- Email: [email protected]
Safety evaluation of titanium middle ear prostheses at 3.0 tesla
Otolaryngology– Head and Neck Surgery Volume 129 Number 2
Room OCCC 204 •
Scientific Session: Otology/Neurotology Karen J Doyle MD PhD; Patrick J Antonelli MD (moderators)
8:00
AM
Advances in Congenital Aural Atresia Surgery: Effects on Outcome Karen Borne Teufert MD (presenter); Antonio De la Cruz MD Glendale CA; Los Angeles CA
Objectives: To compare modifications in the surgical technique of congenital aural atresia (use of argon laser, thinner split-thickness skin graft, Silastic sheets in the external auditory canal [EAC], and Ambrus ear packs) by examining hearing results and complications prior to and after initiation of these changes. Methods: A retrospective chart review of patients who underwent congenital aural atresiaplasty between 1985 and 2002 in a tertiary referral neurotologic private practice was performed. There were 116 atretic ears. Complication rates and hearing results were compared before and after modifications in the surgical technique of congenital aural atresia. Results: Closure of the air-bone gap (ABG) to 30 dB or less at short-term follow-up occurred in 65.7% of surgeries performed after modifications in the surgical technique and 45.0% of surgeries performed before these changes (P ⬍ 0.044). The long-term postoperative ABG was 30 dB or less in 52.1% of the surgeries performed after and 42.9% of the cases performed before the changes in surgical technique. Soft tissue stenosis was seen in 4.2% of surgeries performed after and 11.6% of surgeries performed before the surgical technique changes. Bony growth of the EAC was seen in 2.8% and 14.0% of cases after and prior to these changes, respectively. Ossicular chain refixation occurred in 5.6% of surgeries after and 18.6% of surgeries prior to such changes. There were no dead ears. Conclusions: The use of argon laser, thinner split-thickness skin graft, Silastic sheets in the EAC, and Ambrus ear
packs have, as a group, helped to improve our results and decrease the incidence of complications. 8:08
AM
Safety Evaluation of Titanium Middle Ear Prostheses at 3.0 Tesla Angela Diane Martin MD (presenter); Colin L W Driscoll MD; Christopher P Wood MD; Joel P Felmlee PhD Rochester MN; Rochester MN; Rochester MN; Rochester MN
Objectives: To assess the magnetic resonance imaging (MRI) safety of titanium middle ear prostheses at 3.0 Tesla (T). Methods: Titanium middle ear prostheses from three commercial vendors were examined for magnetic field interactions at 3T. Initially, ex vivo studies were performed testing for rotational motion and forward displacement (translational motion) of the prostheses in a static magnetic field. If movement was observed during this “screening” study, then the prosthesis was tested to determine the translational or rotational force acting upon the prosthesis. In addition to testing for prosthesis displacement, temperature changes of the prostheses were measured to assess for radiofrequency (RF) heating during imaging. Results: 21 of the 24 titanium prostheses tested revealed no movement when tested in the 3T static magnetic field. Three prostheses revealed minimal movement during the screening study. A translational force test (“string test”) was performed upon these 3 prostheses and the measured angle of displacement was used to determine the force. This calculated force acting upon each prosthesis was essentially zero. Therefore, we conclude that the magnetic field interaction is negligible. A positive control with a ferromagnetic stainless steel prosthesis demonstrated obvious displacement during the screening study, as well as deflection of the prosthesis ⬎90 degrees in the translational force test. Lastly, heating of the titanium prostheses did not occur in the seven models tested. Conclusions: Middle ear prostheses made from titanium are safe, neither deflecting nor heating during MR examinations conducted at 3T. 8:16
AM
Appreciation of Music in Children with Cochlear Implants Showkat Mirza FRCS (presenter); Susan Douglas FRCS Ed; Philip Lindsey Newcastle U Tyne United Kingdom; Nottingham United Kingdom; Middlesbrough United Kingdom
Objectives: The cochlear implant has been designed primarily to enhance speech discrimination and the awareness of environmental sounds. However, many patients express hopes that they will enjoy music following implantation. Our aim was to subjectively assess the appreciation of music after cochlear implantation in our pediatric patients.
MONDAY
Many treatment modalities for keloid have been tried with variable degrees of success, including surgery, corticosteroids, laser excision, cryotherapy, silicone gel sheeting, pressure devices, and radiotherapy or brachytherapy. The use of MC for preventing recurrence of keloid was prospectively studied. Methods: Patients with keloid were enrolled in a prospective study. The scar was excised under local or general anesthesia, and prior to skin closure, a pledget with 1 cc of MC 0.4 mg/mL was applied for 5 minutes. Results: Five patients with at least 3 months’ follow-up are currently enrolled in the study. In all (mean follow-up of 4 months), the residual scar was appreciably reduced with considerable patient satisfaction. No adverse side effects were noted. Conclusions: MC application following scar resection appears to be a promising treatment option for keloid.
