Objective:To compare the rate of graft uptake and postoperative hearing outcomes of Type I tympanoplasty with perichondrium reinforced cartilage palisade to temporalis fascia for large tympanic membrane(TM)perforation...Objective:To compare the rate of graft uptake and postoperative hearing outcomes of Type I tympanoplasty with perichondrium reinforced cartilage palisade to temporalis fascia for large tympanic membrane(TM)perforations over 5 years follow-up period.Materials and methods:This was a retrospective comparative study involving patients with chronic otitis media with large TM perforations.The patients underwent type I tympanoplasty using either perichondrium reinforced cartilage palisade(CP group)or temporalis fascia(TF group)as the graft via a transmeatal approach and under local anesthesia.Morphological and functional results were recorded at three-and five years follow-up.Demographic profiles including age and sex,surgery side,contralateral disease and graft uptake rate,as well as hearing outcomes,were compared between the two groups.Results:At three years follow-up,graft uptake was 94.87%for perichondrium reinforced cartilage palisade and 80.7%for fascia,respectively,(p¼0.67).At five years follow-up,the uptake rate dropped to 87.17%in the CP group,but to 66.6%in the TF group(p¼0.019).Hearing improved after surgery in both groups,and showed no significant difference between the two groups.Conclusion:Over long-term,perichondrium reinforced palisade showed a statistically significant better outcome regarding graft uptake than temporalis fascia in type Itympanoplasty for large TM perforations with comparable audiometric results.展开更多
Purpose:Treatment of distal tibia fractures poses significant challenge to orthopedic surgeon because of poor blood supply and paucity of soft tissue coverage.There is considerable controversy regarding the superior o...Purpose:Treatment of distal tibia fractures poses significant challenge to orthopedic surgeon because of poor blood supply and paucity of soft tissue coverage.There is considerable controversy regarding the superior option of treatment for distal tibia fracture between the minimally invasive percutaneous plate osteosynthesis(MIPPO)technique and intramedullary interlocking(IMIL)nailing for extra-articular distal tibia fractures.The aim of our study is to compare the functional outcome between the two treatment methods.Methods:This was the prospective comparative study of 100 patients with distal third tibia fractures divided into two groups.The first group of patients were treated with MIPPO technique while the second group of patients were managed by IMIL nailing.Patients were followed up in outpatient department to assess the functional outcomes,malunion,delayed union,nonunion,superficial and deep infection between the two groups.Statistical analyses were performed using the SPSS software(version 16.0).Results:Average malunion(degrees)in the MIPPO group was 5(3—7)±1.41 vs.10.22(8—14)±2.04 in the IMIL group(p=0.001).Similarly postoperative knee pain in the IMIL group was 10%vs.2%in the MIPPO group(p=0.001).In terms of superficial infection and nonunion,the results were 8%vs.4%and 2%vs.6%for the MIPPO and IMIL group,respectively(p=0.001).Conclusion:Both procedures have shown the reliable method of fixation for distal extra-articular tibia fractures preserving the soft tissue,bony vascularity and fracture hematoma that provide a favourable biological environment for fracture healing.Considering the results of the study,we have slightly more preference for the MIPPO technique.展开更多
文摘Objective:To compare the rate of graft uptake and postoperative hearing outcomes of Type I tympanoplasty with perichondrium reinforced cartilage palisade to temporalis fascia for large tympanic membrane(TM)perforations over 5 years follow-up period.Materials and methods:This was a retrospective comparative study involving patients with chronic otitis media with large TM perforations.The patients underwent type I tympanoplasty using either perichondrium reinforced cartilage palisade(CP group)or temporalis fascia(TF group)as the graft via a transmeatal approach and under local anesthesia.Morphological and functional results were recorded at three-and five years follow-up.Demographic profiles including age and sex,surgery side,contralateral disease and graft uptake rate,as well as hearing outcomes,were compared between the two groups.Results:At three years follow-up,graft uptake was 94.87%for perichondrium reinforced cartilage palisade and 80.7%for fascia,respectively,(p¼0.67).At five years follow-up,the uptake rate dropped to 87.17%in the CP group,but to 66.6%in the TF group(p¼0.019).Hearing improved after surgery in both groups,and showed no significant difference between the two groups.Conclusion:Over long-term,perichondrium reinforced palisade showed a statistically significant better outcome regarding graft uptake than temporalis fascia in type Itympanoplasty for large TM perforations with comparable audiometric results.
文摘Purpose:Treatment of distal tibia fractures poses significant challenge to orthopedic surgeon because of poor blood supply and paucity of soft tissue coverage.There is considerable controversy regarding the superior option of treatment for distal tibia fracture between the minimally invasive percutaneous plate osteosynthesis(MIPPO)technique and intramedullary interlocking(IMIL)nailing for extra-articular distal tibia fractures.The aim of our study is to compare the functional outcome between the two treatment methods.Methods:This was the prospective comparative study of 100 patients with distal third tibia fractures divided into two groups.The first group of patients were treated with MIPPO technique while the second group of patients were managed by IMIL nailing.Patients were followed up in outpatient department to assess the functional outcomes,malunion,delayed union,nonunion,superficial and deep infection between the two groups.Statistical analyses were performed using the SPSS software(version 16.0).Results:Average malunion(degrees)in the MIPPO group was 5(3—7)±1.41 vs.10.22(8—14)±2.04 in the IMIL group(p=0.001).Similarly postoperative knee pain in the IMIL group was 10%vs.2%in the MIPPO group(p=0.001).In terms of superficial infection and nonunion,the results were 8%vs.4%and 2%vs.6%for the MIPPO and IMIL group,respectively(p=0.001).Conclusion:Both procedures have shown the reliable method of fixation for distal extra-articular tibia fractures preserving the soft tissue,bony vascularity and fracture hematoma that provide a favourable biological environment for fracture healing.Considering the results of the study,we have slightly more preference for the MIPPO technique.