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Membrane Perforation (membrane + perforation)
Selected AbstractsThe influence of interfering septa on the incidence of Schneiderian membrane perforations during maxillary sinus elevation surgery: a retrospective study of 52 consecutive lateral window proceduresORAL SURGERY, Issue 1 2009S. Malkinson Abstract Aim:, Sinus lifts are a predictable method of augmenting the height of bone in maxillary posterior sextants. These procedures can be complicated by anatomical factors, such as the presence of interfering bony septa in the sinus. The objectives of this study were to investigate the incidence of interfering septa in patients undergoing sinus lifts and to see if the presence of interfering septa increased the chance of intra-operative membrane perforation. Materials and methods:, This retrospective cohort study assessed presence of interfering antral septa and their effect on Schneiderian membrane elevation in 45 patients with pneumatised sinuses undergoing sinus lifts. Chart audits and radiographic assessments were performed for 52 surgeries. The sinus lift procedure followed established guidelines. Presence of septa and occurrence of perforations were noted, and when perforations occurred, they were repaired with resorbable membranes. Results:, Septa were present in 40% of cases, and were found to be ,interfering' septa in 28.8% of cases. Membrane perforation occurred in 11.5% of cases. There was no statistically significant association between the presence of interfering septa and membrane perforation. Conclusion:, With enough experience and appropriate armamentarium and technique, an operator can overcome the presence of an interfering antral septum during a sinus lift procedure such that it does not increase the chance of perforating the Schneiderian membrane during elevation. [source] Supported Lipid Bilayer on Nanocrystalline Diamond: Dual Optical and Field-Effect Sensor for Membrane DisruptionADVANCED FUNCTIONAL MATERIALS, Issue 1 2009Priscilla Kailian Ang Abstract It is demonstrated that a good biomimetic model lipid membrane with dynamic fluidity can be established on optically transparent nanocrystalline diamond (OTND) with surface roughness below 10,nm. Maigainin II, an antimicrobial peptide, is chosen to investigate the permeation of artificial bacterial membranes constructed on OTND. Due to the unique combination of optical transparency and highly sensitive surface conducting channel, intrinsic OTND affords the possibility of dual-mode sensing based on optical and field effect properties. This opens up new possibilities for making integrated biomolecule,semiconductor microdevices, or sensors where the binding of biomolecules can be tracked using confocal microscopy whilst the associated changes in charge density during membrane perforation can be tracked using the space charge effect in the semiconductor. Such a synergistic approach may provide a powerful methodology for the screening of specific bactericidal activity on biomimetic membrane systems. [source] Implants placed in combination with an internal sinus lift without graft material: an analysis of short-term failureJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 2 2009Olaf Gabbert Abstract Aim: Investigation of the short-term survival of implants placed in combination with an internal sinus lift (ISL) without graft material. Material and Methods: Thirty-six patients received 92 screw-shaped dental implants in combination with an ISL. No bone grafts or bone substitutes were used. Forty-four patients with 77 implants in the native posterior maxilla served as controls. X-rays taken after implant placement and 6 months later were evaluated for the presence of bone gain at the apical aspect of the implants. Kaplan,Meier survival curves and Cox regression analysis were used to estimate survival curves and to isolate risk factors for implant failures. Results: Within a mean observation period of 1.2 years (minimum 9 months; maximum 3.7 years), four failures were recorded in the experimental group and two in the controls. The probability of survival was above 94% for both groups. Six,nine months after surgery, bone gain was observed in 29 out of 92 implants. Comparison of the experimental group and controls revealed no effect of ISL and membrane perforation on the probability of survival. Conclusions: Promising short-term outcomes were observed for implants with ISL without graft material; for a substantial proportion of implants, apical bone gain was observed in the first 6,9 months. [source] Healing patterns in calvarial bone defects following guided bone regeneration in ratsJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 9 