18.2 dB, P = .34) between these two groups. Patients with ITMP were more likely to complain of post-operative dysgeusia (30.0% vs. 5.3%, P = .015) but were no more likely to develop reparative granuloma, otitis media, or SNHL (P > .05). Conclusions The first review of ITMP and hearing outcomes after stapes surgery is presented. Our findings suggest that it is likely safe and appropriate to proceed with primary stapes surgery and concurrent tympanoplasty in the presence of a small ITMP with minimal risk of infection, SNHL, or worsened hearing outcomes. Level of evidence IV Laryngoscope, 2021.
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outcomes after Tympanic Membrane Perforation during primary stapes surgery for otosclerosis
Laryngoscope, 2021Co-Authors: Alexander L Luryi, Amy Schettino, Elias Michaelides, Seilesh Babu, Dennis I Bojrab, Christopher A SchuttAbstract:OBJECTIVE/HYPOTHESIS Stapes surgery is occasionally complicated by an intraoperative Tympanic Membrane Perforation (ITMP), traditionally indicating abortion of the procedure due to concerns for postoperative infection and sensorineural hearing loss (SNHL). This work examines outcomes and complications in completed primary stapes surgeries with and without ITMP. STUDY DESIGN Retrospective review. METHODS All patients diagnosed with otosclerosis between February 2008 and September 2017 at a tertiary otology referral center were reviewed retrospectively. Primary outcome measures were post-operative air-bone gap (ABG), air conduction and bone conduction pure tone averages, and post-operative complications. RESULTS Review revealed 652 primary stapes operations meeting inclusion criteria, of which ITMP occurred in 10. There were no significant differences in pre-operative hearing metrics or demographic characteristics between ears with and without ITMP. There were also no significant differences in post-operative ABG (6.4 vs. 8.0 dB HL, P = .43) or change in ABG after surgery (-21.6 vs. -18.2 dB, P = .34) between these two groups. Patients with ITMP were more likely to complain of post-operative dysgeusia (30.0% vs. 5.3%, P = .015) but were no more likely to develop reparative granuloma, otitis media, or SNHL (P > .05). CONCLUSIONS The first review of ITMP and hearing outcomes after stapes surgery is presented. Our findings suggest that it is likely safe and appropriate to proceed with primary stapes surgery and concurrent tympanoplasty in the presence of a small ITMP with minimal risk of infection, SNHL, or worsened hearing outcomes. LEVEL OF EVIDENCE 4 Laryngoscope, 131:E2026-E2030, 2021.
Dennis I Bojrab - One of the best experts on this subject based on the ideXlab platform.
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outcomes after Tympanic Membrane Perforation during primary stapes surgery for otosclerosis
Laryngoscope, 2021Co-Authors: Alexander L Luryi, Amy Schettino, Elias Michaelides, Seilesh Babu, Dennis I Bojrab, Christopher A SchuttAbstract:Objective/hypothesis Stapes surgery is occasionally complicated by an intraoperative Tympanic Membrane Perforation (ITMP), traditionally indicating abortion of the procedure due to concerns for postoperative infection and sensorineural hearing loss (SNHL). This work examines outcomes and complications in completed primary stapes surgeries with and without ITMP. Study design Retrospective review. Methods All patients diagnosed with otosclerosis between February 2008 and September 2017 at a tertiary otology referral center were reviewed retrospectively. Primary outcome measures were post-operative air-bone gap (ABG), air conduction and bone conduction pure tone averages, and post-operative complications. Results Review revealed 652 primary stapes operations meeting inclusion criteria, of which ITMP occurred in 10. There were no significant differences in pre-operative hearing metrics or demographic characteristics between ears with and without ITMP. There were also no significant differences in post-operative ABG (6.4 vs. 8.0 dB HL, P = .43) or change in ABG after surgery (-21.6 vs. -18.2 dB, P = .34) between these two groups. Patients with ITMP were more likely to complain of post-operative dysgeusia (30.0% vs. 5.3%, P = .015) but were no more likely to develop reparative granuloma, otitis media, or SNHL (P > .05). Conclusions The first review of ITMP and hearing outcomes after stapes surgery is presented. Our findings suggest that it is likely safe and appropriate to proceed with primary stapes surgery and concurrent tympanoplasty in the presence of a small ITMP with minimal risk of infection, SNHL, or worsened hearing outcomes. Level of evidence IV Laryngoscope, 2021.
