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"descripcion" => array:1 [ "en" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">2 years post-operative view after the MMF repair.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Kartik Parelkar, Devika Shere, Keya Shah" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Kartik" "apellidos" => "Parelkar" ] 1 => array:2 [ "nombre" => "Devika" "apellidos" => "Shere" ] 2 => array:2 [ "nombre" => "Keya" "apellidos" => "Shah" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S0001651919301025" "doi" => "10.1016/j.otorri.2019.03.003" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001651919301025?idApp=UINPBA00004N" ] ] "EPUB" => 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"tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "78" "paginaFinal" => "82" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Incidencia de la hiperostosis esquelética difusa idiopática sobre un modelo clínico de disfagia" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 908 "Ancho" => 1250 "Tamanyo" => 115913 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Lateral cervical y dorsal X-rays of one of the 2 patients with DISH who required decompression surgery. In both continuous ossifications were observed in the anterior side of C3–C6 and communicative bony bridges through the dorsal spine with no disk degeneration.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Francisco Javier García Callejo, Natsuki Oishi, Isabel López Sánchez, Beatriz Pallarés Martí, Andrea Rubio Fernández, María José Gómez Gómez" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Francisco Javier" "apellidos" => "García Callejo" ] 1 => array:2 [ "nombre" => "Natsuki" "apellidos" => "Oishi" ] 2 => array:2 [ "nombre" => "Isabel" "apellidos" => "López Sánchez" ] 3 => array:2 [ "nombre" => "Beatriz" "apellidos" => "Pallarés Martí" ] 4 => array:2 [ "nombre" => "Andrea" "apellidos" => "Rubio Fernández" ] 5 => array:2 [ "nombre" => "María José" "apellidos" => "Gómez Gómez" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0001651919300470" "doi" => "10.1016/j.otorri.2019.02.003" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001651919300470?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173573520300284?idApp=UINPBA00004N" "url" => "/21735735/0000007100000002/v1_202004040728/S2173573520300284/v1_202004040728/en/main.assets" ] "en" => array:19 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "Endoscopic type 3 tympanoplasty: Functional outcomes in chronic otitis media" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "83" "paginaFinal" => "87" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Ricardo Bartel, Francesc Cruellas, Miriam Hamdan, Felipe Benjumea, Gabriel Huguet, Xavier Gonzalez-Compta, Enric Cisa, Manel Manos" "autores" => array:8 [ 0 => array:4 [ "nombre" => "Ricardo" "apellidos" => "Bartel" "email" => array:1 [ 0 => "ricardobartel@hotmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "Francesc" "apellidos" => "Cruellas" ] 2 => array:2 [ "nombre" => "Miriam" "apellidos" => "Hamdan" ] 3 => array:2 [ "nombre" => "Felipe" "apellidos" => "Benjumea" ] 4 => array:2 [ "nombre" => "Gabriel" "apellidos" => "Huguet" ] 5 => array:2 [ "nombre" => "Xavier" "apellidos" => "Gonzalez-Compta" ] 6 => array:2 [ "nombre" => "Enric" "apellidos" => "Cisa" ] 7 => array:2 [ "nombre" => "Manel" "apellidos" => "Manos" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Otolaryngology Department, Hospital Universitari de Bellvitge, University of Barcelona, Barcelona, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Timpanoplastia endoscópica tipo 3: resultados funcionales en la otitis media crónica" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1130 "Ancho" => 1505 "Tamanyo" => 157236 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Surgical protocol. (A) Tympanic cavity after ossicular chain and granuloma removal in a chronic otitis media without cholesteatoma of a right ear. (B) Placement of PORP in stapes suprastructure for OCR. (C) Integration of cartilage for tympanic membrane reconstruction. (D) Tympanomeatal flap repositioning.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">The rehabilitation of conductive hearing loss is one of the major challenges for otologic surgeons. Since the 1950s when the surgery of ossicular reconstruction was introduced, it has made more sense to address the hearing problem. The success of the ossicular reconstruction mainly depends on the characteristics of the prosthesis; the ideal prosthesis should be biocompatible, stable, easy to fit, and capable of optimal sound transmission. Although a variety of materials have been used for reconstruction of the ossicular chain, such as autograft, gold prosthesis, ceramic prosthesis, hydroxyapatite, and polyethylene, none of them has proved to have overwhelming superiority over the others.<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">A defect of the long process of the incus is one of the most frequent causes of ossicular discontinuity. There are several etiological factors for incudostapedial joint discontinuity, including chronic middle ear disease with or without cholesteatoma, adhesive otitis media, retraction pockets, tympanosclerosis, and temporal bone trauma. Separation of the incudostapedial joint may lead to conductive hearing loss. Various techniques have been described with which to reconstruct incudostapedial joint continuity, including transposition of a biological autograft or homograft, use of partial ossicular replacement prostheses (PORP) and bone cements.