2002A micro-CT scan analysis Abstract Objective: The objective of this study was to evaluate healing patterns of critical-size calvarial bone defects treated according to principles of guided bone regeneration using micro-CT scan analysis. Specifically, the contribution of bone, periosteum and dura mater to the amount and mineralization of newly formed bone was evaluated. Material and Methods: Surgically induced, critical-size calvarial bone defects in 48 adult male Wistar rats received the following: an occlusive expanded polytetrafluoroethylene (ePTFE) membrane at the exo- and endocranial aspect (OO; n = 12); an occlusive membrane at the exocranial and a perforated membrane at the endocranial aspect (OP; n = 12); a perforated membrane at the exocranial and an occlusive membrane at the endocranial aspect (PO; n = 12); and a perforated membrane at the exo- and endocranial aspect (PP; n = 12). The animals were euthanized at 4 weeks for quantitative analysis of bone volume fraction and mineralization in the region of interest (ROI) as well as in the external, middle and central area of the defect using micro-CT. Results: Bone volume fraction ranged from 31.4% (OP) to 24.5% (PP). No differences were found among the groups. Bone volume fraction and mineralization in the middle area were significantly greater in group OP than in group PP, and in the central area in group OO and PO than in group PP. Conclusions: The results of this study suggest that use of occlusive ePTFE membranes enhances bone formation and maturation in the calvarial skeleton. When occlusion of endo- and exocranial tissues was compromised by membrane perforation, impaired bone formation and mineralization were observed. [source] Dysfunction of an Atrial Septal Defect Occluder 8 Years after ImplantationJOURNAL OF INTERVENTIONAL CARDIOLOGY, Issue 2 2006HENRIK TEN FREYHAUS M.D. Catheter interventional treatment of atrial septal defect (ASD) is widely accepted. The ASD occluder system (ASDOS) is no longer a widely used device nowadays. However, it is implanted in a substantial number of patients. We report a case of severe left-to-right shunt 8 years after catheter interventional closure of an ASD with an ASDOS device. The shunt was due to a membrane perforation, while the arms of the device were not dislocated. Microscopy, microbiology, and histology could not establish a proper explanation for the dysfunction; so long-term follow-up investigation may be required in patients with an implanted ASDOS device. [source] The influence of interfering septa on the incidence of Schneiderian membrane perforations during maxillary sinus elevation surgery: a retrospective study of 52 consecutive lateral window proceduresORAL SURGERY, Issue 1 2009S. Malkinson Abstract Aim:, Sinus lifts are a predictable method of augmenting the height of bone in maxillary posterior sextants. These procedures can be complicated by anatomical factors, such as the presence of interfering bony septa in the sinus. The objectives of this study were to investigate the incidence of interfering septa in patients undergoing sinus lifts and to see if the presence of interfering septa increased the chance of intra-operative membrane perforation. Materials and methods:, This retrospective cohort study assessed presence of interfering antral septa and their effect on Schneiderian membrane elevation in 45 patients with pneumatised sinuses undergoing sinus lifts. Chart audits and radiographic assessments were performed for 52 surgeries. The sinus lift procedure followed established guidelines. Presence of septa and occurrence of perforations were noted, and when perforations occurred, they were repaired with resorbable membranes. Results:, Septa were present in 40% of cases, and were found to be ,interfering' septa in 28.8% of cases. Membrane perforation occurred in 11.5% of cases. There was no statistically significant association between the presence of interfering septa and membrane perforation. Conclusion:, With enough experience and appropriate armamentarium and technique, an operator can overcome the presence of an interfering antral septum during a sinus lift procedure such that it does not increase the chance of perforating the Schneiderian membrane during elevation. [source] Lateral Tympanoplasty for Total or Near-Total Perforation: Prognostic Factors,THE LARYNGOSCOPE, Issue 9 2006Dr. Simon I. Angeli MD Abstract Objective: To identify prognostic factors affecting outcome in lateral tympanoplasty for total or near-total tympanic membrane perforation. Study Design: Retrospective case series. Methods: Patients were those presenting with total or near-total tympanic membrane perforation undergoing lateral tympanoplasty from 1999 to 