Functional Restoration in Tympanoplasty

The disease recurrence rate after the canal wall up or canal wall down technique in adults

“…In two studies, the operation technique was described in a protocol. In the study of Brown, the elected surgical technique for cholesteatoma removal was the intact canal wall tympanoplasty and mastoidectomy, as advocated by House and Sheehy . Only one of our included studies (Ajalloueyan) applied an obliteration technique, published previously by Quaranta et al In the remaining four studies, the operation protocols were not clearly defined.…”

A practical alternative to combined approach tympanoplasty

“…There can be no argument that the Vllth nerve is at risk if its anatomy is not properly understood. Again, if the steps of the operation are not followed exactly_as described (Jansen, 1963;Sheehy, 1965;Smyth et ah, 1967) visualization of the junctional area between the mesotympanum and the attic and additus cannot be adequate "55 for the removal of ingrowing squamous epithelium. We maintain that if this visualization is achieved-and it can be routinely-the risks of leaving a viable squamous remnant behind will be no greater than in the socalled 'myringoplasty' operations which appear to be accepted without question in most major centres.…”

Surgery for Otitis Media With Cholesteatoma: Canal Uo Versus Canal Down Procedures

“…The preservation or improvement of hearing is considered secondary 8 . Removal of only cholesteatoma without creating a radical cavity leaving behind the posterior wall intact is the choice as reported by House and Sheehy 9 . However, Shambugh 10 states that this procedure is suitable only for small sac cholesteatoma, not for an extensive cholesteatoma.…”