<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">2</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Also a recent meta-analysis showed that titanium prosthesis did not show any significant superiority to the non-titanium prostheses in terms of effectiveness and stability, despite the opposite results reported by many investigators.<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">1</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">As commented previously, the most frequently seen ossicular problem is a defective or missing incus with an intact and mobile stapes and the malleus handle (60% of all ossicular defects). In cases with intact stapes but defective incus and/or malleus, type 3 tympanoplasties are the procedure of choice according to the Wullstein classification in 1956.<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">3</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">A recent systematic review made by our group compared the performance between incus transposition technique and PORP for ossicular chain reconstruction (OCR), concluding that there was not difference in decibels (dB) gained after surgery between the two materials, but there was a difference in air-bone gap (ABG) closure rate to less than 20<span class="elsevierStyleHsp" style=""></span>dB favoring PORP.<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">4</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">In the recent years, a growing number of surgeons support for the use of endoscopes in middle ear surgery, with an increasing number of reports showing a benefit in type 1 and even cholesteatoma surgery.<a class="elsevierStyleCrossRefs" href="#bib0125"><span class="elsevierStyleSup">5–7</span></a> By providing a wide angle of view and illumination near to the tympanic membrane (TM), endoscopes overcome the limitation of the operating microscope, in which the direct line of sight is blocked by ear canal morphology. Although endoscopes were first recommended for tympanoplasty in the 1990s,<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">8</span></a> even reasonably recent reports have revealed misgivings about a totally endoscopic technique for tympanoplasty.<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">9</span></a> With the expanding availability of instruction courses dedicated to endoscopic ear surgery, surgical experiences have been shared internationally allowing endoscopic techniques to be developed to the point where totally endoscopic tympanoplasty has now become a very feasible option, reported even in children's ears.<a class="elsevierStyleCrossRefs" href="#bib0125"><span class="elsevierStyleSup">5,10–13</span></a> Although there is limited evidence, at present, on the influence of endoscopic ear surgery on hearing outcomes in patients undergoing ossicular chain reconstruction.<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">14</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">Combining concepts from the reviews from Zhang et al.<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">1</span></a> and Bartel et al.<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">4</span></a> the aim of this study is to measure functional results after endoscopic type III tympanoplasty, as one stage procedure for tympanoplasty and OCR in adult patients diagnosed with chronic otitis media (COM) with or without cholesteatoma.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Materials and methods</span><p id="par0040" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Study design</span>: A prospective study was designed including patients with the following criteria: adult patients; diagnosis of COM with or without cholesteatoma who required surgical treatment.</p><p id="par0045" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Patient criteria</span>: Surgical indication included ears with chronic otitis media with or without cholesteatoma with a preoperative ABG greater than 20<span class="elsevierStyleHsp" style=""></span>dB. Only ears with an intact stapes suprastructure and a mobile footplate were included. Patients with previous surgeries were included only with canal wall up (CWU) procedures. Previous canal wall down (CWD) procedures were excluded from the study. The AAO-HNS pure tone audiometry (PTA) criteria for hipoacusia assessment was used. Mean audiometric results at 500<span class="elsevierStyleHsp" style=""></span>Hz, 1000<span class="elsevierStyleHsp" style=""></span>Hz, 2000<span class="elsevierStyleHsp" style=""></span>Hz and 4000<span class="elsevierStyleHsp" style=""></span>Hz at air and bone conduction thresholds were obtained preoperatively and 6 months after surgery.