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    Cartilage tympanoplasty with island technique for reconstruction of tympanic membrane perforation: anatomic and audiologic results.
    (2010) Ulkü C.H.
    The aim of this study was to evaluate anatomic/audiologic outcomes of cartilage tympanoplasty with island technique and compare the results with the results of temporalis fascia tympanoplasty. The charts of 40 patients who underwent surgery for primary type 1 tympanoplasty either with perichondrium-cartilage (12 males, 11 females; mean age 29.7 years; range 12 to 58 years) or fascia graft (9 males, 8 females; mean age 32.4 years; range 13 to 61 years) between January 2006 and January 2008 were retrospectively reviewed. Patients in whom the only pathology was subtotal tympanic membrane perforation with intact ossicular chain were included in the study. Pre- and postoperative audiograms, postoperative otoscopy findings and follow-up time were obtained from the patient's chart in both groups. Reviewed parameters were the complete closure rates of the tympanic membrane perforation and the change in air bone gap at each of four frequencies (0.5, 1, 2, 4 kHz). Audiologic evaluation was made among the patients in whom complete ear drum closure was achieved in both groups. Anatomic closure rates of the tympanic membrane perforation for perichondrium-cartilage and fascia group were 91.3% and 88.2%, respectively. Pre- and postoperative pure tone average air bone gap obtained at four frequencies for the perichondrium-cartilage and fascia group were 21.3+/-6.7 dB, 9.0+/-3.9 dB, and 21.2+/-6.9 dB, 8.5+/-4.4 dB, respectively. These findings revealed the overall gains of 12.3 dB for the cartilage-perichondrium group and 12.7 dB for the fascia group (p>0.05). The anatomic and audiologic results after cartilage tympanoplasty with island technique are comparable to those after temporalis fascia tympanoplasty. Furthermore, the cartilage is more resistant than the fascia to the anatomic deformation and necrosis. Therefore, we advise its use as a routine tympanic membrane reconstruction material without concern about effecting audiometric resuls.
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    [Isolated stapedius tendon ossification: a case report]. [İzole stapedial tendon ossifikasyonu: Olgu sunumu.]
    (2011) Ulkü C.H.
    In this study, a case with bilateral isolated stapedius tendon ossification was reported, since it is a rare clinical condition. A 46-year-old female patient was admitted to our clinic with the complaint of bilateral hearing loss. Tympanic membrane was bilateral normal in color and appearance on otomicroscopic examination. Pure tone air bone gap was between 20-25 dB at 1 kHz and 4 kHz on audiogram bilaterally. Middle ear pressure was normal and stapedius reflex was negative bilaterally. Preoperative diagnosis was otosclerosis. Right exploratory tympanotomy was performed. Isolated stapedius tendon ossification was determined. Normal stapedius movement was achieved by cutting the tendon. Three months later, the same procedure was performed on the left ear. Pure tone air bone gap was bilateral 0 dB at 0.5 kHz, 1 kHz and 2 kHz, and 5-10 dB at 4 kHz on audiogram postoperatively.
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    Petrous bone lesions [Petröz kemik lezyonlari]
    (2006) Oztürk K.; Uyar Y.; Ulkü C.H.; Arba? H.; Keleş B.; Yaman H.
    OBJECTIVES: We evaluated the results of treatment and follow-up of patients with petrous bone lesions. PATIENTS AND METHODS: We retrospectively evaluated 13 patients (5 females, 8 males; mean age 33.8+/-17.4 years; range 4.5 to 65 years) who were treated and followed-up for petrous bone lesions between 1990 and 2004. The diagnoses were cholesterol granuloma (n=2; 15.4%), chondrosarcoma (n=1; 7.7%), and cholesteatoma (n=10; 76.9%). RESULTS: Patients with cholesterol granuloma had complaints of cephalgia and diplopia while those with cholesteatoma complained of otorrhea and hearing loss. One patient with cholesterol granuloma and eight patients with cholesteatoma underwent surgical operations with the use of middle skull base approach (n=1), transcochlear approach (n=2), translabyrinthine approach (n=1), and tympanopetrosectomy (n=5). Two cases with congenital cholesteatoma and one patient with cholesterol granuloma refused surgical intervention and were only followed-up. CONCLUSION: Besides surgical intervention, follow-up by computed tomography or magnetic resonance imaging may be considered in patients with incidental petrous bone lesions, presenting with limited symptoms.