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outcomes after Tympanic Membrane Perforation during primary stapes surgery for otosclerosis
Laryngoscope, 2021Co-Authors: Alexander L Luryi, Amy Schettino, Elias Michaelides, Seilesh Babu, Dennis I Bojrab, Christopher A SchuttAbstract:OBJECTIVE/HYPOTHESIS Stapes surgery is occasionally complicated by an intraoperative Tympanic Membrane Perforation (ITMP), traditionally indicating abortion of the procedure due to concerns for postoperative infection and sensorineural hearing loss (SNHL). This work examines outcomes and complications in completed primary stapes surgeries with and without ITMP. STUDY DESIGN Retrospective review. METHODS All patients diagnosed with otosclerosis between February 2008 and September 2017 at a tertiary otology referral center were reviewed retrospectively. Primary outcome measures were post-operative air-bone gap (ABG), air conduction and bone conduction pure tone averages, and post-operative complications. RESULTS Review revealed 652 primary stapes operations meeting inclusion criteria, of which ITMP occurred in 10. There were no significant differences in pre-operative hearing metrics or demographic characteristics between ears with and without ITMP. There were also no significant differences in post-operative ABG (6.4 vs. 8.0 dB HL, P = .43) or change in ABG after surgery (-21.6 vs. -18.2 dB, P = .34) between these two groups. Patients with ITMP were more likely to complain of post-operative dysgeusia (30.0% vs. 5.3%, P = .015) but were no more likely to develop reparative granuloma, otitis media, or SNHL (P > .05). CONCLUSIONS The first review of ITMP and hearing outcomes after stapes surgery is presented. Our findings suggest that it is likely safe and appropriate to proceed with primary stapes surgery and concurrent tympanoplasty in the presence of a small ITMP with minimal risk of infection, SNHL, or worsened hearing outcomes. LEVEL OF EVIDENCE 4 Laryngoscope, 131:E2026-E2030, 2021.
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Tympanic Membrane Perforation repair using alloderm
Otolaryngology-Head and Neck Surgery, 1999Co-Authors: William J Mcfeely, Dennis I Bojrab, Jack M KartushAbstract:BACKGROUND: Some patients lack quality autologous tissue for Tympanic Membrane (TM) grafting. AlloDerm (LifeCell Corp, The Woodlands, TX) is a preserved allograft that has been effective in nonotol...
N. Principi - One of the best experts on this subject based on the ideXlab platform.
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prospective evaluation of the aetiology of acute otitis media with spontaneous Tympanic Membrane Perforation
Clinical Microbiology and Infection, 2017Co-Authors: P. Marchisio, N. Principi, S. Esposito, Marina Picca, Elena Baggi, Leonardo Terranova, Annalisa Orenti, Elia Biganzoli, P GalliaAbstract:Abstract Objectives To evaluate the aetiological role of the main bacterial pathogens associated with acute otitis media (AOM) in children with AOM and spontaneous Tympanic Membrane Perforation (STMP). Methods Between 1 May 2015 and 30 April 2016, 177 children, aged 6 months to 7 years, with AOM complicated by STMP within 12 h were prospectively enrolled. Middle ear fluid (MEF) was tested by real-time PCR for Streptococcus pneumoniae , non-typeable Haemophilus influenzae , Streptococcus pyogenes , Moraxella catarrhalis and Staphylococcus aureus . Results Among the 177 children with AOM and STMP, 92/100 (92.0%) of those with recurrent AOM and 13/77 (16.9%) without recurrent AOM had recurrent STMP (p H. influenzae was the most common and was identified in 90 children (50.8%), followed by M. catarrhalis (62 cases, 35.0%) and S. pneumoniae (48 cases, 27.1%). Non-typeable H. influenzae was the most frequent pathogen in children with co-infections. Children with co-infections, including non-typeable H. influenzae, had significantly more frequent recurrent AOM (adjusted OR 6.609, 95% CI 1.243–39.096, p 0.029). Conclusions Recurrent AOM episodes appear to be associated with an increased risk of AOM with STMP. In AOM with STMP, non-typeable H. influenzae is detected at a high frequency, especially in children with recurrent STMP and often in association with other pathogens.
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serotypes not included in 13 valent pneumococcal vaccine as causes of acute otitis media with spontaneous Tympanic Membrane Perforation in a geographic area with high vaccination coverage
Pediatric Infectious Disease Journal, 2017Co-Authors: P. Marchisio, S. Esposito, Marina Picca, Elena Baggi, Leonardo Terranova, Annalisa Orenti, Elia Biganzoli, N. PrincipiAbstract:In 177 children living in an area with high 13-valent pneumococcal conjugate vaccine 13 coverage, who had acute otitis media complicated with spontaneous Tympanic Membrane Perforation, Streptococcus pneumoniae was identified in the middle ear fluid of 48 (27.1%) subjects, with 37 (77.1%) cases caused by nonpneumococcal conjugate vaccine 13 serotypes.
