title: Reconstruction of the tensor tympani tendon.
abstract: We describe a case in which reconstruction of the tendon of the tensor tympani muscle was necessary for the successful restoration of sound conduction. The right ear of a nine-year-old boy was treated for cholesteatoma with staged surgery. During the first operation, the tendon was cut to ensure good visibility in the tympanic cavity. Post-operatively, maintenance of aeration of the middle ear required ventilation tubes at first and Valsalva manoeuvres later on. The position of the reconstructed tympanic membrane varied a great deal, moving between the medial wall of the tympanic cavity and extreme bulging. This made exact measurement of a columella for ossicular reconstruction impossible. The preserved handle of the malleus was bound to the cochleariform process with ionomer cement, using a piece of surgical suture material as a substitute for the tendon. This arrangement prevented the tympanic membrane from undergoing excessive lateral movement after inflation and the ossicular chain was replaced with a successful ossiculoplasty with an autogenous bone 'drum to footplate' columella. The pre-operative 55.0 dB air-bone gap decreased immediately to 3.3 dB, widening after three years to 15.0 dB.
authors.affiliation: Department of Otorhinolaryngology and Head & Neck Surgery, University of Pécs, Pécs, Hungary. bauer@ent.pote.hu
authors.forename: M
authors.initials: M
authors.lastname: Bauer
authors.forename: I
authors.initials: I
authors.lastname: Vóna
authors.forename: I
authors.initials: I
authors.lastname: Gerlinger
mesh_terms: D002648:Child; D018424:Cholesteatoma, Middle Ear / Q000150:complications / Q000601:surgery*; D004429:Ear Ossicles / Q000601:surgery; D005899:Glass Ionomer Cements; D034381:Hearing Loss / Q000209:etiology / Q000601:surgery; D006801:Humans; D008297:Male; D012086:Reoperation; D013710:Tendons / Q000601:surgery*; D013719:Tensor Tympani / Q000601:surgery*; D016896:Treatment Outcome; D014433:Tympanoplasty / Q000379:methods*
chemical_list: D005899:Glass Ionomer Cements