2004. We systematically collected demographic, clinical, audiologic, and outcome information. Student t test was used to determine group differences. Logistic regression analysis was used to examine the relationship between success of grafting (dependent variable) and the independent variables. Multiple regression analysis was used to examine the relationship between postoperative air-bone gap (ABG) and independent variables. Results: There were seventy-seven cases (58 primary and 19 revision cases) with average follow-up of 17 months. Successful tympanic membrane grafting occurred in 91% of cases. None of the independent variables studied was predictive of the success of graft incorporation (P > .05). The mean preoperative ABG was 29.8 ± 10 dB and improved to a postoperative ABG of 16.5 ± 11 dB (P < .001). Smaller preoperative ABG and normal malleus handle were associated with smaller postoperative ABG. In revision cases, mastoidectomy was associated with better functional results. Conclusions: Successful grafting of near-total and total tympanic membrane perforations occurred in 91% of the cases and was independent of demographic, disease, and technical variables. Disease variables (preoperative ABG and status of malleus handle) had a greater prognostic value on postoperative ABG than other variables. In revision tympanoplasty, mastoidectomy is associated with a better functional outcome. [source] Hearing Results After Primary Cartilage Tympanoplasty,THE LARYNGOSCOPE, Issue 12 2000Matthew J. Gerber MD Abstract Objectives/Hypothesis Cartilage,perichondrium grafting of the tympanic membrane has been used in an effort to reduce recurrence or progression of middle ear disease. The rigidity of cartilage has obvious benefit in preventing tympanic membrane retraction, but concern has been raised regarding its sound conduction properties. Few studies in the literature address hearing results after cartilage tympanoplasty. The purpose of this study was to investigate the hearing results after primary cartilage tympanoplasty and compare them with results after primary tympanoplasty with temporalis fascia. Study Design A retrospective review of all ear surgeries using cartilage between 1994 and 1999 was performed. Methods Only primary cases in which the ossicular chain was intact and no mastoid surgery was performed were included. Indications for surgery included tympanic membrane perforation, retraction, and cholesteatoma. Pre- and postoperative speech reception thresholds and air,bone gaps at 500 Hz, 1000 Hz, 2000 Hz, and 4000 Hz were compared. Results Eleven patients comprised the cartilage study group, and there were 11 age- and temporally matched control subjects. The mean improvement in speech reception threshold for both the study group and the control group was 10 dB. The majority of patients in both groups had ABG closure to within 10 dB at all frequencies examined. There were no statistically significant differences in speech reception threshold improvement or air,bone gap closures between the two groups. Conclusions These results demonstrate that hearing results after cartilage tympanoplasty are comparable to those after temporalis fascia tympanoplasty. Therefore, when indicated, a cartilage,perichondrium graft can be used for prevention of disease recurrence or progression without fear of impairing hearing. [source] Osteotomy and membrane elevation during the maxillary sinus augmentation procedureCLINICAL ORAL IMPLANTS RESEARCH, Issue 5 2008A comparative study: piezoelectric device vs. conventional rotative instruments Abstract Objectives: The aim of the present study was to investigate in a randomized-controlled clinical trial the performance of rotary instruments compared with a piezoelectric device during maxillary sinus floor elevation. Materials and methods: Thirteen patients who required a bilateral maxillary sinus augmentation for implant,prosthetic rehabilitation were included in this study. A within-patient control study was carried out. The osteotomy for sinus access was performed on one side of the maxilla using the piezosurgery (test sites) and on the other side using conventional rotary diamond burs (control sites). The parameters recorded were as follows: bony window length (L), bony window height (H), bone thickness (T) and osteotomy area (A) , calculated by multiplying L and H. In addition, the time necessary for the osteotomy and sinus membrane elevation as well as the number of surgical complications were calculated. Results: The mean length and height of the bone window were similar in both groups. The osteotomy area (A) obtained by multiplying L and H was wider in the control group (151.2 ± 20.4 mm2) compared with the test group (137 ± 