[The original method for bypass surgery of the tympanic cavity to treat chronic dysfunction of the Eustachian tube].

The objective of the present study was to improve the effectiveness of the treatment of intractable dysfunctionof the Eustachian tube responsible for the relapses of catarrhal and exudative otitis media. The authors developed the diaphragmatic slot valve integrated into the silicone tympanic shunt tube. The proposed diaphragmatic slot valve was shown to counterbalance extra- and intratympanic pressure at the experimentally found compression threshold equaling 123.06 daPa. This original functional shunt ensured the continuous functioning of tensor tympani muscle and maintained tympano-tubal innervation. The comprehensive examination and treatment encompassed 104 patients (104 ears) presenting with long-standing dysfunction of the Eustachian tube. In 52 patients (52 ears), otitis media was treated with the use of the functional shunt tube and in the remaining 52 (52 ears) with the standard silicone shunt tube. The comparative analysis has demonstrated that the effectiveness of the treatment of intractable dysfunctionof the Eustachian tube can be increased by 13.3% using the functional tympanic shunt. Simultaneously, this method made it possible to totally normalize the ventilation function of the Eustachian tube in 51 (98.1%) patients. The duration of the treatment with the use of the functional shunt tube averaged 42.11±8.46 days (in the patients with catarrhal inflammation of the middle ear) and 59.03±7.17 days (in the case of exudative otitis media) which was 42.9% and 37.3% shorter respectively than the duration of the traditional treatment (p<0.5).

[Analysis of the effectiveness of tympanoplasty in the patients presenting with chronic otitis media complicated by perforation].

AIM: The objective of the present study was to analyse the causes behind reperforation of the tympanic membrane in the patients presenting with chronic otitis media (mesotympanitis) after type I--III intrameatal tympanoplasty. Characteristic of the patients and methods of investigation. Intrameatal type I--III tympanoplasty with the use of autotransplants was performed in 652 patients presenting with chronic otitis media complicated by perforation of the tympanic membrane (CPOM). Fifty (7.6%) of these patients suffered recurrent perforation within one year after the primary treatment. The analysis of the medical histories, the character of secondary perforations, and intraoperative findings in 50 patients provided the data for the elucidation of the causes of poor anatomical and morphological outcomes of the surgical treatment. RESULTS: It was shown that the anatomical and morphological effectiveness of type I--III intrameatal tympanoplasty in the patients with CPOM amounted to 92.4%. The main causes of reperforation are an extensive defect of the tympanic membrane, tympanic cavity mucositis associated with the compromised function of the Eustachian tube, in-growth of epidermis into the structures of the tympanic membrane, and the combination of these conditions as well as technical difficulties inherent in the surgical intervention.