</p><p id="par0050" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Surgical technique</span>: Standardized surgical technique was performed in all cases by a single senior surgeon. Endoscopic type III tympanoplasty was performed, atticotomy, complete incus and head of the malleus removal, manubrium of the malleus was spared if it was possible. In ears affected with COM with cholesteatoma, disease removal was attempted transcanal in all cases. In cases were mastoid extension of the disease was present, CWU mastoidectomy procedure was done (combined approach). No CWD procedures were included in the study. OCR was performed with a polyethylene PORP. Tympanic membrane reconstruction was performed using a full thickness cartilage with perichondrium in both sides harvested from tragus or auricular conchae. In cases of insufficient coverage, overlay fascia temporalis was added (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Results</span><p id="par0055" class="elsevierStylePara elsevierViewall">Distribution and surgical approach: A total of 24 ears met inclusion criteria. The mean patient age was 55 years (range, 25–79 yr). The mean length of follow-up was 13.2 months (range, 6–23.8 mo). Nine were diagnosed with COM with cholesteatoma and 15 with COM without cholesteatoma. All 15 cases of COM without cholesteatoma were treated fully with transcanal endoscopic ear surgery (TEES), while in cases of COM with cholesteatoma, 3 were treated fully with TEES and 6 required EES and CWU mastoidectomy (combined approach).</p><p id="par0060" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Morphofunctional results</span> (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>): Dry ears with no residual perforations were obtained in 22 cases (91.7%); in 14 cases of COM without cholesteatoma (93%); and in 8 out of 9 cases of COM with cholesteatoma (88.9%). Self-cleaning ears were obtained in every patient.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Hearing outcomes</span> (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>): <span class="elsevierStyleItalic">Preoperative</span>: mean air conduction PTA was 60.6<span class="elsevierStyleHsp" style=""></span>dB (SD 14.7); mean bone conduction PTA was 30.2<span class="elsevierStyleHsp" style=""></span>dB (SD 14.3); mean ABG was 30.4<span class="elsevierStyleHsp" style=""></span>dB (SD 9.6). <span class="elsevierStyleItalic">Postoperative</span>: mean air conduction PTA was 46.4<span class="elsevierStyleHsp" style=""></span>dB (SD 16.9); mean bone conduction PTA was 29.7<span class="elsevierStyleHsp" style=""></span>dB (SD 15.9); mean ABG was 16.7<span class="elsevierStyleHsp" style=""></span>dB (SD 9.1). ABG difference of 13.7<span class="elsevierStyleHsp" style=""></span>dB (SD 13.0). ABG closure rate to less than 20<span class="elsevierStyleHsp" style=""></span>dB of 79.2% and ABG closure rate to less than 10<span class="elsevierStyleHsp" style=""></span>dB of 29.2%. Differences were made regarding the presence or absence of cholesteatoma. In the COM without cholesteatoma group a postoperative ABG of 14.4<span class="elsevierStyleHsp" style=""></span>dB (SD 8.5) was obtained with a closure rate to less than 20<span class="elsevierStyleHsp" style=""></span>dB of 93.3% and to less than 10<span class="elsevierStyleHsp" style=""></span>dB of 40%. In the COM with cholesteatoma a postoperative ABG of 20.6<span class="elsevierStyleHsp" style=""></span>dB (SD 9.6) was obtained with a closure rate to less than 20<span class="elsevierStyleHsp" style=""></span>dB of 55.6% and to less than 10<span class="elsevierStyleHsp" style=""></span>dB of 11.1%.</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Discussion</span><p id="par0070" class="elsevierStylePara elsevierViewall">Reconstruction of the ossicular chain, successful physiological and functional results with long-term stability are still a challenge even for experienced otologists.</p><p id="par0075" class="elsevierStylePara elsevierViewall">The aim of ossicular chain reconstruction is to restore the middle ear conduction mechanism, but if cochlear function is poor particularly with regard to word discrimination or in a monaural patient a hearing aid could another valid option. Type 3 tympanoplasties are performed in cases that had incus defects with normal stapes, by interpositioning a prosthesis between the malleus handle/tympanic membrane and stapes suprastructure.<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">3</span></a></p><p id="par0080" class="elsevierStylePara elsevierViewall">Otologic surgeons have used a variety of materials for reconstruction of the ossicular chain; autograft, homograft or allograft materials.<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">15–18</span></a> Most commonly used ossiculoplasty technique and materials in type 3 tympanoplasties are the incus transposition technique and titanium PORPs.</p><p id="par0085" class="elsevierStylePara elsevierViewall">According to a systematic review published by our group as Bartel et al. in 2018, comparing audiometric outcomes in 614 patients with incus transposition technique and 441 patients with PORP technique, results showed that there was no difference in decibels gained between both ossiculoplasty materials, but a better closure rate in air bone gap to less than 20<span class="elsevierStyleHsp" style=""></span>dB was observed in the PORP group.<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">4</span></a></p><p id="par0090" class="elsevierStylePara elsevierViewall">In the meta-analysis made by Zhang et al. in 2011, they indicated that the titanium prostheses did not show any significant superiority to the non-titanium prostheses in terms of effectiveness and stability, despite the opposite results reported by many investigators.