24.2 mm2). The time necessary for the osteotomy and the sinus membrane elevation with conventional instruments was 10.2 ± 2.4 min, while with the piezoelectric device it was 11.5 ± 3.8 min. Moreover, membrane perforation occurred in 30% of the maxillary sinuses in the test group and in 23% of the control group. None of the differences observed between the two groups reached a level of significance. Conclusions: Within the limits of the present study, it may be concluded that piezosurgery and conventional instruments did not show any differences in the clinical parameters investigated for the maxillary sinus floor elevation. [source] Dental implants placement in conjunction with osteotome sinus floor elevation: a 12-year life-table analysis from a prospective study on 588 ITI®implantsCLINICAL ORAL IMPLANTS RESEARCH, Issue 2 2006Nicola Ferrigno Abstract Objectives: The purpose of this prospective study was to evaluate the clinical success of placing ITI dental implants in the posterior maxilla using the osteotome technique. Material and methods: All implants were placed following a one-stage protocol (elevating the sinus floor and placing the implant at the same time). Five hundred and eighty-eight implants were placed in 323 consecutive patients with a residual vertical height of bone under the sinus ranging from 6 to 9 mm. The mean observation follow-up period was 59.7 months (with a range of 12,144 months). This prospective study not only calculated the 12-year cumulative survival and success rates for 588 implants by life-table analysis but also the cumulative success rates for implant subgroups divided per implant length and the percentage of sinus membrane perforation were evaluated. Results: The 12-year cumulative survival and success rates were 94.8% and 90.8%, respectively. The analysis of implant subgroups showed slightly more favourable cumulative success rates for 12 mm long implants (93.4%) compared with 10 and 8 mm long implants (90.5% and 88.9%, respectively). During the study period, only 13 perforations of the Schneiderian membrane were detected with a perforation rate of 2.2% (13 perforations/601 treated sites). Ten perforations out of 13 were caused during the first half of the study period and of these, seven were detected during the first 3 years of this prospective study. Conclusion: Based on the results and within the limits of the present study, it can be concluded that ITI implant placement in conjunction with osteotome sinus floor elevation represents a safe modality of treating the posterior maxilla in areas with reduced bone height subjacent to the sinus as survival and success rates were maintained above 90% for a mean observation period of ,60 months. Shorter implants (8 mm implants) did not significantly fail more than longer ones (10 and 12 mm implants): the differences were small compared with the number of events; hence, no statistical conclusion could be drawn. But, from the clinical point of view, the predictable use of short implants in conjunction with osteotome sinus floor elevation may reduce the indication for complex invasive procedures like sinus lift and bone grafting procedures. [source] Ototoxic eardrops and tympanic membrane perforations: Time for a change?JOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 8 2005Harvey Coates Abstract: Until recently the only available antibiotic eardrops for treatment of the discharging middle ear and mastoid cavity have been potentially ototoxic. With the advent of non-ototoxic fluoroquinolone eardrops, consensus panels in the USA, Canada and the UK have advocated the preferential use of these agents in the open middle ear. However, in Australia, no fluoroquinolone topical agent is approved for use with tympanic membrane perforations, and when used as an ,off label' eardrop, none is on the Pharmaceutical Benefits Scheme. This creates an ethical dilemma, particularly with best practice management of chronic suppurative otitis media in indigenous children. Despite concerns regarding resistance issues with ototopical use of systemic antibiotics, bacterial resistance has not been documented in major studies. For equity and ethical reasons, Australian regulatory authorities should consider approving a sterile non-ototoxic eardrop for use in the open middle ear. [source] The influence of interfering septa on the incidence of Schneiderian membrane perforations during maxillary sinus elevation surgery: a retrospective study of 52 consecutive lateral window proceduresORAL SURGERY, Issue 1 2009S. Malkinson Abstract Aim:, Sinus lifts are a predictable method of augmenting the height of bone in maxillary posterior sextants. These procedures can be complicated by anatomical factors, such