Srpski arhiv za celokupno lekarstvo 2015 Volume 143, Issue 7-8, Pages: 480-486
https://doi.org/10.2298/SARH1508480D
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Techniques of the tympanomastoidectomy with reconstruction of the posterior bone wall of the external auditory canal
Dankuc Dragan (Faculty of Medicine, Novi Sad + ENT Clinic, Clinical Centre of Vojvodina, Novi Sad)
Vlaški Ljiljana (Faculty of Medicine, Novi Sad + ENT Clinic, Clinical Centre of Vojvodina, Novi Sad)
Pejaković Nemanja (Faculty of Medicine, Novi Sad + ENT Clinic, Clinical Centre of Vojvodina, Novi Sad)
A combined tympanoplasty method, the mobile-bridge tympanoplasty, has been
applied at the Clinic for Ear, Nose and Throat Diseases in Novi Sad since
1998. Mobile-bridge tympanoplasty is performed at our Clinic by applying
Feldmann’s procedure utilizing a microsurgical oscillating saw. It is a
combination of closed and open techniques for surgical treatment of middle
ear diseases. In addition to this technique, a method for reconstruction of
the posterior bone wall of the external auditory canal was introduced. This
procedure is applied in cases of damage or impairment of the bony ear canal
wall using mastoid cortical temporal bone graft or modeled cartilage of the
concha. Maintenance of general anatomical relations in the middle ear enables
good ventilation of pneumatic spaces of the middle ear and Eustachian tube
permeability, thus providing good conditions for ossicular chain
reconstruction. The incidence of recurrent cholesteatoma in combined
mobile-bridge tympanoplasty and tympanoplasty with reconstruction of the
posterior bone wall was 6% in total. The incidence values for the recurrent
cholesteatoma in closed tympanoplasty and in cases of open techniques were
10%. Mobile-bridge tympanoplasty and reconstruction of the posterior bone
wall of external auditory canal are methods of choice in surgical treatment
of middle ear cholesteatoma that progressed to the attic space, sinus tympani
and facial recess.
Keywords: cholesteatoma, middle ear, tympanoplasty, ear canal, reconstructive surgical procedures