<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">1</span></a></p><p id="par0095" class="elsevierStylePara elsevierViewall">According to Yawn et al. in 2017, endoscopic ossiculoplasty yields comparable audiometric results and surgical complications to traditional microscopic OCR. An endoscopic OCR is a reasonable option for properly trained surgeons comfortable with the use of endoscopes in the middle ear as it affords increased visualization of the prosthesis at the time of reconstruction.<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">19</span></a></p><p id="par0100" class="elsevierStylePara elsevierViewall">In 2017 Jalali et al. made a meta-analysis comparing tympanic membrane repair with cartilage grafts vs temporal fascia graft. Concluding that the current available evidence suggests the superiority of cartilage grafting over temporal fascia grafting in type 1 tympanoplasty in both adults and children with COM in terms of graft integration, whereas the hearing outcome in the two groups was comparable.<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">20</span></a></p><p id="par0105" class="elsevierStylePara elsevierViewall">Yawn in 2017 published a study where the microscope was used to reconstruct the ossicular chain in 31 cases, while an exclusive endoscopic approach was used in other 31 patients. Postoperative control for the prosthesis, there were no significant postoperative differences in bone PTA, air PTA, and ABG between primary and staged ossiculoplasties, or surgical approach. Concluding that there were no significant differences in hearing outcomes with respect to staged ossicular chain reconstruction or whether the endoscope or microscope was used for visualization.<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">19</span></a></p><p id="par0110" class="elsevierStylePara elsevierViewall">Functional results in this study seem to be according to the actual literature. It is important to make a difference cases with or without cholesteatoma as they are completely different diseases. The difference in decibel gain between preoperative ABG and postoperative ABG an their closure rate are important between cases with or without cholesteatoma.</p><p id="par0115" class="elsevierStylePara elsevierViewall">Our study population was small. A multi-institutional study, accounting for several different endoscopic surgeons may be able to provide enough cases to draw more meaningful conclusions on the safety, efficacy, and audiometric outcomes of endoscopic OCR in chronic otitis media with or without cholesteatoma.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Conclusion</span><p id="par0120" class="elsevierStylePara elsevierViewall">Endoscopic tympanoplasty and OCR is a valid option for surgeons who are comfortable with the use of endoscopes for middle ear surgery as it allows improved visualization of the prosthesis and grafts placement at the time of middle ear reconstruction. Possibly a second stage OCR in cases of COM with cholesteatoma may improve partial OCR audiometric outcomes. We think that more studies are needed to ensure our surgical behavior in front of different scenarios of COM.</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Conflict of interest</span><p id="par0125" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:11 [ 0 => array:3 [ "identificador" => "xres1323808" "titulo" => "Abstract" "secciones" => array:5 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Background" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Objective" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Materials and methods" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Results" ] 4 => array:2 [ "identificador" => "abst0025" "titulo" => "Conclusion and significance" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1220682" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres1323807" "titulo" => "Resumen" "secciones" => array:5 [ 0 => array:2 [ "identificador" => "abst0030" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0035" "titulo" => "Objetivos" ] 2 => array:2 [ "identificador" => "abst0040" "titulo" => "Materiales y métodos" ] 3 => array:2 [ "identificador" => "abst0045" "titulo" => "Resultados" ] 4 => array:2 [ "identificador" => "abst0050" "titulo" => "Conclusiones" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec1220683" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Materials and methods" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0025" "titulo" => "Conclusion" ] 9 => array:2 [ "identificador" => "sec0030" "titulo" => "Conflict of interest" ] 10 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2018-08-17" "fechaAceptado" => "2019-02-14" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1220682" "palabras" => array:5 [ 0 => "Type 3 tympanoplasty" 1 => "Partial ossicular replacement prostheses" 2 => "Ossicular chain reconstruction" 3 => "Chronic otitis media" 4 => "Endoscopic ear surgery" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec1220683" "palabras" => array:5 [ 0 => "Timpanoplastia tipo 3" 1 => "Partial ossicular replacement prostheses" 2 => "Reconstrucción de la cadena osicular" 3 => "Otitis media crónica" 4 => "Cirugía endoscópica de oreja" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Background</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Type 3 tympanoplasty is the surgery of choice for middle ear reconstruction in cases where an integral stapes suprastructure and mobile footplate are present.