METHOD FOR SURGICAL SANITATION OF PERIOTIC BONE CHOLESTEATOMA WITH COCHLEA PRESERVATION Russian patent published in 2017 - IPC A61B17/00 

FIELD: medicine.

SUBSTANCE: method includes skeletonization of the fallopian canal, hypothympanum enlargement by removing the bone canopy of the lower wall of the external auditory canal along with the tympanic ring to the jugular vein bulb, and also by removing the bone canopy of the anterior wall of the external auditory canal to the temporomandibular joint, as well as thinning of the cochlear capsule to its membraneous department. After this, the sinuses of hypothympanum, infralabyrinth cellular path, pericarotid and precarotid cells are removed to the internal carotid artery, going deeper to the periotic bone tip. At that, prior to fallopian canal skeletonization, access is made by a BTE approach, with extended anthro-mastoidotomy, removal of the malleus, anvil, all cells of the temporal bone cellular tract. Simultaneously with fallopian canal skeletonization, intra-operative monitoring of the facial nerve is performed using needle electromyography by means of a drill before occurrence of threshold events at a current strength of 0.8 mA to 0.5 mA, sanition of the formed trepanation cavity is performed, and then the external auditory canal is plasticized, tympanoplasty according to type III or IV is performed with ossiculoplasty, depending on the degree of damage to the sound-conducting system of the middle ear, while the trepanation cavity in the postoperative period is open.

EFFECT: method allows to exclude direct damage to the facial nerve, to preserve the auditory function of patients during sanitation of the infralabyrinth apical cholesteatoma of the periotic bone and simultaneously reduce the risk of relapse.

1 ex, 5 dwg