as the presence of interfering bony septa in the sinus. The objectives of this study were to investigate the incidence of interfering septa in patients undergoing sinus lifts and to see if the presence of interfering septa increased the chance of intra-operative membrane perforation. Materials and methods:, This retrospective cohort study assessed presence of interfering antral septa and their effect on Schneiderian membrane elevation in 45 patients with pneumatised sinuses undergoing sinus lifts. Chart audits and radiographic assessments were performed for 52 surgeries. The sinus lift procedure followed established guidelines. Presence of septa and occurrence of perforations were noted, and when perforations occurred, they were repaired with resorbable membranes. Results:, Septa were present in 40% of cases, and were found to be ,interfering' septa in 28.8% of cases. Membrane perforation occurred in 11.5% of cases. There was no statistically significant association between the presence of interfering septa and membrane perforation. Conclusion:, With enough experience and appropriate armamentarium and technique, an operator can overcome the presence of an interfering antral septum during a sinus lift procedure such that it does not increase the chance of perforating the Schneiderian membrane during elevation. [source] Lateral Tympanoplasty for Total or Near-Total Perforation: Prognostic Factors,THE LARYNGOSCOPE, Issue 9 2006Dr. Simon I. Angeli MD Abstract Objective: To identify prognostic factors affecting outcome in lateral tympanoplasty for total or near-total tympanic membrane perforation. Study Design: Retrospective case series. Methods: Patients were those presenting with total or near-total tympanic membrane perforation undergoing lateral tympanoplasty from 1999 to 2004. We systematically collected demographic, clinical, audiologic, and outcome information. Student t test was used to determine group differences. Logistic regression analysis was used to examine the relationship between success of grafting (dependent variable) and the independent variables. Multiple regression analysis was used to examine the relationship between postoperative air-bone gap (ABG) and independent variables. Results: There were seventy-seven cases (58 primary and 19 revision cases) with average follow-up of 17 months. Successful tympanic membrane grafting occurred in 91% of cases. None of the independent variables studied was predictive of the success of graft incorporation (P > .05). The mean preoperative ABG was 29.8 ± 10 dB and improved to a postoperative ABG of 16.5 ± 11 dB (P < .001). Smaller preoperative ABG and normal malleus handle were associated with smaller postoperative ABG. In revision cases, mastoidectomy was associated with better functional results. Conclusions: Successful grafting of near-total and total tympanic membrane perforations occurred in 91% of the cases and was independent of demographic, disease, and technical variables. Disease variables (preoperative ABG and status of malleus handle) had a greater prognostic value on postoperative ABG than other variables. In revision tympanoplasty, mastoidectomy is associated with a better functional outcome. [source] Ventilation Time of the Middle Ear in Otitis Media With Effusion (OME) After CO2 Laser MyringotomyTHE LARYNGOSCOPE, Issue 4 2002Benedikt Sedlmaier MD Abstract Objective The aim of this study was to investigate the transtympanic ventilation time, the healing course of the tympanic membrane, the early and late complications, and the recurrence rate of otitis media with effusion (OME) within 6 months after CO2 laser myringotomy with the CO2 laser otoscope Otoscan. Study Design Prospective clinical study. Materials and Methods In this study, laser myringotomy was performed with the CO2 laser otoscope Otoscan in a patient population comprising 81 children (159 ears) with a history of otitis media with effusion (OME) associated with adenoidal and sometimes tonsillar hyperplasia. The procedure on the tympanic membrane was accordingly combined with an adenoidectomy, a CO2 laser tonsillotomy, or a tonsillectomy and therefore performed under insufflation anesthesia. In all ears, approximately 2 mm circular perforations were created in the lower anterior quadrants with a power of 12 to 15 W, a pulse duration of 180 msec, and a scanned area of 2.2 mm in diameter. Results None of the children showed postoperative impairment of cochleovestibular function such as sensorineural hearing loss or nystagmus. Otomicroscopic and videoendoscopic monitoring documented the closure time and healing pattern of tympanic membrane perforations. The mean closure time was found to be 16.35 days (minimum, 8 days; maximum, 34 