Posterior canal wall reposition for management of cholesteatoma: Technique and results

Mobashir, Mohammad; Basha, Waleed M.; Mohamed, Abd ElRaof Said; Elmaghawry, Mohammed Elsayed

doi:10.1016/j.anl.2017.05.020

Cited by 4 publications

(4 citation statements)

References 25 publications

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“…This technique also allows for better visualization of the tympanic cavity in chronic otitis media and permits exposure of the horizontal portion of the FN during the decompression of the nerve itself. Not only do chronic middle ear diseases and some tumors arising in the middle ear cavity, but many more procedures and pathologies depend on these steps [2,3,27,31]. In fact, it is also the pathway to access the round window through which to insert the electrode in CI surgery [2,26].…”

Section: How To Avoid Mistakes In Step 4: Opening the Mastoid Antrummentioning

confidence: 99%

“…To improve the training of This study suggests that the last two steps are the most important to focus on, as they involve mostly ENT senior residents who will soon be approaching surgery on living patients. These are two essential steps for the treatment of numerous ear pathologies [2][3][4]27,31]. The facial recess is often a pathway for the spread of middle ear pathology from the tympanic cavity to the mastoid.…”

Section: How To Avoid Mistakes In Step 4: Opening the Mastoid Antrummentioning

confidence: 99%

“…Cortical mastoidectomy (CM) and posterior tympanotomy (PT) are the two most fundamental steps to perform ear surgery, being the two procedures required in the vast majority of middle ear operations, including those for inflammatory pathologies, cochlear implantation (CI), and tumors arising in the middle ear cavity. These procedures are essential for providing surgeons with adequate access to the middle ear and its delicate structures, enabling them to effectively manage and treat a wide range of ear conditions [1][2][3][4]. To be successful in this type of intervention, cadaveric dissections of the temporal bone are an essential part of the training of ENT residents who aspire to perform middle ear surgery.…”

Section: Introductionmentioning

confidence: 99%

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Critical Steps and Common Mistakes during Temporal Bone Dissection: A Survey among Residents and a Step-by-Step Guide Analysis

Motta,

Massimilla,

Allosso

et al. 2024

JPM

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Background: Given that the temporal bone is one of the most complex regions of the human body, cadaveric dissection of this anatomical area represents the first necessary step for the learning and training of the young oto-surgeon in order to perform middle ear surgery, which includes the management of inflammatory pathology, hearing rehabilitation, and also cognitive decline prevention surgery. The primary objective of this study was to identify common mistakes and critical passages during the initial steps of temporal bone dissection, specifically cortical mastoidectomy and posterior tympanotomy. Methods: A survey among 100 ENT residents was conducted, gathering insights into the most prevalent errors encountered during their training to uncover the most challenging aspects faced by novice surgeons during these procedures. Results: The most common mistakes included opening the dura of the middle cranial fossa (MCF), injury of the sigmoid sinus (SS), chorda tympani (CT), and facial nerve (FN) injury while performing the posterior tympanotomy. The most important critical steps to prevent mistakes are related to the absence of wide exposure during cortical mastoidectomy and the consequent impossibility of identifying the landmarks of the facial recess before performing posterior tympanotomy. Injury of these structures was more common in younger surgeons and in the ones who performed less than five temporal bone dissection courses. Conclusions: Numerous temporal bone dissections on cadavers are mandatory for ENT residents looking forward to performing middle ear surgery.

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Section: How To Avoid Mistakes In Step 4: Opening the Mastoid Antrummentioning

confidence: 99%

Section: How To Avoid Mistakes In Step 4: Opening the Mastoid Antrummentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Critical Steps and Common Mistakes during Temporal Bone Dissection: A Survey among Residents and a Step-by-Step Guide Analysis

Motta,

Massimilla,

Allosso

et al. 2024

JPM

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“…2,3) 이를 극복하기 위해 근골막 피판, 연골, 피 질 골분 등을 사용하여 외이도 후벽 재건술 및 유양동 폐 쇄술(mastoid obliteration)을 시행하고 있으나, 시간이 지날 수록 물질이 자연 흡수되어 외이도가 넓어지는 부 작용이 있다. [4][5][6]…”

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Canal Wall Down Mastoidectomy with Preservation of Remnant Posterior Canal Wall for Mastoid Obliteration and Canal Wall Reconstruction: 4 Cases

Kim¹,

Lee²,

Kang³

2020

J Clin Otolaryngol Head Neck Surg

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The aim of cholesteatoma surgery is to completely eradicate cholesteatoma and to reconstruct the normal anatomy of the middle ear. Canal wall down mastoidectomy (CWD) is often applied for the complete eradication of cholesteatoma and prevention of recurrence in patients with cholesteatoma. However, CWD involves a significant destruction of the middle ear and the mastoid anatomy, that leads to potential complications including chronically draining cavity, retention of debris that requires frequent cleaning, and difficulty in fitting a hearing aid. To resolve these problems, surgeons have attempted to reconstruct posterior external auditory canal wall with a variety of techniques and materials. We recently experienced four cases of patients who had tympanomastoid surgery because of cholesteatoma. In the operation, superior segment of posterior canal wall was removed but remnant inferior segment of posterior canal wall was preserved. CWD with preservation of the remnant canal wall was performed unlike the conventional CWD operation. Surgical view was sufficient to eradicate the entire cholesteatoma. Canal wall reconstruction was done with remnant canal wall and conchal cartilage, and then mastoid obliteration was done with Tissue glue mixed demineralized bone matrix. This procedure was enough to eradicate cholesteatoma without lowering facial ridge. Saucerization, mastoid tip amputation and meatoplasty were not even needed. We report these four cases with a review of literature.

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Use of the Auto Osteomatrix Forte Graft in Total Tympanomastoid Dissection

et al. 2019

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Posterior canal wall reposition for management of cholesteatoma: Technique and results

Cited by 4 publications

References 25 publications

Critical Steps and Common Mistakes during Temporal Bone Dissection: A Survey among Residents and a Step-by-Step Guide Analysis

Critical Steps and Common Mistakes during Temporal Bone Dissection: A Survey among Residents and a Step-by-Step Guide Analysis

Canal Wall Down Mastoidectomy with Preservation of Remnant Posterior Canal Wall for Mastoid Obliteration and Canal Wall Reconstruction: 4 Cases

Use of the Auto Osteomatrix Forte Graft in Total Tympanomastoid Dissection

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