Scientific Session—Monday P69
Room OCCC 204 •
Scientific Session: Otology/Neurotology Karen J Doyle MD PhD; Patrick J Antonelli MD (moderators)
8:00
AM
Advances in Congenital Aural Atresia Surgery: Effects on Outcome Karen Borne Teufert MD (presenter); Antonio De la Cruz MD Glendale CA; Los Angeles CA
Objectives: To compare modifications in the surgical technique of congenital aural atresia (use of argon laser, thinner split-thickness skin graft, Silastic sheets in the external auditory canal [EAC], and Ambrus ear packs) by examining hearing results and complications prior to and after initiation of these changes. Methods: A retrospective chart review of patients who underwent congenital aural atresiaplasty between 1985 and 2002 in a tertiary referral neurotologic private practice was performed. There were 116 atretic ears. Complication rates and hearing results were compared before and after modifications in the surgical technique of congenital aural atresia. Results: Closure of the air-bone gap (ABG) to 30 dB or less at short-term follow-up occurred in 65.7% of surgeries performed after modifications in the surgical technique and 45.0% of surgeries performed before these changes (P ⬍ 0.044). The long-term postoperative ABG was 30 dB or less in 52.1% of the surgeries performed after and 42.9% of the cases performed before the changes in surgical technique. Soft tissue stenosis was seen in 4.2% of surgeries performed after and 11.6% of surgeries performed before the surgical technique changes. Bony growth of the EAC was seen in 2.8% and 14.0% of cases after and prior to these changes, respectively. Ossicular chain refixation occurred in 5.6% of surgeries after and 18.6% of surgeries prior to such changes. There were no dead ears. Conclusions: The use of argon laser, thinner split-thickness skin graft, Silastic sheets in the EAC, and Ambrus ear
packs have, as a group, helped to improve our results and decrease the incidence of complications. 8:08
AM
Safety Evaluation of Titanium Middle Ear Prostheses at 3.0 Tesla Angela Diane Martin MD (presenter); Colin L W Driscoll MD; Christopher P Wood MD; Joel P Felmlee PhD Rochester MN; Rochester MN; Rochester MN; Rochester MN
Objectives: To assess the magnetic resonance imaging (MRI) safety of titanium middle ear prostheses at 3.0 Tesla (T). Methods: Titanium middle ear prostheses from three commercial vendors were examined for magnetic field interactions at 3T. Initially, ex vivo studies were performed testing for rotational motion and forward displacement (translational motion) of the prostheses in a static magnetic field. If movement was observed during this “screening” study, then the prosthesis was tested to determine the translational or rotational force acting upon the prosthesis. In addition to testing for prosthesis displacement, temperature changes of the prostheses were measured to assess for radiofrequency (RF) heating during imaging. Results: 21 of the 24 titanium prostheses tested revealed no movement when tested in the 3T static magnetic field. Three prostheses revealed minimal movement during the screening study. A translational force test (“string test”) was performed upon these 3 prostheses and the measured angle of displacement was used to determine the force. This calculated force acting upon each prosthesis was essentially zero. Therefore, we conclude that the magnetic field interaction is negligible. A positive control with a ferromagnetic stainless steel prosthesis demonstrated obvious displacement during the screening study, as well as deflection of the prosthesis ⬎90 degrees in the translational force test. Lastly, heating of the titanium prostheses did not occur in the seven models tested. Conclusions: Middle ear prostheses made from titanium are safe, neither deflecting nor heating during MR examinations conducted at 3T. 8:16
AM
Appreciation of Music in Children with Cochlear Implants Showkat Mirza FRCS (presenter); Susan Douglas FRCS Ed; Philip Lindsey Newcastle U Tyne United Kingdom; Nottingham United Kingdom; Middlesbrough United Kingdom
Objectives: The cochlear implant has been designed primarily to enhance speech discrimination and the awareness of environmental sounds. However, many patients express hopes that they will enjoy music following implantation. Our aim was to subjectively assess the appreciation of music after cochlear implantation in our pediatric patients.
MONDAY
Many treatment modalities for keloid have been tried with variable degrees of success, including surgery, corticosteroids, laser excision, cryotherapy, silicone gel sheeting, pressure devices, and radiotherapy or brachytherapy. The use of MC for preventing recurrence of keloid was prospectively studied. Methods: Patients with keloid were enrolled in a prospective study. The scar was excised under local or general anesthesia, and prior to skin closure, a pledget with 1 cc of MC 0.4 mg/mL was applied for 5 minutes. Results: Five patients with at least 3 months’ follow-up are currently enrolled in the study. In all (mean follow-up of 4 months), the residual scar was appreciably reduced with considerable patient satisfaction. No adverse side effects were noted. Conclusions: MC application following scar resection appears to be a promising treatment option for keloid.
Scientific Session—Monday P69