</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Objective</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">The objective of this study was to obtain functional results after endoscopic type 3 tympanoplasty in chronic otitis media.</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Materials and methods</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Prospective study including 24 patients who underwent endoscopic type 3 tympanoplasty, using PORP for ossicular chain reconstruction (OCR) and cartilage graft for tympanic membrane reconstruction. Audiograms were made preoperatively, and 6 months after surgery.</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Results</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Dry, closed, self-cleaning ears were obtained in 91.7% of the cases. Mean preoperative air-bone gap (ABG) was 30.4<span class="elsevierStyleHsp" style=""></span>dB, mean postoperative ABG was 16.7<span class="elsevierStyleHsp" style=""></span>dB, dB gain of 13.6<span class="elsevierStyleHsp" style=""></span>dB. ABG closure rate to 20<span class="elsevierStyleHsp" style=""></span>dB or less of 79.2%, and to 10<span class="elsevierStyleHsp" style=""></span>dB or less of 29.2%.</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Conclusion and significance</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Endoscopic tympanoplasty and OCR is a valid option for surgeons who are comfortable with the use of endoscopes for middle ear surgery as it allows improved visualization of the prosthesis and graft placement during middle ear reconstruction.</p></span>" "secciones" => array:5 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Background" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Objective" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Materials and methods" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Results" ] 4 => array:2 [ "identificador" => "abst0025" "titulo" => "Conclusion and significance" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "<span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Introducción</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">La timpanoplastia tipo 3 es la cirugía de elección para la reconstrucción del oído medio en casos donde se encuentra íntegra la supraestructura del estapedio, y hay una platina móvil.</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Objetivos</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">El objetivo de este estudio es obtener resultados funcionales tras timpanoplastias tipo 3 con abordaje endoscópico.</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Materiales y métodos</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Estudio prospectivo incluyendo 24 pacientes quienes fueron operados de timpanoplastia tipo 3 endoscópicas, usando una PORP como material de osiculoplastia, y cartílago como injerto de reconstrucción de membrana timpánica. Audiometrías tonales fueron hechas previas a la cirugía y 6 meses posterior a ella.</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Resultados</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Oídos cerrados, secos y autolimpiantes fueron obtenidos en el 91,7% de los casos. El GAP aéreo-óseo preoperatoria medio fue de 30,4<span class="elsevierStyleHsp" style=""></span>dB, la misma diferencia media postoperatoria fue de 16,7<span class="elsevierStyleHsp" style=""></span>dB. La reducción de GAP postoperatoria fue de 13,6<span class="elsevierStyleHsp" style=""></span>dB. La tasa de cierre de GAP a menos de 20<span class="elsevierStyleHsp" style=""></span>dB o menos fue del 79,2% y a menos de 10<span class="elsevierStyleHsp" style=""></span>dB del 29,2%.</p></span> <span id="abst0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Conclusiones</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">La timpanoplastia y reconstrucción osicular con abordaje endoscópico es una técnica válida y segura cuando es usada por cirujanos que están cómodos con el uso de endoscopios en la cirugía de oído medio, como permite mejor visualización de la colocación de prótesis e injertos durante la cirugía.</p></span>" "secciones" => array:5 [ 0 => array:2 [ "identificador" => "abst0030" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0035" "titulo" => "Objetivos" ] 2 => array:2 [ "identificador" => "abst0040" "titulo" => "Materiales y métodos" ] 3 => array:2 [ "identificador" => "abst0045" "titulo" => "Resultados" ] 4 => array:2 [ "identificador" => "abst0050" "titulo" => "Conclusiones" ] ] ] ] "multimedia" => array:3 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1130 "Ancho" => 1505 "Tamanyo" => 157236 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Surgical protocol. (A) Tympanic cavity after ossicular chain and granuloma removal in a chronic otitis media without cholesteatoma of a right ear. (B) Placement of PORP in stapes suprastructure for OCR. (C) Integration of cartilage for tympanic membrane reconstruction. (D) Tympanomeatal flap repositioning.