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Acute otitis media with spontaneous Tympanic Membrane Perforation
European Journal of Clinical Microbiology & Infectious Diseases, 2017Co-Authors: N. Principi, P. Marchisio, C. Rosazza, C. S. Sciarrabba, S. EspositoAbstract:The principal aim of this review is to present the current knowledge regarding acute otitis media (AOM) with spontaneous Tympanic Membrane Perforation (STMP) and to address the question of whether AOM with STMP is a disease with specific characteristics or a severe case of AOM. PubMed was used to search for all studies published over the past 15 years using the key words “acute otitis media” and “othorrea” or “spontaneous Tympanic Membrane Perforation”. More than 250 articles were found, but only those published in English and providing data on aspects related to Perforation of infectious origin were considered. Early Streptococcus pneumoniae infection due to invasive pneumococcal strains, in addition to coinfections and biofilm production due mainly to non-typeable Haemophilus influenzae , seem to be precursors of STMP. However, it is unclear why some children have several STMP episodes during the first years of life that resolve without complications in adulthood, whereas other children develop chronic suppurative otitis media. Although specific aetiological agents appear to be associated with an increased risk of AOM with STMP, further studies are needed to determine whether AOM with STMP is a distinct disease with specific aetiological, clinical and prognostic characteristics or a more severe case of AOM than the cases that occur without STMP. Finally, it is important to identify preventive methods that are useful not only in otitis-prone children with uncomplicated AOM, but also in children with recurrent AOM and those who experience several episodes with STMP.
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genetic polymorphisms of functional candidate genes and recurrent acute otitis media with or without Tympanic Membrane Perforation
Medicine, 2015Co-Authors: S. Esposito, P. Marchisio, C. Rosazza, Annalisa Orenti, Elia Biganzoli, Silvia Spena, Sonia Bianchini, Erica Nazzari, Alberto Zampiero, N. PrincipiAbstract:Evaluation of the genetic contribution to the development of recurrent acute otitis media (rAOM) remains challenging. This study aimed to evaluate the potential association between single nucleotide polymorphisms (SNPs) in selected genes and rAOM and to analyze whether genetic variations might predispose to the development of complicated recurrent cases, such as those with Tympanic Membrane Perforation (TMP).A total of 33 candidate genes and 47 SNPs were genotyped in 200 children with rAOM (116 with a history of TMP) and in 200 healthy controls.INFγ rs 12369470CT was significantly less common in the children with rAOM than in healthy controls (odds ratio [OR] 0.5, 95% confidence interval [CI] 0.25-1, P = 0.04). Although not significant, interleukin (IL)-1β rs 1143627G and toll-like receptor (TLR)-4 rs2737191AG were less frequently detected in the children with rAOM than in controls. The opposite was true for IL-8 rs2227306CT, which was found more frequently in the children with rAOM than in healthy controls. The IL-10 rs1800896TC SNP and the IL-1α rs6746923A and AG SNPs were significantly more and less common, respectively, among children without a history of TMP than among those who suffered from this complication (OR 2.17, 95% CI 1.09-4.41, P = 0.02, and OR 0.42, 95% CI 0.21-0.84, P = 0.01).This study is the first report suggesting an association between variants in genes encoding for factors of innate or adaptive immunity and the occurrence of rAOM with or without TMP, which confirms the role of genetics in conditioning susceptibility to AOM.
Alexander L Luryi - One of the best experts on this subject based on the ideXlab platform.
