Canal – Wall – Down Retympanoplasty With SC (Short Columella) Ossiculoplasty
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After cutting the soft tissue behind the ear and preparation the skin from the posterior wall of external auditory canal, the cavity past previous surgery was exposed. Taking into consideration a progress and recurrence of the inflammatory process and the level of the bone destruction, was made the decision to perform canal-wall-down tympanoplasty. The bone of the posterior and superior wall of the EAC were reduced and fibrous tissues occuping the cavity from the previous surgery were removed by gently preparation from the stapedius muscle and denuded facial nerve sheath. After revealing the canal of the facial nerve in its mastoid part, the nerve was decompressed.. During the revision of the tympanic cavity, the previously made short columella and remnants of the ossicular chain was removed. Tympanic cavity was cleared from the granulation tissue, which was sent for the histopatological examination. The Euctachian tube orifice was made permeable. Next, stapedius muscle, stapes and round window were separated from the granulation tissue. The mobility of the stapes was confirmed. The flap from the temporal fascia was taken for myringoplasty. Short columella was created and arranged on the head of the stapes and the tympanic cavity was covered especially fitted piece of the fascia. Denuded part of the facial nerve will be protected by the another piece of the fascia. Next, the partial obliteration of the mastoid cavity was performed with the flaps of the soft tissue. The aim of the plasty of external auditory canal is to extend its orifice and enable the clearing the postoperative cavity from the wax and epidermis.
Procedure was performed by Kazimierz Niemczyk, MD, PhD
International Federation of Oto-Rhino-Laryngological Societies
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