cholesteatoma : surgical strategy · cholesteatoma and surgical strategy canal wall up technique...

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5 VIDEOS 062 01’49’’ 063 02’00’’ 064 02’05’’ 065 02’05’’ 066 02’08’’

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Page 1: Cholesteatoma : surgical strategy · CHOLESTEATOMA AND SURGICAL STRATEGY Canal wall up technique with anterior epitympanotomy Anterior and posterior epitympanic cholesteatoma Removal

5 VIDEOS

06201’49’’

06302’00’’

06402’05’’

06502’05’’

06602’08’’

Page 2: Cholesteatoma : surgical strategy · CHOLESTEATOMA AND SURGICAL STRATEGY Canal wall up technique with anterior epitympanotomy Anterior and posterior epitympanic cholesteatoma Removal

CHOLESTEATOMA SURGERY VIDEO SESSION

B. FRAYSSE, J. FAYAD

DUBAIMarch 2019, 28-29-30

IFOS WORLD MASTER COURSE ON HEARING REHABILITATION

Page 3: Cholesteatoma : surgical strategy · CHOLESTEATOMA AND SURGICAL STRATEGY Canal wall up technique with anterior epitympanotomy Anterior and posterior epitympanic cholesteatoma Removal

CHOLESTEATOMA AND SURGICAL STRATEGY

Canal wall up technique with anterior epitympanotomy

Anterior and posterior epitympanic cholesteatoma

● Removal of the incus, head of the malleus,attic bony plate, tensor fold

- To improve accessibility

- To create a new aeration pathway

from the supratubal recess to the antrum

Page 4: Cholesteatoma : surgical strategy · CHOLESTEATOMA AND SURGICAL STRATEGY Canal wall up technique with anterior epitympanotomy Anterior and posterior epitympanic cholesteatoma Removal

064 – TF épitympanotomie antérieure - 2’05’’

Page 5: Cholesteatoma : surgical strategy · CHOLESTEATOMA AND SURGICAL STRATEGY Canal wall up technique with anterior epitympanotomy Anterior and posterior epitympanic cholesteatoma Removal

CHOLESTEATOMA AND SURGICAL STRATEGY

Canal wall up technique with posterior tympanotomy

Mesotympanic cholesteatoma

● Identification of the vertical (mastoid) segment of the

facial nerve

● Opening of the facial recess and large posterior

tympanotomy (extended facial recess)

Page 6: Cholesteatoma : surgical strategy · CHOLESTEATOMA AND SURGICAL STRATEGY Canal wall up technique with anterior epitympanotomy Anterior and posterior epitympanic cholesteatoma Removal

065 – TF tympanotomie postérieure - 2’05’’

Page 7: Cholesteatoma : surgical strategy · CHOLESTEATOMA AND SURGICAL STRATEGY Canal wall up technique with anterior epitympanotomy Anterior and posterior epitympanic cholesteatoma Removal

CHOLESTEATOMA AND SURGICAL STRATEGY

Sclerotic mastoid

Holotympanic cholesteatoma

Large mastoid

Open technique

Combined approach

Anterior and posterior tympanotomy

Page 8: Cholesteatoma : surgical strategy · CHOLESTEATOMA AND SURGICAL STRATEGY Canal wall up technique with anterior epitympanotomy Anterior and posterior epitympanic cholesteatoma Removal

● Lateral incision

● Cartilage removal

● Skin dissection

Page 9: Cholesteatoma : surgical strategy · CHOLESTEATOMA AND SURGICAL STRATEGY Canal wall up technique with anterior epitympanotomy Anterior and posterior epitympanic cholesteatoma Removal

066 – Technique ouverte - 2’08’’

Page 10: Cholesteatoma : surgical strategy · CHOLESTEATOMA AND SURGICAL STRATEGY Canal wall up technique with anterior epitympanotomy Anterior and posterior epitympanic cholesteatoma Removal

OBLITERATIVE TECHNIQUE

FELDMANN 1978

MERKE 1987

GANTZ 2005

VERCRUYSSE 2008

Muscle

Fascia

Bone chips

Cartilage

Page 11: Cholesteatoma : surgical strategy · CHOLESTEATOMA AND SURGICAL STRATEGY Canal wall up technique with anterior epitympanotomy Anterior and posterior epitympanic cholesteatoma Removal

062 – Cholé oblitération technique - 1’49’’

Page 12: Cholesteatoma : surgical strategy · CHOLESTEATOMA AND SURGICAL STRATEGY Canal wall up technique with anterior epitympanotomy Anterior and posterior epitympanic cholesteatoma Removal

Thank you for your attention

IFOS WORLD MASTER COURSE ON HEARING REHABILITATION