</p>" ] ] 1 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">COM: chronic otitis media. TEES: transcanal endoscopic ear surgery.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Ears \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Dry ears \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">% \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Self-cleaning ears \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">% \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">COM without cholesteatoma \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">15 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">93 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">15 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">100 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">COM with cholesteatoma \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">88.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">100 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>TEES resection \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">100 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">100 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Combined approach \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">83.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">100 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="6" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Total \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">24 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">22 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">91.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">24 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">100 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2268937.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Morphofunctional results.</p>" ] ] 2 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at2" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">ABG: air-bone gap. COM: chronic otitis media. TEES: transcanal endoscopic ear surgery.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Ears \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Preop ABG \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Postop ABG \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">dB gain \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">AGB<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>20 \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">% \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">ABG<span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>10 \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">% \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">COM without cholesteatoma \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">15 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">33.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">18.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">93.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">40.0 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">COM with cholesteatoma \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">26.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">20.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">55.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11.1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">TEES resection \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">25.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">25.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">−0.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">33.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.0 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Combined approach \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">26 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">18 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">66.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16.7 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="9" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Total \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">24 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">30.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">19 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">79.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">29.2 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2268938.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Audiometric outcomes.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:20 [ 0 => array:3 [ "identificador" => "bib0105" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Titanium versus non-titanium prostheses in ossiculoplasty: a meta-analysis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "L.C. 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Journal Information
Original article
Endoscopic type 3 tympanoplasty: Functional outcomes in chronic otitis media
Timpanoplastia endoscópica tipo 3: resultados funcionales en la otitis media crónica
Ricardo Bartel
, Francesc Cruellas, Miriam Hamdan, Felipe Benjumea, Gabriel Huguet, Xavier Gonzalez-Compta, Enric Cisa, Manel Manos
Corresponding author
Otolaryngology Department, Hospital Universitari de Bellvitge, University of Barcelona, Barcelona, Spain