days). As a rule, an onion-skin-like membrane of keratinized material was seen in the former myringotomy perforations at the time of closure. At the follow-up 6 months later, the condition of the tympanic membrane of 129 ears (81.1%) could be checked by otomicroscopy and videoendoscopy and the hearing ability by audiometry and tympanometry. The CO2 laser myringotomy sites appeared normal and irritation-free. Two of the tympanic membranes examined (1.6%) showed atrophic scar formation, and 1 (0.8%) had a perforation with a diameter of 0.3 mm. The perforation was seen closed in a control otoscopy 15 months postoperatively. OME recurred in 26.3% of the ears seen intraoperatively with mucous secretion (n = 38) and in 13.5% of the ears with serous secretion (n = 37;P <.05). Conclusion The most important principle in treating OME is ventilation of the tympanic cavity. CO2 laser myringotomy achieves this through a self-healing perforation in which its diameter roughly determines the duration of transtympanic ventilation. Laser myringotomy competes with ventilation tube insertion in the treatment of OME. It may be a useful alternative in the surgical management of secretory otitis media. [source] Dimensional Stability of the Free Fascia Grafts: An Animal Experiment,THE LARYNGOSCOPE, Issue 4 2002Shabbir Indorewala MS (ENT) Abstract Objectives/Hypothesis It appears that autologous free fascia grafts (fascia lata and temporal fascia) change their dimensions during the vital first 5 days of healing. Poor dimensional stability of these grafts can be an important reason for failure of complete closure of tympanic membrane perforations in tympanoplasty operations. There has been no study regarding this dimensional instability. Study Design Prospectively dimensional instability of the free fascia grafts was studied in 14 mongrel dogs. Methods Fourteen healthy Mongrel dogs were operated on twice. During the first surgery, fascia lata and temporal fascia grafts of measured dimensions (length, breadth, and thickness) were implanted in the subcutaneous pockets on the thoracoabdominal wall of the same dog (autograft). Five dogs were operated on again after 2 days, and 7 dogs were operated on again after 5 days to harvest the implanted grafts. The dimensions of the harvested grafts were noted. Changes with respect to their implant dimensions after 2 days and after 5 days were calculated. Results It was found that free fascia lata exhibits significantly superior dimensional stability when compared with free temporal fascia during the early healing phase, before graft integration has occurred. Shrinking and thickening of temporal fascia are greaterand are also most unpredictable. Conclusions Poor dimensional stability of temporal fascia may compromise a well-sealed perforation at the time of surgery, and it may reopen by the 5th day. This must be one of the causes of failure of tympanoplasty, which needs to be studied further. [source] Prevalence and management of Schneiderian membrane perforations during sinus-lift proceduresCLINICAL ORAL IMPLANTS RESEARCH, Issue 1 2008Federico Hernández-Alfaro Abstract: This clinical study was undertaken to evaluate the prevalence of surgical complications of the sinus graft procedure and to set a protocol to repair sinus membrane perforations intraoperatively using a variety of techniques and materials. From January 2000 to May 2005, 338 patients were studied, on whom 474 sinus floor augmentation procedures were performed, and a total of 1166 dental implants were simultaneously placed. A total of 104 perforations of the sinus membrane were observed (19 were bilateral). In group number 1, sinus membrane perforations of <5 mm were observed in 56 sinus augmentation procedures (53.85%), 44 were treated using a resorbable collagen membrane and 12 were sutured with a resorbable material. In group number 2, 28 sinus membranes had a perforation size between 5 and 10 mm (26.92%) and were treated using lamellar bone combined with a resorbable membrane. Group number 3 consisted of 20 sinus membrane perforations>10 mm (19.23%), 10 were covered with lamellar bone combined with a buccal fat pad flap, six were treated with a mandibular block graft and four perforations were treated with only a lamellar bone sheet. Two-hundred and seventy-eight implants were placed under repaired membrane perforations and 247 implants survived. Interestingly enough, all the 25 implants that failed to integrate were placed under perforated and reconstructed membranes during the sinus lift procedure. Based on the results of this study, the survival rates of implants placed under reconstructed membranes correlate inversely with the size of the perforations. [source] | ||||||||||