The posterosuperior quadrant of the tympanic membrane

Paço, João; Branco, C.M.; Estibeiro, Hugo; Carmo, Diogo Oliveira

doi:10.1016/j.otohns.2009.01.009

Cited by 19 publications

(24 citation statements)

References 2 publications

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“…The retracted segment of eardrum is often known as a retraction pocket. The pathology occurs in 40% of cases in the pars flaccida (the flaccid portion of the tympanic membrane, located in the upper portion of the eardrum, which shows more fragility, due to the lack of the fibrous middle layer, present in the pars tensa) and in 36% of cases in the posterior/superior quadrant of the pars tensa (Paço et al, 2009). Otalgia is occasionally a feature and is due to changes in middle ear pressure or infection.…”

Section: Introductionmentioning

confidence: 99%

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Effects of the fibers distribution in the human eardrum: A biomechanical study

Gentil

Parente

Martins

et al. 2016

Journal of Biomechanics

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a b s t r a c tThe eardrum separates the external ear from the middle ear and it is responsible to convert the acoustical energy into mechanical energy. It is divided by pars tensa and pars flaccida. The aim of this work is to analyze the susceptibility of the four quadrants of the pars tensa under negative pressure, to different lamina propria fibers distribution. The development of associated ear pathology, in particular the formation of retraction pockets, is also evaluated. To analyze these effects, a computational biomechanical model of the tympano-ossicular chain was constructed using computerized tomography images and based on the finite element method. Three fibers distributions in the eardrum middle layer were compared: case 1 (eardrum with a circular band of fibers surrounding all quadrants equally), case 2 (eardrum with a circular band of fibers that decreases in thickness in posterior quadrants), case 3 (eardrum without circular fibers in the posterior/superior quadrant).A static analysis was performed by applying approximately 3000 Pa in the eardrum. The pars tensa of the eardrum was divided in four quadrants and the displacement of a central point of each quadrant analyzed. The largest displacements of the eardrum were obtained for the eardrum without circular fibers in the posterior/superior quadrant.

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Section: Introductionmentioning

confidence: 99%

“…Surgery should be performed to prevent cholesteatoma formation. In studies of the temporal bone, Paço et al (2009) found some anatomical aspects that may be related to a greater susceptibility of this quadrant to pressure changes. One of the factors mentioned was a different constitution of the lamina propria in different quadrants.…”

Section: Introductionmentioning

confidence: 99%

Effects of the fibers distribution in the human eardrum: A biomechanical study

Gentil

Parente

Martins

et al. 2016

Journal of Biomechanics

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“…The postero-superior is the largest of the quadrants, which justifies its greater deflection due to the lower intratympanic pressure. In this region, the fibre distribution of the lamina propria is less able to withstand pressure differences, the tympanic sulcus decreases in depth until it practically no longer exists and the annulus is also reduced in calibre, which explains a less resistant insertion of the TM [13]. Unfortunately, due to the close proximity to the long process of the incus, which is the most vulnerable part of the ossicular chain, postero-superior RPs may result in bone erosion [14].…”

Section: Discussionmentioning

confidence: 99%

Transmeatal excision of pars tensa retraction pockets with simultaneous ventilation tube insertion in children: a prospective study

Ráth

Gerlinger

Csákányi

et al. 2011

Eur Arch Otorhinolaryngol

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Grade II and III (according to Sadé's classification) retraction pockets (RPs) in 40 ears of 30 children were excised transmeatally with simultaneous ventilation tube insertion. At a mean follow-up of 16.1 months, an intact tympanic membrane and mild, grade I retractions not requiring treatment were observed in 32 ears (80%). The mean air-bone gap had decreased from 22.4 to 9.7 dB. Two residual perforations and six recurrent grade II RPs were detected, all these eight ears undergoing further surgery. The second surgery solved both of the residual perforations and four of the six grade II recurrences. The age of the children did not influence the success rate, whereas bilateral pathology, a higher grade and more extensive RPs were associated with a higher rate of unsuccessful cases. A staging system is introduced to ease the selection of candidates with a good prognosis for this procedure.

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“…In the eardrum, the acoustical energy is transformed into mechanical energy that is transmitted along on its travel into the inner ear. The eardrum is an ovoid, three-layered structure consisting laterally of squamous epithelium, medially, respiratory mucosa and an interwoven fibrous layer (Paço 2009). Normally, it has a conical shape, with the apex maintained medially by the support of the malleus.…”

Section: Anatomophysiology Of the Earmentioning

confidence: 99%