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outcomes after Tympanic Membrane Perforation during primary stapes surgery for otosclerosis
Laryngoscope, 2021Co-Authors: Alexander L Luryi, Amy Schettino, Elias Michaelides, Seilesh Babu, Dennis I Bojrab, Christopher A SchuttAbstract:Objective/hypothesis Stapes surgery is occasionally complicated by an intraoperative Tympanic Membrane Perforation (ITMP), traditionally indicating abortion of the procedure due to concerns for postoperative infection and sensorineural hearing loss (SNHL). This work examines outcomes and complications in completed primary stapes surgeries with and without ITMP. Study design Retrospective review. Methods All patients diagnosed with otosclerosis between February 2008 and September 2017 at a tertiary otology referral center were reviewed retrospectively. Primary outcome measures were post-operative air-bone gap (ABG), air conduction and bone conduction pure tone averages, and post-operative complications. Results Review revealed 652 primary stapes operations meeting inclusion criteria, of which ITMP occurred in 10. There were no significant differences in pre-operative hearing metrics or demographic characteristics between ears with and without ITMP. There were also no significant differences in post-operative ABG (6.4 vs. 8.0 dB HL, P = .43) or change in ABG after surgery (-21.6 vs. -18.2 dB, P = .34) between these two groups. Patients with ITMP were more likely to complain of post-operative dysgeusia (30.0% vs. 5.3%, P = .015) but were no more likely to develop reparative granuloma, otitis media, or SNHL (P > .05). Conclusions The first review of ITMP and hearing outcomes after stapes surgery is presented. Our findings suggest that it is likely safe and appropriate to proceed with primary stapes surgery and concurrent tympanoplasty in the presence of a small ITMP with minimal risk of infection, SNHL, or worsened hearing outcomes. Level of evidence IV Laryngoscope, 2021.
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outcomes after Tympanic Membrane Perforation during primary stapes surgery for otosclerosis
Laryngoscope, 2021Co-Authors: Alexander L Luryi, Amy Schettino, Elias Michaelides, Seilesh Babu, Dennis I Bojrab, Christopher A SchuttAbstract:OBJECTIVE/HYPOTHESIS Stapes surgery is occasionally complicated by an intraoperative Tympanic Membrane Perforation (ITMP), traditionally indicating abortion of the procedure due to concerns for postoperative infection and sensorineural hearing loss (SNHL). This work examines outcomes and complications in completed primary stapes surgeries with and without ITMP. STUDY DESIGN Retrospective review. METHODS All patients diagnosed with otosclerosis between February 2008 and September 2017 at a tertiary otology referral center were reviewed retrospectively. Primary outcome measures were post-operative air-bone gap (ABG), air conduction and bone conduction pure tone averages, and post-operative complications. RESULTS Review revealed 652 primary stapes operations meeting inclusion criteria, of which ITMP occurred in 10. There were no significant differences in pre-operative hearing metrics or demographic characteristics between ears with and without ITMP. There were also no significant differences in post-operative ABG (6.4 vs. 8.0 dB HL, P = .43) or change in ABG after surgery (-21.6 vs. -18.2 dB, P = .34) between these two groups. Patients with ITMP were more likely to complain of post-operative dysgeusia (30.0% vs. 5.3%, P = .015) but were no more likely to develop reparative granuloma, otitis media, or SNHL (P > .05). CONCLUSIONS The first review of ITMP and hearing outcomes after stapes surgery is presented. Our findings suggest that it is likely safe and appropriate to proceed with primary stapes surgery and concurrent tympanoplasty in the presence of a small ITMP with minimal risk of infection, SNHL, or worsened hearing outcomes. LEVEL OF EVIDENCE 4 Laryngoscope, 131:E2026-E2030, 2021.
S. Esposito - One of the best experts on this subject based on the ideXlab platform.
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prospective evaluation of the aetiology of acute otitis media with spontaneous Tympanic Membrane Perforation
Clinical Microbiology and Infection, 2017Co-Authors: P. Marchisio, N. Principi, S. Esposito, Marina Picca, Elena Baggi, Leonardo Terranova, Annalisa Orenti, Elia Biganzoli, P GalliaAbstract:Abstract Objectives To evaluate the aetiological role of the main bacterial pathogens associated with acute otitis media (AOM) in children with AOM and spontaneous Tympanic Membrane Perforation (STMP). Methods Between 1 May 2015 and 30 April 2016, 177 children, aged 6 months to 7 years, with AOM complicated by STMP within 12 h were prospectively enrolled. Middle ear fluid (MEF) was tested by real-time PCR for Streptococcus pneumoniae , non-typeable Haemophilus influenzae , Streptococcus pyogenes , Moraxella catarrhalis and Staphylococcus aureus . Results Among the 177 children with AOM and STMP, 92/100 (92.0%) of those with recurrent AOM and 13/77 (16.9%) without recurrent AOM had recurrent STMP (p H. influenzae was the most common and was identified in 90 children (50.8%), followed by M. catarrhalis (62 cases, 35.0%) and S. pneumoniae (48 cases, 27.1%). Non-typeable H. influenzae was the most frequent pathogen in children with co-infections. Children with co-infections, including non-typeable H. influenzae, had significantly more frequent recurrent AOM (adjusted OR 6.609, 95% CI 1.243–39.096, p 0.029). Conclusions Recurrent AOM episodes appear to be associated with an increased risk of AOM with STMP. In AOM with STMP, non-typeable H. influenzae is detected at a high frequency, especially in children with recurrent STMP and often in association with other pathogens.
