(1) This can only be explained by movements in the incudo-malleal joint, if this is intact.
(2) These include (a) Gelfilm (no-graft) induction of tympanic membrane regrowth; (b) the use of tragal cartilage and perichondrium in columellization and in Type III neomyringostapediopexy; (c) the use of laboratory-prefabricated ossicular homografts to correct malleal-capitulum and malleal-footplate discontinuities more precisely; and (d) the circumferential approach (circumnavigation of patient's head) and anterior position of the surgeon in order to visualize the sinus tympani, retropyramidal, and retrofacial areas, obviating extensive posterior tympanotomy bone dissections.
(3) The required antagonism of the pull of the muscle is accomplished by the change of the direction of movement in the gliding incudo-malleal joint.
(4) In the regular middle-ear, the direction of this movement is changed within the ossicular chain into a predominantly upward-downward direction of the lenticular process, due to a gliding function of the incudo-malleal (IM) joint.
(5) In the normal middle ear, the gliding incudo-malleal joint, serving as a protective mechanism, confined these movements to a mean of 232 microns.
(6) Removal can be accomplished without sectioning the chorda tympani and the anterior malleal ligament.
(7) In the older literature, however, the histological structure of the incudo-malleal joint has been controversial.
(8) Therefore, the unique benefit of the tympano-malleal homograft (TMH) is that it is an effective way of replacing the malleus, the "building block" for reconstruction of the ossicular chain.
(9) A simple technique may intraoperatively reveal the gliding or ankylosed condition of incudo-malleal joint surfaces, prior to adapting the length of the prosthesis.
(10) These in- and excursions could exceed 0.5 mm, however, with an ankylosed incudo-malleal joint.
(11) In view of the normal tympano-malleal fixation, the normal static pressure accomodation in the incudo-malleal joint and the normal topological situation, monobloc implant obviates the disadvantages inherent in the columellar technique.
(12) In the normal ossicle chain, the air pressure-induced inward-outward excursions of the malleus are transformed by the gliding incudo-malleal joint, resulting predominantly in an upward and downward movement of the lenticular process.
Malleus
Definition:
(n.) The outermost of the three small auditory bones, ossicles; the hammer. It is attached to the tympanic membrane by a long process, the handle or manubrium. See Illust. of Far.
(n.) One of the hard lateral pieces of the mastax of Rotifera. See Mastax.
(n.) A genus of bivalve shells; the hammer shell.
Example Sentences:
(1) Unfortunately, both the malleus and the stapes have to be in good position to use this type of reconstruction making it much less common than other forms of ossiculoplasty.
(2) These complications are of much higher frequency than after tympanoplasty with autograft, and indications for tympano-ossicular homografts are now limited to total tympanic destruction with absence of handle of malleus.
(3) In our series of 31 patients, it was found that severe conductive hearing loss, abundant pale granulations, and denuded malleus handle are constant findings and, in our opinion, are significant clinical features of the pathology.
(4) The observed pattern of development in nonirradiated specimens was the following: hypertrophy of the rostral process and endochondral-type ossification, fibrous atrophy in the midsection, and mineralization of the malleus and incus.
(5) The position, displacement and phase angle of the rotation axis of the ossicles was calculated based on the displacement and phase angle of the umbo, malleus head and lenticular process.
(6) The reshaped incus is repositioned between the malleus handle and oval window when the stapes is fixed and there also exists a lateral ossicular chain defect.
(7) The malleus exhibits a handle separated from its head and keeping a persistant relationship with the tubotympanic recess.
(8) The position of the normal-shaped mobile stapes was just medial, and not posteromedial, to the malleus.
(9) This paper presents the authors' experiences with one method of reconstruction of the tympanic membrane when it is totally absent or when there is a fixed, retracted, defective, or absent malleus.
(10) pseudomallei only, and with it, it is possible to resolve the immunological problem of distinguishing diagnosis between Malleus and Melioidosis.
(11) At high levels, the attachment is less intimate, most of the fibers appearing to pass lateral to the malleus handle.
(12) Temporal fascia placed medially to the tympanic remnants with the malleus handle exteriorized has been used successfully in over 1,200 tympanoplasties with adequate conization of the drumhead produced in most cases.
(13) All points on the tympanic membrane vibrate in phase with the malleus up to a frequency of 1 kHz.
(14) A review of 62 cases of blockage of head of malleus showed that apart from secondary lesions (post-traumatic, postoperative, postinfectious), primary blockades were a definite entity.
(15) Measurements of tympanic membrane surface area; depth of the tympanic membrane cone; the lengths of the malleus and incus long processes; and stapes footplate, annular space, and oval window areas were obtained using video micrographs and computer digitization techniques.
(16) These procedures, short and long "L-shaped" assemblies, used for patients without a malleus, resulted in a mean 27 dB bone-air gap postoperatively.
(17) Thus, disarticulation of ossicles can be localized precisely, and fixation of the head of the malleus can be differentiated from stapes fixation.
(18) However, conventional atticotomy was not able to achieve improvement in the mobility of the ossicles because the mobility is usually severely restricted at the malleus.
(19) We report on a 5-year experience with 44 patients (1980-1985) with incus interposition using a modelled or sculptured incus, either autograft or homograft, to correct ossicular discontinuity when a functional malleus and stapes are present.
(20) Meckel's cartilage appeared as a single, continuous fibrous structure lying between the mandibular lingula and the malleus of the middle ear in fetuses of 210 mm crown-rump length (22 weeks of age) and over.