Tympanoplasty: Science, Art, or Acrobatics
2019 AAO-HNSF Annual Meeting & OTO Experience
Keyword(s)
Tympanoplasty, tympanic membrane repair, endoscopic techniques
Tympanoplasty is one of the most common otologic procedures performed by general otolaryngologists, yet there is a vast array of techniques and materials used to accomplish tympanic membrane repair. Since Wullstein described the basic principles, many different materials have been utilized. For many years, this field was dominated by microscopic approaches using temporalis fascia. In spite of this uniformity, a vigorous debate persists regarding the placement of the graft material (medial graft, lateral graft, or variation of these preferences). Within the last few years, the biomechanical evidence and the widespread use of cartilage techniques, the development of specific agents that may augment healing or offer non-surgical options, and the rise of endoscopic ear surgical techniques have added new dimensions to this already controversial subject. Both the choice of graft materials and technique influence healing rates, hearing outcomes, and Quality of Life outcomes. Furthermore, these outcomes are also strongly influenced by a myriad of patient characteristics. This evolving milieu of clinical options has created a confusing environment for many otolaryngologists. In Part I of these symposia, this diverse panel of international experts will discuss the science exploring various grafting materials, the use of growth factors, and the mechanics of the reconstructed middle ear and the factors involved with successful outcomes. In Part II, the panel will discuss the application of these principles and various management approaches to specific case presentations. Panelists will debate different approaches to common problems and discuss the fundamental surgical principles that influence patient outcomes.
Description
Tympanoplasty is one of the most common otologic procedures performed by general otolaryngologists, yet there is a vast array of techniques and materials used to accomplish tympanic membrane repair. Since Wullstein described the basic principles, many different materials have been utilized. For many years, this field was dominated by microscopic approaches using temporalis fascia. In spite of this uniformity, a vigorous debate persists regarding the placement of the graft material (medial graft, lateral graft, or variation of these preferences). Within the last few years, the biomechanical evidence and the widespread use of cartilage techniques, the development of specific agents that may augment healing or offer non-surgical options, and the rise of endoscopic ear surgical techniques have added new dimensions to this already controversial subject. Both the choice of graft materials and technique influence healing rates, hearing outcomes, and Quality of Life outcomes. Furthermore, these outcomes are also strongly influenced by a myriad of patient characteristics. This evolving milieu of clinical options has created a confusing environment for many otolaryngologists. In Part I of these symposia, this diverse panel of international experts will discuss the science exploring various grafting materials, the use of growth factors, and the mechanics of the reconstructed middle ear and the factors involved with successful outcomes. In Part II, the panel will discuss the application of these principles and various management approaches to specific case presentations. Panelists will debate different approaches to common problems and discuss the fundamental surgical principles that influence patient outcomes.Learning Objectives: 1. Discuss the latest scientific research in tympanoplasty outcomes. 2. Contrast the advantages of different materials and non-surgical techniques for tympanic membrane repair. 3. Compare various surgical approaches (including endoscopic techniques) in tympanoplasty.Faculty: James Saunders, MD(Leadership Role: Coalition for Global Hearing Health), Joachim Mueller, MD, PhD(Did Not Disclose), Peter Santa Maria, MBBS, PhD(Intellectual Property Rights: Auration Biotech; FlOther:m; Stock or Stock Options: Auration Biotech; FlOther:m; Audience; Consulting Fees: Earlens), Allan Ho, MBBS, MSc, FRCSC(Nothing to Disclose), Ali Kouhi, MD(Nothing to Disclose), Manuela Fina, MD(Nothing to Disclose), David Haynes, MD(Consulting Fees: Cochlear Corp; Advanced Bionics; Med el; Etryker).
Courses in package:
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