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serotypes not included in 13 valent pneumococcal vaccine as causes of acute otitis media with spontaneous Tympanic Membrane Perforation in a geographic area with high vaccination coverage
Pediatric Infectious Disease Journal, 2017Co-Authors: P. Marchisio, S. Esposito, Marina Picca, Elena Baggi, Leonardo Terranova, Annalisa Orenti, Elia Biganzoli, N. PrincipiAbstract:In 177 children living in an area with high 13-valent pneumococcal conjugate vaccine 13 coverage, who had acute otitis media complicated with spontaneous Tympanic Membrane Perforation, Streptococcus pneumoniae was identified in the middle ear fluid of 48 (27.1%) subjects, with 37 (77.1%) cases caused by nonpneumococcal conjugate vaccine 13 serotypes.
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Acute otitis media with spontaneous Tympanic Membrane Perforation
European Journal of Clinical Microbiology & Infectious Diseases, 2017Co-Authors: N. Principi, P. Marchisio, C. Rosazza, C. S. Sciarrabba, S. EspositoAbstract:The principal aim of this review is to present the current knowledge regarding acute otitis media (AOM) with spontaneous Tympanic Membrane Perforation (STMP) and to address the question of whether AOM with STMP is a disease with specific characteristics or a severe case of AOM. PubMed was used to search for all studies published over the past 15 years using the key words “acute otitis media” and “othorrea” or “spontaneous Tympanic Membrane Perforation”. More than 250 articles were found, but only those published in English and providing data on aspects related to Perforation of infectious origin were considered. Early Streptococcus pneumoniae infection due to invasive pneumococcal strains, in addition to coinfections and biofilm production due mainly to non-typeable Haemophilus influenzae , seem to be precursors of STMP. However, it is unclear why some children have several STMP episodes during the first years of life that resolve without complications in adulthood, whereas other children develop chronic suppurative otitis media. Although specific aetiological agents appear to be associated with an increased risk of AOM with STMP, further studies are needed to determine whether AOM with STMP is a distinct disease with specific aetiological, clinical and prognostic characteristics or a more severe case of AOM than the cases that occur without STMP. Finally, it is important to identify preventive methods that are useful not only in otitis-prone children with uncomplicated AOM, but also in children with recurrent AOM and those who experience several episodes with STMP.
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genetic polymorphisms of functional candidate genes and recurrent acute otitis media with or without Tympanic Membrane Perforation
Medicine, 2015Co-Authors: S. Esposito, P. Marchisio, C. Rosazza, Annalisa Orenti, Elia Biganzoli, Silvia Spena, Sonia Bianchini, Erica Nazzari, Alberto Zampiero, N. PrincipiAbstract:Evaluation of the genetic contribution to the development of recurrent acute otitis media (rAOM) remains challenging. This study aimed to evaluate the potential association between single nucleotide polymorphisms (SNPs) in selected genes and rAOM and to analyze whether genetic variations might predispose to the development of complicated recurrent cases, such as those with Tympanic Membrane Perforation (TMP).A total of 33 candidate genes and 47 SNPs were genotyped in 200 children with rAOM (116 with a history of TMP) and in 200 healthy controls.INFγ rs 12369470CT was significantly less common in the children with rAOM than in healthy controls (odds ratio [OR] 0.5, 95% confidence interval [CI] 0.25-1, P = 0.04). Although not significant, interleukin (IL)-1β rs 1143627G and toll-like receptor (TLR)-4 rs2737191AG were less frequently detected in the children with rAOM than in controls. The opposite was true for IL-8 rs2227306CT, which was found more frequently in the children with rAOM than in healthy controls. The IL-10 rs1800896TC SNP and the IL-1α rs6746923A and AG SNPs were significantly more and less common, respectively, among children without a history of TMP than among those who suffered from this complication (OR 2.17, 95% CI 1.09-4.41, P = 0.02, and OR 0.42, 95% CI 0.21-0.84, P = 0.01).This study is the first report suggesting an association between variants in genes encoding for factors of innate or adaptive immunity and the occurrence of rAOM with or without TMP, which confirms the role of genetics in conditioning susceptibility to AOM.
